OASIS Alert

Patient satisfaction comparisons may be next.

Your agency may be part of the problem. An all out effort fails to budge hospitalization and emergent care national averages.

As of Dec. 12, the updated Home Health Compare Web site, which publicly reports quality outcomes, includes 12 measures. The new prospective payment system refinements added two new wound-related outcomes to the report (see p. 4).

Check your results: "Improvement in status of surgical wounds" in its consumer-friendly wording of "Percentage of patients whose wound improved or healed after an operation" debuts with a national average of 79 percent. And "Emergent care for wound infections, deteriorating wound status," with its cumbersome wording of "Percentage of patients who need unplanned medical care related to a wound that is new, is worse or has become infected" starts off with a national average of 1 percent.

Some progress: The Dec. 12 update to HH Compare shows three of the measures improved by two percentage points, three improved by one percentage point and four remained the same. Despite two years of concentrated focus by quality improvement organizations and agencies, the outcome measures for emergent care and unplanned hospitalizations remain unchanged, four years after HH Compare began.

And in preparation for a future measure to allow comparison of agencies based on patient satisfaction, look for field testing of a preliminary instrument designed to obtain consumer assessment of home health agency care.

The Department of Health and Human Services' Agency for Healthcare Research and Quality has requested Office of Management and Budget approval for a home health patient satisfaction survey tool, according to a notice in the Dec. 6 Federal Register.

Background: The Centers for Medicare & Medicaid Services already collects such information for clinicians, group practices, nursing homes and hospitals under the Consumer Assessment of Health Plans Survey (CAHPS) program, the notice says. Now it wants to add home health agencies to that list.

"A critical component missing from the current measurement set for home health agencies is information from the consumer perspective on the quality of care provided," HHS says in the notice.

Watch for: AHRQ plans to pilot the tool in 36 volunteer agencies nationwide, varying by size, financial ownership and organizational type. AHRQ wants to send out about 5,000 surveys and expects to receive about 2,000 responses. Selected patients will receive the questionnaire and cover letter in the mail and receive an additional follow-up request for participation by mail and by phone.

Note: The notice is at http://www.access.gpo.gov/su_docs/fedreg/a071206c.html, under AHRQ.