Grooming & Professional Presence

The personal appearance of all employees is vitally important in our relations with patients and their families, volunteers, donors and visitors. Without restricting individual tastes, it is our policy to expect excellent personal hygiene, good grooming and appropriateness of dress while employees are on duty.

We operate in a professional work environment, and your personal appearance is a reflection of your pride in your work. Your personal appearance represents a first and lasting impression. Specific attire should be consistent with one's role within the organization. Soiled clothing, poor grooming, a lack of personal cleanliness and/or inappropriate dress reflects poorly on both the employee and the organization.

DPH Survey

By Jeanne Callahan Lydon, Senior Vice President, Clinical Services, Quality and Risk Management

I want to thank everyone for their ongoing commitment to our patients and their excellence in service delivery.  Staff were phenomenal in showing the great care delivered to our patients as well as our in-house cooperation and coordination. The Management Team worked diligently behind the scene to make sure all data needed was available and communication was effective. 

This very successful survey was a true measure of the ongoing interaction among all departments.  QA, Clinical Services, IT, HR, Finance, Medical Records, Referrals, Admissions/PAP/UM, Development, HHA Department, Horizon Application Specialist and Coordinators, Facilities, Administrative Support Staff and Reception did an outstanding job in making sure the auditors received everything they needed. They saw a true coordination of efforts across all departments. It was clear we are focused on securing our patients safety, health and outcomes through performing our work at the highest standards possible. 

Kudos to everyone in the agency as there was little the auditors  did not audit, observe and evaluate from signing into the office, HIPAA security in the office and the field, timeliness of care, professionalism at the point of care, documentation, communication, standards of practice, QA program and policies.  They were very thorough and impressed with all of you and I am grateful to work with team of dedicated Staff, Managers, Directors and Senior Members. Thanks to all.

Capturing the Customer's Point of View

By Mary Campbell, Director of Transitional Care and Business Development

Analyzing complaints can become our lowest cost and most accurate source of information about what needs improvement.At VNA Care Network Foundation and Subsidiaries, we will make it a priority to increase the documentation of comments from customers and spend more time understanding why dissatisfaction, or maybe even "delight", was perceived.Our goal is to design a better way to capture all complaints and customer comments and to respond and resolve quickly and efficiently.

A revised form for all divisions, VNACN, VNAB, and VNAHC, designed to capture incidents and complaints can be found in VNAB/VNAHC's Outlook Public Folders under Customer complaints /incidents form. The form is accessible at VNACN through the intranet.

You may type directly onto the form, click File > Send to or Attach to email.

The form should be forwarded to the manager and director of the department, Donna Peters (dpeters@vnab.org) and Keith Giannelli (kgiannelli@vnab.org) in QA and Mary Campbell (mcampbell@vnab.org) in Service Excellence.

Examples of Incidents

Examples of an "Incident" include: harm or risk of harm to patient, missed visit, delay in treatment, injury, questioning number of visits, clinical competence issues, Med errors, threats of legal action, threat of injury to staff, complaints made to the CEO or Board.

There is a section for complaints, and you can also document compliments under (other) in this category. This paper process will be a temporary solution while we are developing a more efficient and user-friendly electronic entry system.

Questions? Contact Mary Campbell at 617.886.6433 or mcampbell@vnab.org. 

iPhone Deployment Update

Communication plays such a big part in our lives today. It is hard to think of a single activity that we engage in that does not involve communications in some way. Being available is important for those trying to connect with you, and on the flip side, having the tools to respond is equally important for those on the receiving end. Cell phones have become a critical and necessary tool that we use to communicate with each other.

Up until now, VNA Care Network employees have been asked to use their personal cell phone for agency business. While there is a reimbursement given to those who do so, we have heard loud and clear that using personal cell phones to communicate with patients, referral sources, and colleagues is challenging and not ideal. VNA of Boston clinicians are currently provided non-smart phones, which do not allow for access to email or other advanced features. To that end, the decision has been made to begin deploying agency iPhones to clinical/field staff.

We have heard many of the communication challenges clinicians encounter in the field. Here are some of the benefits you can expect with the agency-provided cell phone:

• Standardized Caller ID
  It is well known that many patients do not answer their phone if they do not recognize the name/number on the caller ID. The new phones will feature a standardized caller ID, with the organization's name appearing whenever you call from your iPhone. This will help identify to the patient who is calling and does not provide your cell phone number to everyone you call.

• VM Greeting
  Using an agency provided cell phone will enable you to customize your voicemail greeting to alert callers of your work schedule and/or vacations and extended leaves. If patients or referral sources leave a message, your greeting will advise them when they should expect a return call. If they need a response sooner than your greeting indicates, they will also have an alternate number to call for a live-person.

• Email at your Fingertips
  iPhones have the added benefit of real-time email access. As Outlook becomes our primary way of communicating agency information, having easy access will help you stay informed and up to date!

A communication guideline is being developed with everything you will need to know about the new iPhones. Stay tuned to the Connecter for more information and the deployment schedule.

 

Children's Garden Featured in Telegram and Gazette

Children's Garden child care center in the Worcester office recently celebrated 25 years of caring for little ones. Pat Hare, director, was at the helm before the center's walls were even in place.

"It's been an unbelievable experience," Pat told the Worcester Telegram and Gazette, which featured her work and the center in the Jan. 17 article "Children's Garden celebrates 25 years of helping kids thrive."

Read the article on the Worcester Telegram and Gazette's website by clicking here. Congratulations to Pat and her team for a fantastic 25 years!

http://www.telegram.com/article/20150117/TOWNNEWS/301239999

Telehealth Expanded to COPD

By Joan Roth, Manager of Special Initiatives

In our efforts to increase the use of telemonitors for the VNAB we have just received 25 more telemonitors! This means we can now provide telemonitoring for more patients.

Here are the answers to some questions you may have about the expanded program.

1. Which patients should be considered for telemonitoring?
   You all know that we have used telemonitoring for Heart Failure patients but now we are able to provide monitoring as part of our Standard of Care for any patient who has Heart Failure and/or Chronic Obstructive Pulmonary Disease.
    
2. Which insurances cover telemonitoring?
   Medicare and Medicaid Episodic insurances "cover" telemonitoring as part of our PPS payment. CCA will cover telemonitoring with authorization.
    
3. Do patients need a regular phone line to have telehealth?
   No, the monitors have their own cellular transmitter so if the patient does not have to have a land line to have telemonitoring. The cell service is completely independent of the patient's phone service.
    
4. Are there other languages on the telemonitor?
   The monitor can be adjusted to communicate with the patient in Spanish (both verbally and for the written directions)
    
5. What else should I consider when I am evaluating my patient for telemonitoring?
• Is the patient High Risk for Hospitalization?
• Can the patient or their caregiver manage the equipment safely?
• Is the home environment safe for the equipment?


6. Does telemonitoring help patients keep out of the hospital?
   Yes! The 30 Day Rehospitalization Rate from 12/1/13 to 11/31/14 for all reasons for the telehealth patients was: 12%. If the patient was hospitalized for heart failure it was only 6%.
   
   Remember: Patients are most vulnerable for going back into the hospital the first week they are out of the hospital so get the monitors in as soon as possible. If you can call me from the patient's house we can schedule the installation quickly.
    
7. How do I refer a patient for telemonitoring?
• There are two ways to refer to telehealth:
• Call Joan Roth 781.535.5410
• Send Joan Roth a Telehealth Monitoring (TM) note

Behavioral Health News

By Molly Lukason, Behavioral Health Manager

The Behavioral Health Team is coming together as we prepare for the Cognitive Behavioral Training at the end of January. We have formed a strong collaboration with the team at The Center for Anxiety and Related Disorders who will be providing the training and on-going supervision. The workshop will focus on treatment for patients with depression, anxiety and early stage dementia promoting a deeper awareness of emotions such as fear, sadness, anxiety and anger. We all have these emotions and our actions often reflect these emotions and assumptions we have strengthened throughout the years. But what happens when one's emotions prevent one from getting well, from leaving their home, from connecting with family and friends or from reflecting proudly on accomplishments? Several research studies show that cognitive behavioral therapy (CBT) is very successful for many age groups but highly successful with the population over age 65. This particular population is opened to reminiscing, to looking at ways to improve their lives and to engaging in discussions about what positive change could mean for them.

As clinicians, we have success each and every day gaining the trust and respect of our patients while helping them to improve their quality of life. Cognitive Behavioral Therapy connects specially trained clinicians with patients in providing a structured therapeutic protocol to enhance their emotional well-being and to help them understand that their feelings and thoughts do matter. We welcome any RN clinicians who are interested in learning more about this specialized training or wondering about possible positions.

Plan on Unexpected McKesson Updates

By Kathy Schuft, Clinical Application Specialist

This year has had a number of regulatory changes that began on January 1st. Some of the changes have involved billing and transmission of OASIS data. We have experience some software glitches that have caused problems in these areas. McKesson has been working to resolves these problems as quickly as possible.

Due to our strong need to install the repairs once they are available we may announce McKesson system updates with very little notice. Right now it is likely we will have an update next week and another one in a few weeks. Because next week's update has not been released yet it is not possible to plan at date.

Once we choose a date, iPad user should only be affected by a 9pm shutdown time. Our few laptop users will need to come to the office to perform an ESD transfer after the update.  

Communication will be via email or the Connecter time permitting. Please let me know if you have any questions at 617-886-6968 (x6968) or kschuft@vnab.org.

Plan for Next Visit:  Ensuring a Safe Patient Handoff

By Maria Dunn, Patient Care Manager and Annemarie Martin, Director of Patient Services

In last week's Connecter, the Plan for Next Visit was highlighted.

The following are examples of revisit planning and provision of a safe patient handoff using the PNV documentation.

Flexible Spending Account Participants

By Sue Schroepfer, Benefits Specialist

For VNA of Boston FSA Participants

Claims for flexible spending account reimbursement for paychecks distributed on 1/29/15 must be into Sue Schroepfer no later than Friday, January 23, 2015.

You have until March 31, 2015 to submit claims incurred during 2014.

Questions? Contact Sue Schroepfer at (781) 535-5341 (X5341) or sschroepfer@vnab.org.

DHP Update - Thank You to Everyone!!

By Donna Peters, Director, Quality Assurance and Risk Management

From the words of the Surveyor..."kudos to all of you, I am impressed by your work, how you make the workings of a large agency look easy"...and he is happy to re-certify us for 3 more years! A great big thank you to everyone who participated in this endeavor of success!

What happened in the 7-day survey:

10 visits, 10 record reviews, both of which were great and showed appropriate patient care, adequate care plans and referrals to disciplines. The joint visits were great, thanks to those who drove and who visited with the survey team.

He voiced that he was impressed with the chart reviews for our work in case conference documentation, notification to the MD and each other with changes in patient conditions, completed med profiles with med education woven into the care plan and visits, overall great communication evidenced by communication notes and point of care documentation. He was impressed that each clinician on the joint visit documented in the home, at point of care.

Staff that accompanied the surveyors on the visits, to be commended for great work are: Joan Brosnahan, Jessica Dimenna, Lindsey Keaney, Joyce Hart, Deb Gallahue, Deb Soper, Val Green, Kyra Mihalik, Kerri Stevens, and Lisa McNeil. Drivers included: Jenn Bilodeau, Carol Morris, Elaine Gardner, and Carol Bourne.

Some additional highlights included:

• F2F all good, MD orders no problems, 110 orders all intact and back signed timely.
• A random selection of personnel files reviewed and intact.
• A random selection of HHA personnel files reviewed and intact.
• Review of our complaint process was good, he saw good follow through and review in the complaint process.
• Update with Carol Morris regarding our CQI/QA process: He was impressed with the program and its integration with VNACN, he said that he sees evidence of good process in OA review and accuracy, he voiced that there is a good fabric of QA woven into our work.
• COTA and PTA sups no problem, evidence in the record that these are being done timely and concurrently with patient care.
• HHA supervisions all intact, no problems with compliance.

Opportunities: PLEASE NOTE THAT MANY TIMES WHAT IS SAID AT THE EXIT INTERVIEW MAY BE UPDATED WHEN WE GET OUR FINAL PAPER WORK FROM DPH

• LPN supervision, this is something that in practice we do well, we will be reviewing our policy to insure that we have enough detail and information in the policy to reflect what we do.
• OASIS transmission: we need to insure that we have an OA tool for each patient in a 60 day window, to determine recert, DC or transfer. The preliminary report that we reviewed in the exit conference shows that we may have some opportunity to get these OASIS tools, more specifically DC and transfers tools, completed more timely for the transmission process to be on target.

 Congratulations to a great team!

**Clarification of last week's Immunization Changes with OASIS C-1**

By Jennifer Bilodeau, Patient Care Manager

Last week's article highlighted the changes to the Flu and PNA immunization questions with OASIS C-1. Below is a correction to last week's statement regarding documentation requirements on immunization status.

Reminder: It is a requirement to document the immunization status of all patients at every OASIS time point (SOC, ROC, Recertification). This documentation is captured in the Interventions section of all SN, PT, OT and SLP visits.

As stated last week, you will notice an updated [IM macro that reflects the current OASIS C-1 immunization questions.

Please contact Carol Morris 781.535.5380 (X5380) or Elaine Gardner 617.886.6464 (X6464) with any questions/concerns.