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March 23, 2015
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Volume 4, Issue 12
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SERVICE EXCELLENCE
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We Made It!
We've made it through each of our ten VNA Service Standards! Before we rush into starting them over again, we wanted to take the week to celebrate and acknowledge this great achievement. With our Service Standards, we're shaping the future culture of our organization and setting the expectation for exceptional Service Excellence to all our customers. Way to go!
Now we face the true test, can we sustain the great momentum we've created? I think we can!!
VNA Service Standards
Service Standard #1: Customer Loyalty
We ensure that our customers are the priority focus at all times by anticipating their needs and delivering exceptional service.
Service Standard #2: Customer Contact
We greet our patients, customers, and colleagues with a warm smile, maintain eye contact (when culturally appropriate) and acknowledge their needs or concerns.
Service Standard #3: Professional Image
We are service professionals who uphold the reputation of our company by demonstrating a professional appearance.
Service Standard #4: Professional Language
We communicate with respect and courtesy to colleagues and patients. We address patients, families, and customers based on their preference, using Mr., Mrs., Ms. or their preferred name.
Service Standard #5: Service Recovery
We ensure complaints are acknowledged, addressed, and proper action is taken by utilizing LEAP.
Service Standard #6: Employee Empowerment
We are all a part of the customer experience. We are empowered to use resources and training to enhance our customer's experience as well as our own professional goals and growth.
Service Standard #7: Communication Etiquette
We follow communication standards and expectations when engaging in electronic and telephone communications; ensuring to always use a warm and friendly tone.
Service Standard #8: Workplace Safety
We assess and maintain a safe work environment.
Service Standard #9: Workplace Cleanliness
We maintain a professional, clean, organized work bag and work area, whether in the patient's home or in the workplace.
Service Standard #10: Teamwork
We work collaboratively with a spirit of teamwork, holding each other accountable.
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Facilities Maintenance Technicians
Hat's off to our facilities maintenance tech's who might be described as the unsung heroes of the organization. All of the gentlemen below played a huge role in making sure all of our facilities were safe and accessible for staff, and in the cases of the hospice house, patients and families over this past winter. A big thank you to:
Daniel Pagliuca, Maintenance Technician
Dan has been with VNAB since 2001. Dan is based out of Charlestown, but also covers other office locations as needed. Dan's purpose is to keep our locations safe, clean, and accessible. Dan has had the responsibility of maintaining the VNAB's ID system, installing keyboard trays, as well as fixing and adjusting items as needed. Dan does conference room setups and has even spackled and painted walls when the need arises. Dan makes himself available day and night, for instance, he had to remain in the Charlestown office during the building's electrical shutdown just a few weeks ago. Dan is always ready and willing to assist in any way he can. If all this wasn't enough, Dan was instrumental in making sure that clinicians were transported in and around the city of Boston to visit their patients during the worst of the snow this February. Dan is a great colleague and example of Service Excellence!
Percy Perez, Hospice Maintenance Technician
Percy has two locations he is responsible for, the Stanley R. Tippett and Elizabeth Evarts de Rham Hospice Homes. Percy's function is also to make sure the Homes are clean and the grounds kept clear and clean. Percy is known for his care of the grounds, and took particular pride in making sure the walkways were clear to the Tippett residence during our winter of storms. While his function is well defined, he believes his purpose is to make sure staff and family can get into the building to care for our patients. Percy has so much pride in his work and staff he comes into contact with often say "Percy is always on the move."
Timothy Remillard, Maintenance Technician Tim is based out of the Worcester Office, but also travels to other locations to assist in tasks. As many may already know Tim takes very good care of our 120 Thomas Street office location. Tim's purpose is to keep our locations safe, clean, and accessible for employees and visitors. Tim worked many hours snowblowing and clearing away the snow that blocked our entrances, sidewalks, and parking lot area. On any given day you may find Tim fixing items, hanging boards, installing a keyboard tray, moving furniture, or setting up conference rooms. Tim also helps the Children's Garden daycare and Leominster and Southborough offices with maintenance projects...but don't be surprised if you see Tim in other locations! Tim always has a big smile on his face and portrays all that is wonderful with Service of Excellence! Shane Watson, Hospice Maintenance Technician Shane is based out of Rose Monahan Hospice Home but helps out at the Worcester and Southborough offices as needed. Shane's primary function is to maintain the Rose Monahan residence and that is not an easy task! Shane keeps the house, grounds, and structure clean and safe. Shane assists the staff with many miscellaneous tasks and is always happy to help. He reported to the house on the day of the Blizzard of 2015 to make sure the walks and entrances were clear for the employees and patient's family members to come and go. What a great display of Service Excellence and more importantly, price and care in your work!
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AGENCY ANNOUNCEMENTS AND UPDATES
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Scenes from the Street
 Let's all give one last "SEE YA LATER" to the winter and all the snow that it dumped on us.
| | Amanda Gorman, CSA out of the Worcester office, cleans off her car for what is probably not the first or last time of the day! (Photo credit: Erica Friend, Team 40 Clinical Coordinator) |
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CLINICAL SERVICES
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Clinical Services Announcements and Updates
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Reminder: McKesson System Upgrade April 1 By Kathy Schuft, Clinical Application Specialist Reminder that the Spring Regulatory Update to the McKesson System will take place on Wednesday, April 1st for VNAB Home Care and Hospice. More information will be provided via the Connecter on the Monday prior to the upgrade. If you have any questions please contact Kathy Schuft at 617-886-6968 or kschuft@vnab.org. |
VNAB Supply Order Change Effective April 1 |
IT'S ALMOST TIME -
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to order supplies from Byram Medical!
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VNAB clinicians will be able to order supplies for all patients, regardless of insurance plan, using the Byram Medical Supply Phone Order System at 800.248.4546. The Byram phone order process will be similar in many ways to using the VNAB Supply Line, except that you will be speaking live with a customer service representative. The Byram phone Reps are product experts, and will answer your product questions efficiently. They will alert you promptly if there are any "special approval" needs for off-formulary items, and they will give you email confirmation that your supply order has been shipped to your patient.
The VNAB Supply Line will close on April 1 at 12 noon, so please plan accordingly.
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Preparing the Preceptor As a part of our new, robust education and on-boarding program, preceptors are provided with extensive training to ensure a positive orientation for new hires. The skills lab, one component of the training, is to focus on how the preceptor can best teach a new hire a specific skill that they will encounter in a home care setting. In each of the scenarios shown below, one staff nurse role-plays being the new hire, one is the home care nurse, and others play the role of referral source, case manager, etc. |
| | Preceptors posing with their "patient" L-R: Jun Wong, Stacy Campbell, Suzie Blacker, Kathy Trahon, Michelle Patterson, Kim McCarthy, and Shannon Granata |
 |  |  | | Draining a Pluerex catheter | Passing an indwelling catheter | Changing a Suprapubic catheter |
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Behavioral Health Program Update
By Molly Lukason, Behavioral Health Program Manager
I just wanted to keep you updated on the progress of the Behavioral Health program. Currently, we have 15 active patients who are benefiting from the program. We continue to receive great questions and thoughts related to the program and process from all across the organization. Helping patients with a diagnosis of depression, anxiety, or dementia work through their illness and help them to realize that their lives can be happier and more fulfilling is what we all strive to accomplish.
Some questions that we have received since the initiation of referrals include:
- "How do I put a referral into the Behavioral Health Program?"
For VNAB clinicians on the McKesson system, an internal referral to the Behavioral Health program is the same process that one would use to put in for any other discipline. Behavioral health has its own macro [BH]F10.
- "Do I need to put in a verbal order?"
Yes, please put a verbal order in and then we can proceed with setting up a joint visit with the primary clinician to meet the patient.
- "Does the patient need to have a documented diagnosis of depression, anxiety, or dementia?
Yes, the patient needs to have at least one of these documented diagnoses in order for the behavioral health team to proceed. The behavioral health team can assist with this.
We wanted to take this time to introduce the behavioral health clinicians:
Also, we are happy to announce that Christine Bryne, a seasoned clinician with the VNA, will be joining the team as of March 30, 2015!
With any new program, there will be initial challenges that we will work through. On behalf of the team, I want to say thank you to all who have answered my calls and worked through some difficult scenarios in order to help the patient. Thank you for your patience as we solidify the process. Keep those referrals coming!! Please feel to call or email Molly with any questions or concerns at mlukason@vnacarenetwork.org or (774) 502-5545.
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Two New Exciting Programs in Population Health - Looking for Nurses to Participate
By Kathy Duckett, Director of Population Health
We have two new programs that we are very excited about and are looking for nurses currently working part-time with the VNA who would be interested in doing something a little "outside the box".
Virtual MD Visit Program
The Virtual MD Visit program is a pilot with Atrius Health. Our home health nurse will make scheduled home visits for patients who cannot make it to the MD office for their appointments and need to see the physician. The nurse will provide e-visits in consultation with the Atrius physician or nurse practitioner using electronic equipment including an e-stethoscope, e-otoscope, webcam and a two way video link so the nurse and the provider can consult on the patient status in real time. We are looking for nurses in the south area (Weymouth, Braintree, Quincy, etc) who would be interested in this innovative approach to home visits. For more information on the program please see the Virtual Nurse job listing in the HR section below.
Hospital at Home
The Hospital at Home program is an ED diversion to home program. The program is from 6am - 8pm, 7days/week. When an appropriate patient is identified we would take the patient home with appropriate orders and equipment. The RN would stay with the patient for the first 8 - 12 hours and then would be relieved by an aide for the remaining 12 - 16 hours. The nurse will see the patient daily for 3 days to assess the patient's status and consult with the physician daily on the patient status. The patient would receive 24 hour aide care in the home during that time. Once the patient's condition has improved the patient will either be discharged to the VNA for home health services or to self-care, depending on the patient's needs. We are looking for nurses in the Worcester area who are looking for something different and are able to be on call and then able to assume patient care. You can be available 1 day/week or more depending on your schedule. For more information on the program, please click on the Worcester link in the Human Resources - VNA Care Network section below.
Questions? Contact Kathy Duckett at kduckett@vnab.org.
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FUND DEVELOPMENT
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Boston Globe Print and Website Subscribers: Go Online to Give a "GRANT"
By Jane Woodbury, Vice President of Fund Development
The Globe Readers And Nonprofits Together (GRANT) program enables subscribers of the print and website versions of the Boston Globe to donate advertising space to nonprofits, including VNA of Boston, VNA Care Network and VNA Hospice Care.
Subscribers have already received information via mail or email. If you misplaced your voucher or didn't receive it, you can go to the Globe GRANT web page, https://services.bostonglobe.com/grant/default.aspx. You will need either a subscriber number, email or phone number to complete the online form.
We hope you will consider designating your GRANT ($100 for seven-day print subscribers and $50 for all others) to our organization. We'll use the free ad space to raise awareness of our services and special events. On the form, please indicate the name of the nonprofit as either VNA Care Network with location in Danvers or Needham, VNA Hospice Care with location in Woburn, or VNA of Boston with location in Charlestown.
GRANT vouchers must be submitted by April 30, 2015. Thank you for helping us take advantage of this incredible opportunity.
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HUMAN RESOURCES
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VNAB/MRI FSA Participants
FSA claims for health care and dependent care in 2014 must be into Sue Schroepfer, Benefits Specialist, at the Weymouth office no later than Friday, March 20, 2015 to be included in pay check of 03/26/15.
*All claims for 2014 must be submitted no later than Tuesday, March 31, 2015 to be eligible for reimbursement. Please contact Sue Schroepfer at sschroepfer@vnab.org with any questions.
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Job Postings - VNA Care Network and VNA Hospice Care
To learn more about career opportunities, contact a human resources representative:
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Job Postings - VNA of Boston and VNA Hospice Care
To learn more about career opportunities listed in the links above, contact Debbie Brown, Human Resources Manager at dbrown@vnab.org. |
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QUALITY AND RISK MANAGEMENT
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Coding Corner: Capture Pressure Ulcers Correctly to Protect Outcomes
By DecisionHealth Staff
Stage 3 and 4 pressure ulcers damage the tissue to the point where it is forever left vulnerable to further breakdown. They are not healed even though they may have closed. It's quite common for these wounds to re-open and thus they require continual monitoring by the agency.
Tip: Assign closed stage 3 and 4 pressure ulcers among the codes that go on the Plan of Care. While closed stage 3 or 4 pressure ulcer codes may not warrant inclusion in the top six diagnoses if they are not the focus of the admission, they should be somewhere on the claim to ensure that the Medicare Administrative Contractor (MAC) gives the agency credit for monitoring the patient's skin.
Tip: Code stage 3 and 4 pressure ulcers that re-open to the stage they were prior to closing, not what they currently appear to be.
Scenario: Stage 3 pressure ulcers, morbid obesity
A 76-year-old woman has three stage 3 pressure ulcers and is admitted to home health for wound care. The ulcers are on her right heel, left ankle and buttocks. She is morbidly obese with a BMI of 41.
Code the scenario:
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Primary and Secondary Diagnoses
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M1024
Case Mix
3 4
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M1020a: Decubitus ulcer heel
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707.07
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M1022b: Decubitus ulcer ankle
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707.06
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M1022c: Decubitus ulcer buttock
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707.05
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M1022d: Pressure ulcer stage III
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707.23
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M1022e: Morbid obesity
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278.01
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M1022f: Body Mass Index 40.0-44.9, adult
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V85.41
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Source: March 2015 Decision Health "Coding Pro"
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OASIS and Coding Education Sessions - To Be Completed by March 31 All Clinical Staff: We have appreciated the excellent participation thus far! - We are continuing the first of four quarterly and required OASIS and Coding Education Sessions to be held this year (March, June, September, and November).
- You may attend any session in any office since the same presentation is being given across the VNAB/VNACN organization.
- This quarter's focus is OASIS C-1 Updates, Risk Identification, Risk Adjustment, and the Heart Failure Patient.
- Please plan to attend if you are a Clinical Manager, RN, PT, OT, LPN, PTA, or COTA, as the OASIS is an assessment influencing the plan of care and the outcomes of our work.
Please contact the Patient Care Manager in your office with any questions. The remaining sessions include: 
Patient Care Managers
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Office
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Name
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Office
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Cell/Direct
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Position
| | Rehab | Kyra Mihalick | 617-886-6500 X3085 |
617-913-6823
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Patient Care Manager
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Quincy/
Weymouth
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Carol Morris
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781-535-5380
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617-913-3006
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Patient Care Manager
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Charlestown
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Elaine Gardner
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617-886-6464
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617-680-1105
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Patient Care Manager
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Danvers
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Marilyn Bowden
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888-663-3688 X1271
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774-502-7478
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Patient Care Manager
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Gloucester
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Marilyn Bowden
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888-663-3688 X1271
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774-502-7478
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Patient Care Manager
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Leominster
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Terry Dancewicz
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888-663-3688 X1341
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774-502-7481
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Patient Care Manager
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Needham
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Maura Vitello
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888-663-3688 X4536
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774-502-7475
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Patient Care Manager
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Southborough
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Maria Dunn
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888-663-3688 X1317
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508-688-2449
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Patient Care Program Manager
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Worcester
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Christine Gill
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as of 3/30/15
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TBD
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Patient Care Manager
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