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OASIS Alert

Quality Improvement:

Take Action To Prepare For Public Scrutiny

Published on Tue Sep 30, 2003

You may be about to experience your 15 minutes of fame. Will you be ready?

Whether your outcomes are terrific or not, you'll want to be braced for the inevitable questions that will follow the Home Health Compare launch.

When the home health quality initiative launched in eight pilot states back in May, many local papers covered the event and highlighted agencies with both high and low outcomes. Questions may come your way from patients, reporters and referral sources when your own stats hit the Web in the near future, experts say.

To prepare for the perusal your 11 patient outcomes will receive, experts suggest the following actions:

  • Review your data. The Centers for Medicare & Medicaid Services will send a preview of your HHQI data to your QIES mailbox between Oct. 1 and Oct. 21, it says. But you can figure out your own HHQI data now by taking the 11 outcomes in your outcome-based quality improvement (OBQI) report and putting them through the conversion calculator available under the "Phase I Data" heading at www.cms.hhs.gov/quality/hhqi/default.asp.

    Consultant Judy Adams suggests taking that route so you can start analyzing your HHQI data for strengths and weaknesses as soon as possible. "If the reports are less than stellar for the agency, they need to investigate to learn why," says Adams, with the LarsonAllen Health Care Group.

    But avoid using your most recent data, warns Marion Donahue, with Simione Consultants in Hamden, CT. Using data ending in December 2002 will more accurately reflect what will show up on Home Health Compare, she says, since those results come from data for the 2002 calendar year.

  • Formulate an improvement plan. For low patient outcomes, you should jump start efforts to improve those numbers immediately, experts say. Instructions for improving patient outcomes are in CMS' OBQI Manual at www.obqi.org.

    Sign up with your state's Quality Improvement Organization, the Home Care Association of Louisiana suggests to its members. Signing on to participate in a quality improvement project and submitting a plan of action demonstrate that you have already begun working on your weaknesses, HCLA says.

    Even though your efforts might not show outcome improvements for a few quarters at best, it's important to get started and show you are making an effort to improve the quality of your care, says consultant Terri Ayer with Tucson, AZ-based Ayer Associates.

  • Investigate and report errors. If your patient outcomes just don't add up, you should look into them further, Adams recommends. If your investigation uncovers an error, contact your state OASIS coordinator to resolve the problem.

  • Prepare a response. You should examine any low patient outcomes you uncover and decide how you will answer questions about them if the press or others come knocking, Ayer advises. For example, a variance in patient populations might help explain lower outcomes, or poor OASIS data collection techniques might be the culprit.

    You might simply want to say how you are working to improve the outcomes in that area, Adams notes. If there was an error, you can explain that you are in the correction process.

    Agencies can get a better idea of what will be coming by looking at the older Nursing Home Compare project as well as at the pilot Home Health Compare, Donahue advises.

  • Designate a spokesperson. To make sure your message gets to the public without slip-ups, you should designate one person to answer questions and give comments about your outcomes, Ayer counsels. You should pick two people at the most, Adams adds.

    Make sure the people who answer your phones know where to direct outcomes questions, Ayer says.

  • Watch the satellite broadcast. HHAs can "gain a better understanding of how the data is used, why the results differ from the OBQI reports, what to expect and, most importantly, ask questions of the CMS staff" by tuning into the Oct. 3 satellite broadcast about the HHQI rollout, Adams says.

    If agencies miss the original broadcast, they can watch a replay on http://cms.internetstreaming.com for up to a year, CMS says. HHAs that want to show the presentation to large groups might want to purchase a videotape of the program, which will be available for only two weeks after the Oct. 3 transmission from National Technical Information Services, CMS notes. NTIS can be reached at www.ntis.gov or 703-605-6186.

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