OASIS Alert

In an environment increasingly devoid of nurses, managers at home health agencies are caught in a tough spot when it comes to cajoling clinicians into completing OASIS paperwork within a reasonable time frame.

Agencies certainly don't want to lose nurses in the face of such a shortage, but at the same time they must hold nurses to paperwork deadlines. "You can't just go alienating and running off nurses without really considering what you're losing," notes consultant Pam Warmack with Clinic Connections in Ruston, LA.

That means to convince nurses to work with in your agency's established OASIS time frame, you have to rule with a kind hand not an iron fist.

If you find that many clinicians are consistently unable to meet your established OASIS paperwork deadline, there's a chance that the problem lies with the deadline and not the clinicians. Take a close look at your expectations and make sure they're realistic, Warmack counsels. Forty-eight hours generally is a reasonable amount of time to allow between completing a visit and turning in OASIS paperwork.

In some cases, the timeframe might be perfectly acceptable, but certain clinicians often miss the mark. When that happens, management should sit down with the clinicians in question and ask why they're having problems working within your timeframe, Warmack says. "Sometimes we're scared to ask people what the problem is, but we need to know the problem before we can come up with solutions."

Another key to ensuring timely OASIS paperwork is to alert new hires about your agency's expectations from the beginning. Be up-front with clinicians when you hire them, and then "hold them accountable from the outset," Warmack suggests.

Include your OASIS paperwork timeframe in employment agreements new hires must sign, Warmack offers. That way there's a signed document in a nurse's personnel file that says by accepting a position at your agency, she agrees to abide by your OASIS expectations.

Agencies also can coax clinicians into timely OASIS submission by offering incentives for turning paperwork in early, offers consultant Rose Kimball with Med-Care Administrative Services in Dallas.

On the other side of the coin, you could dock part of the per-visit pay for clinicians who turn their work in late, Kimball notes. However, you must establish this policy from day one and document it in an employment agreement, she warns. And be prepared for opposition, she cautions.

When it comes to disciplining employees who don't meet deadlines or rewarding clinicians who beat them be consistent, Warmack urges. Playing favorites will only cause more problems.

When push comes to shove, management needs to carefully assess what they're asking of staff, identify the hindrances that might be keeping clinicians from meeting their expectations and put "realistic solutions in place to overcome those hindrances," Warmack says. Then, consistently hold all clinicians accountable for working within the agency's established timeframe.