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April 6, 2015
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Volume 4, Issue 14
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SERVICE EXCELLENCE
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Service Standard of the Week:
Customer Loyalty: We ensure that our customers are the priority focus at all times by anticipating their needs and delivering exceptional service.
 BREAKING NEWS: 30+ New Employees Joining the Agency!!! By Debbie Brown and Adele Pike What do you remember about being new in this Agency? We remember being excited, apprehensive, curious, nervous, and afraid to ask questions because we were uncertain of whom to ask for help. We remember being a bit overwhelmed and confused about home care with all its rules and regulations, its unfamiliar computer systems, its phone system and intranet all the while trying to learn names and communicate with fellow employees who we never saw because they were out in the field, or we were out in the field, or working in the office. STARTING A JOB IN HOME CARE IS HARD! It's hard in the first six months, and then - just as colleagues think you should know what you are doing, you come off your mutual assessment period and you still feel like a novice. We don't know about you, but we found ourselves feeling embarrassed and ashamed that we still had questions and still could not "pull our weight", and feeling like everything was moving 100 miles per minute. But, we also remember all the colleagues who were supportive and caring. Our preceptors or coaches and managers who checked in with us frequently and were always open to phone calls with questions. Our co-workers who recognized that our frown lines and decreasing cheerfulness were signs of stress and took steps to talk with us and support us as we became skilled and confident in our new jobs. Our managers who responded to our novice mistakes by turning them into learning opportunities. Our team members who asked us to join them for lunch and agency staff gatherings that made us feel like part of a family. Those emails from employees we didn't even know thanking us for our work or giving us nonjudgmental feedback about how we could work smarter or faster or better. That first year with the agency, and how we were welcomed and supported as we learned our jobs, and established a fierce loyalty. Being new in an organization is HARD, being a NOVICE is hard. New hires are all of our customers, and we need them to become loyal customers. So, as we bring on new hires across the Agency, let's realize that they are VERY important customers and let's work together to keep their needs as one of our priorities, and do whatever we can to anticipate their needs and support them over the course of their employment! Remember it is a TEAM effort!
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Service Excellence in Action
By Patti Darling, RN, BSN, Office Nurse
Staff throughout VNAB and VNACN have been working hard on service excellence these last few months. As an Office Nurse for the VNAB, I am always impressed with the exceptional level of care provided by our clinicians, but was particularly struck by this case. I believe this case represents true teamwork, using our resources to enhance the customer experience and create customer loyalty.
Patient Facing Difficult Injury
Ms. A is a 31 year old mother of two, who fell and fractured her ankle on an icy snowy street. She was referred to the VNAB for home physical therapy. During Ms. A's initial assessment visit, Bevin Durant, PT found that her fractured foot, which had been immobilized by her surgeon, was developing a significant blister that looked like a pressure ulcer. Her dressing and boot were fully saturated and her left leg was very swollen. Ms. A had a lot of questions about her medications, the side effects, and how she was going to pay for them. She had a very limited insurance policy, with a co-pay for home visits and no coverage for equipment or supplies. She was in a tough situation.
Bevin not only called the surgeon to get a next day appointment for Ms. A, but also referred her for nursing. The surgeon debrided the blister, replaced the soiled immobilizer boot with a bi-valved cast, and ordered daily wound care.
Coordinating with Referral Source
Ms. A's HVMA case manager, Pat Costello, RN, held a case conference with the VNAB's nurse and the therapist and together they referred Ms. A to the Malden Masons for free equipment. After fully reviewing her options, Ms. A opted to have home visits, focusing on therapy, with a family member learning her wound care regime.
Teamwork in Action
Patient services manager, Judy Sojack, RN, CWOCN, facilitated a rapid wound consult. Debbie Gibson, RN, CWON & the patient's primary nurse, Lisa King, RN, and Bevin made a joint home visit the day after her surgical appointment. Lisa taught medications and instructed on pain and bowel management. Debbie assessed her wounds and taught the wound care regime to Ms. A and her Mom. Debbie worked with Ms A's physician to obtain an order for a treatment that could be done every other day. Bevin observed the wound care and medication teaching so that she could reinforce it during her subsequent visits. It worked.
This plan means that Ms. A has fewer out of pocket expenses and can get the home PT she needs to get ready for outpatient therapy. Working as a team, these clinicians anticipated this patient's needs, provided exceptional service, and acknowledged and addressed her concerns. Ms. A is more comfortable and on her way to a good recovery.
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We Want to Increase Customer Complaints...WHAT???
By Mary Campbell, Director of Organizational Development and Service Excellence
Well, in a way. What customers tell us (both internal and external) helps us improve or it can reinforce what we do well. Capturing customer communication; both compliments and complaints, is the best way to understand what is important and what we need to focus on.
Compliments/Complaints form can be forwarded to my attention at mcampbell@vnab.org and through team managers.The form can be found in the following locations:
- VNACN intranet under Compliments and Concerns by clicking here from within the office or when connected via VPN
- VNAB Outlook Public Folders under Compliments and Concerns
- You can also click here to save a copy to your desktop or network folder for quick and easy access
Please ask your manager if you need assistance with accessing to the form, both electronically or if you would like paper copies. Use it frequently to recognize a colleague or department that demonstrates service excellence.
IMPORTANT
Using Complaints to Analyze and Address Patient/Customer Needs
- Priority One: to increase the documentation of comments from customers and to spend more time understanding why dissatisfaction is perceived
- Capturing customer complaints, recording and analyzing them is the lowest cost method for service process improvement
- There is extreme value in the time we spend recording and addressing complaints
- By analyzing patterns and frequencies of complaints we can uncover root causes of customer dissatisfaction
- As an organization we would like to recognize those who take the time to record and submit communication from our customers, respond quickly and efficiently and L.E.A.P to Service Recovery
Recording Compliments and Appreciation for employees from internal staff and external sources:
- Allows us to celebrate our success and each other
- Highlights what is important to both internal and external customers
- Provides well deserved recognition
- Feels great
- Shines a Spotlight on Service Excellence
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AGENCY ANNOUNCEMENTS AND UPDATES
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Welcome to New Employees!
The Rehab department would like to welcome Judith Walsh as the new Director of Rehabilitation Services. This new position, created within the Clinical Services Department, will lead the organization-wide rehabilitation program.
Judy comes to the VNA with more than 20 years of experience in acute hospital, skilled nursing, assisted living, outpatient, and home care settings. She most recently served as the Rehabilitation Manager for South Shore VNA where she utilized the LEAN approach to process improvement, leading the charge for standard work development. In this role, she also had direct oversight of 53 clinicians who covered 30 communities from Milton to Plymouth.
Judy brings with her years of experience of working with organizations undergoing transformational change and growth. She has created on-boarding and orientation programs for new orientees as well as management development opportunities for current staff. She has helped to establish clinical training, program development, marketing campaigns, customer partnerships, quality review initiatives, and training priorities based on operational and clinical quality results for individual business units as well as on an organizational-wide basis.
We are thrilled to have someone with Judy's breadth and scope of experience leading our rehabilitation services effort. She will be joining us at the end of the month and will be based out of the Weymouth office.
The QA department would like to welcome Susan Stiller, RN to the Quality Team. Susan has many years experience in home care and infection control and will be working with Bev Salate to increase the foundation of the Infection Control Department across the organization for policy and procedure standardization and congruent best care practices related to infection control. She will participate in infection control orientation, reporting, monitoring and surveillance of our infections. Susan will be working out of the Worcester office, but will be available to all offices and can be reached at sstiller@vnacarenetwork.org. Please join me in welcoming Susan to the VNA!
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Moving Forward Update
Issue 13 - March 31, 2015
Dear Atrius Health Colleagues:
For many years now, the Atrius Health medical groups have employed numerous population health methods to improve preventive care, chronic disease, and high risk management. From a patient perspective, these efforts result in better management of chronic disease, help between visits and at home, and support and guidance during difficult transitions across care settings which are particularly tough on our frailest patients.
A Patient Story For example, we have one 89-year old female patient with macular degeneration and declining vision who uses a cane, is on oxygen at home and lives alone with minimal support from family. This patient was enrolled in the Harvard Vanguard Primary Care Case Management program that was established in November 2013. She was receiving at the time minimal services from Springwell, a community agency that provides a range of services for seniors. After assessing the patient, the case manager made multiple referrals for this patient and assisted in facilitating access to resources. - The patient was referred to our Atrius Health preferred home care agency, VNA Care Network, for a Physical Therapy and home safety evaluation. The physical therapist from VNA Care Network worked with the patient on gait training, strengthening, and balance. The therapist also worked with the case manager to order a raised toilet seat for the patient's home.
- The patient was referred to our case management social worker to explore obtaining expanded services from Springwell and identify available resources for the vision impaired. Based on this referral, the patient agreed to the services from Commission of the Blind, received low vision aides, accepted a homemaker, and receives a volunteer for rides to appointments once a week.
- The case manager also made a referral to our Intensive Home-Based (IHB) program for home visits when coming in to see her PCP became problematic. The IHB Nurse Practitioner followed the patient at home, making regular medical follow-up available to her.
As a result of this assistance, the patient has the necessary care coordination to help her achieve her goal of remaining in her home safely for as long as possible.
As a System Looking at our Population Health efforts from a system level, we have been working to: - Data-identify gaps in a care/outcomes for a clinical population
- Engage clinical and operational leaders in understanding reason for gaps
- Identify evidence-based best practice
- Design future state care delivery based on evidence
- Develop standards & tools to implement
- Measure and monitor execution to get results
The challenge for the Population Health workgroup is to take the good work we've done in individual practices, the successes we've had when we work together, and recommend a pathway forward for key population health programs within an integrated Atrius Health. We have assembled clinical and operational staff to create the design platform for an integrated approach to Population Health, to recommend program development and accountability at the system, region and practice level.
We don't know the answers yet, but have developed together a project plan with Care Improvement support, in the form of a Vertical Value Stream, to get the work started. The team is very excited for the opportunity to take some of the signature programs of Dedham Medical Associates, Granite Medical Group, Harvard Vanguard and VNA Care Network -- programs that really make us distinctive and help us reach our triple aim goals - and use these a foundation to build something even better for all of Atrius Health.
The Population Health workgroup prioritized two programs to focus on for the first six months of 2015: Case Management (CM) and the Skilled Nursing Facility (SNF) program. We will be focusing on: - Scope of work - what services need to be provided within our CM and SNF programs to be successful?
- Body of standard work, tools and processes, roles and responsibilities -- what are those which will help us work better to deliver our services most effectively within the defined scope of work?
- Structure and accountability - what decisions does the team recommend be at the system, region and practice level, to get us the strongest triple aim results?
We pulled together a cross-functional Population Health Workgroup with members from all of the medical groups and VNA Care Network to participate in the Vertical Value Stream. Our workgroup is led by Emily Brower, Executive Director, Accountable Care Programs and Deb Morsi, Vice President of Nursing.
Vertical Value Stream Participants: Kristine Bartzokis Mark Berenberg Deb Bradford Emily Brower Bob Calway Katie Cardarelli Jennifer Childs-Roshak Peggy Chou Jennifer Connor James Cooley Karen DaSilva David Green Helen Jenest Kathy Davis Kathy Duckett Rick Lopez Anna Marinilli Deb Morsi Deborah Nolan Anne O'Donnell Linda Oliver Mike Querner Pippa Shulman Madeleine St. Denis
Our thanks to all of the Vertical Value Stream event participants. We look forward to updating you as our work progresses.
Emily Brower, Executive Director, Accountable Care Programs Deb Morsi, PhD, RN, NEA-BC, Vice President, Nursing Send your questions about integration activities to Integration@AtriusHealth.org. Please note that, if you would like your question to be anonymous, you may indicate that and your name will not be shared beyond the one person who manages the mailbox.
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Scenes from the Street
Gloucester Nurse Goes WAY Above and Beyond Story submitted by Kim Connelly, RN We have a registered nurse named Diane Crudden who works out of our Gloucester office. She has been a nurse for VNACN for the past nine years and covers her home communities of Rockport and Gloucester. It goes without saying that Diane is extremely dedicated to her community. On the night on March 18 2015, Diane and her spouse were returning home in the later eve hours. As they got out of the car they both smelled smoke. Instinctively, as both had been EMT's in the past, they knew this was not just regular fireplace smoke. They scanned the neighborhood and around the corner from their home, came upon a house with thick black smoke pouring out of the windows. There were no fire alarms going off, but with two cars in the yard, no evidence of movement in the house, and no people outside, Diane knew something was wrong and sprang into action. As her spouse called 911, Diane starting banging on doors and yelled to wake the residence of the home. She was persistent in her attempt to get these residents out and was finally successful in getting the attention of the families that lived inside. Two families successfully escaped with just the clothes on their backs, all because of Diane's actions. Both families had children under the age of two and one of the families infants has medical issues. The home was fully engulfed in flames within minutes of the residents escape and ended up being a total loss, however all eight residents escaped without injury. The point of sharing this is to show how, as nurses, we take care of our patients in the community on a daily basis...but the truth is, as home care nurse it doesn't stop when the clock hit 5pm. We take care of our community day in and day out, and this is a perfect example. Many people would have not paid attention to a smoke smell on a cold evening. Instinct took over and alerted this nurse there was something wrong and she went looking. Our Gloucester community is so lucky to have such a caring and talented nurse! Thanks for giving me the opportunity to share this incredible story, Kim Connelly, RN Team 48, Gloucester
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CLINICAL SERVICES
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Clinical Services Announcements and Updates
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Behavioral Health Program Update
By Molly Lukason, Behavioral Health Program Manager
When we began to create and initiate the Behavioral Health Program, we knew how it important it was going to be for patients throughout the VNA. What is so wonderful to see is how clinicians throughout the organization have connected with the program as well. We have received an overwhelming number of calls from all asking great questions and even providing some great advice about the process. We currently have patients all over the map-from Salisbury to South Boston. We do ask all clinicians when making a behavioral health referral to please make sure the patient has a documented diagnosis of depression, anxiety or dementia. We are currently able to accept patients with either Medicare or Medicaid.
We hope you have not forgotten that there is a huge and delicious breakfast waiting for the office that makes the most behavioral health referrals by April 30, 2015!
Keep those questions and referrals coming. Please do not hesitate to contact Molly at 774-502-5455 or via email at mlukason@vnacarenetwork.com. Even though it is early in the process, we have already heard from some patients who are currently participating in the program. One patient commented, "I feel different, more calm...I think this stuff is working on me."
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Ethics Committee Opportunities
By Elaine Buckley, Patient Services Manager
The VNAB has had a long standing Ethics Committee that meets every other month (as needed for emergencies) and committee members can participate at the Charlestown office, or by phone via conference line. We are in need of three new committee members and would like to extend the scope of this committee across the entire organization, for VNAB, VNACN, and VNAHC. If you are interested or think you may be interested, please contact Elaine Buckley via email at ebuckley2@vnab.org or by calling 617-886-6550.
Staff can request that an issue be brought to the Ethics Committee by emailing ebuckley2@vnab.org or cbourne@vnab.org. If the situation is urgent, we will gather a group together before the pre-scheduled meetings.
Issues that have been recently been discussed at Ethics include:
- A very depressed man with CHF that was living in a rodent infested home and did not have the energy to move or participate in his plan of care
- How to care for a patient that hoards
- Should an RN admit the patient who has a guardian, needs Lovenox , and we cannot reach the guardian for consent to treat
The Ethics Committee has strength from a group approach. Almost always, the clinician comes out feeling proud of what they have already accomplished and a bit excited with some new approaches to the current problem. We look forward to welcoming some new staff!
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Remote Patient Monitoring Program Start Date
By Kathy Duckett, Director of Population Health
The start date for the Remote Patient Monitoring program has been changed. The new start date will be April 13, 2015.
Please contact Kathy Duckett with any questions or if you need further information at kduckett@vnab.org.
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Product Recall
By Beth Mena, IV Clinical Service Manager
Products from Prescription Center Pharmacy in Fayetteville, N.C.: Recall - Lack of Sterility Assurance
ISSUE: FDA is joining the North Carolina Board of Pharmacy (NC BOP) to urge health care professionals, including veterinarians, and patients not to use products made and distributed by the Prescription Center pharmacy, located at 915 Hay Street in Fayetteville, North Carolina. In an inspection conducted in March by the NC BOP, state inspectors observed significant deficiencies that raise concerns about the company's ability to assure the sterility, stability, and potency of the sterile and non-sterile human and veterinary drug products that it produced. The Prescription Center has been closed by order of the NC BOP, and the NC BOP has ordered a recall of all lots of sterile and non-sterile products compounded or repackaged and distributed by the Prescription Center between Sept. 10, 2014, and March 10, 2015.
BACKGROUND: Drug products made by the Prescription Center have been distributed nationwide and to Canada.
RECOMMENDATION: Health care professionals should check their medical supplies, quarantine any drug products from the Prescription Center and should not administer them to either human or animal patients.
Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:
- Complete and submit the report online at www.fda.gov/MedWatch/report
- Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178
Click here to read the MedWatch safety alert, including links to the press releases.
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HHA Corner
By Elaine Buckley, Patient Services Manager
The HHA Department is still celebrating the deficiency free DPH survey in January! We are almost done with the results of the HHA supervision audit for Jan/ Feb 2015. The results will be announced in the Connecter soon. I can tell you there was a significant dip in the supervision compliance in Feb...can you guess why?
Our next goal is to explore ways in how the Home Health Aide can be pulled into the plan of care to help reduce rehospitalizations. I plan on coming to team meetings this spring and look forward to hearing ideas from the field staff about how we can make this happen.
In the meantime, please remember to supervise the HHA at every visit and to ask the patients if they received the HHA assignment in the mail. Let me know if you have any questions at ebuckley2@vnab.org.
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FACILITIES
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Worcester Office New ID System Installed
By Lorraine Potter, Director of Facilities
On Monday, April 6, a new ID/security system was installed in the Worcester office. This will require all staff who currently have access to the Worcester office to be issued new ID badges. Please see Donna, Worcester office receptionist, to sign for and receive your new badge.
If you encounter issues accessing the parking lot gate, the front door, and/or the supply room, please see Donna or contact Lorraine Potter at lpotter@vnab.org or 508-751-6826.
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FUND DEVELOPMENT
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Halloween Party Added to this Year's Fundraisers
By Jane Woodbury, Vice President of Fund Development
Our growing list of fundraisers now includes the Worcester Area Community Cabinet's third annual Halloween Cocktail Party on Thursday, October 29, at the Beechwood Hotel in Worcester. The party is one of numerous Fund Development events throughout the year that raises money for and awareness of our home health and hospice services.
These events are a great way for our former patients and their families to give back and support our mission of caring. We hope you can join us at one of our upcoming benefits and help us spread the word to your family and friends.
April
The 28th Annual Gloucester Pride Stride on April 26 is a five-mile walk around scenic Gloucester to benefit numerous Gloucester nonprofits, including VNA Care Network. Registration begins at 10 am, and the walk begins at noon. All walkers can join in a post-walk cookout and celebration at 1:15. More info is available at www.gloucesterpridestride.com. To sponsor a walker or join VNA Care Network's team, contact Sheila McCarthy at 888-663-3888, ext. 1304 or smccarthy@vnacarenetwork.org.
May
The 21st Annual Dine Around, Casino Night and Auction takes place Friday, May 1, from 7 pm to midnight at the Winchester Country Club. The evening features table games and money wheel, cocktail hour, dinner and dessert, entertainment, live and silent auctions, and music and dancing. Billy Costa of Kiss 108 returns as the auction emcee. The evening is organized by the Winchester Friends of VNA Hospice Care to support end-of-life care. Tickets are $200 each and include 500 casino chips. For more information or to purchase tickets, please contact Meaghan Gangi at 781-569-2820 or mgangi@vnab.org or visit www.vnahospicecare.org.
The Third Annual North Shore Spring Event will be held Saturday, May 9, at 7 p.m. to benefit home health care services. This is your chance to step inside a private Danvers home that's been featured in The New York Times and Chronicle. Enjoy music by Just In Time, and dance demonstrations and informal instruction in rhumba, foxtrot, salsa and more. There will also be live and silent auctions and heavy hors d'oeuvres. This benefit is being organized by the North Shore Community Cabinet of VNA Care Network & Hospice. Tickets are $50. For more information or to purchase tickets, please call Beth Sobezenski at 888-663-3688, ext. 1361 or esobezenski@vnacarenetwork.org or visit www.vnacarenetwork.org.
The 23rd Annual New England Coffee Golf Classic to benefit VNA Hospice Care will be held Monday, May 11, at Andover Country Club. Registration and lunch on the veranda begin at noon. Shotgun start at 1:30 p.m. Cost is $250 per player. Registration form and more details at www.newenglandcoffee.com/golf.
Fall Events: Save the Date
- VNA Care Network & Hospice Needham Community Cabinet's second annual benefit concert at the Needham Country Club on Friday, September 25
- Woburn Friends of VNA Hospice Care's 18th Annual Step Out for Hospice Walk/Run on October 4 beginning at the Woburn Irish American Club, 147 Main St.
- VNA Care Network & Hospice's Worcester Area Community Cabinet's third annual Halloween Cocktail Party at the Beechwood Hotel, 363 Plantation St., Worcester, on Thursday, October 29
- VNA of Boston's 10th Annual Heroes in Health Care Gala on Saturday, November 14, at the Mandarin Oriental Hotel, Boston
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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 VNAB, VNACN, and VNAHC.
Subscribers have already received information via mail or email. If you misplaced your voucher or did not receive it, you can go to the Globe GRANT web page by clicking here. 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 will 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 VNACN with the location as Danvers or Needham, VNAHC with the location of Woburn, or VNAB with the location of 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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Employee Advisory Team Suggestions
To suggest an area of focus to the Employee Advisory Team (EAT), please email your suggestion to EATSuggestionbox@vnab.org. Suggestions can include ideas to improve current processes and procedures, remove redundancies, or even to provide feedback on something you think is/is not working. Please feel free to discuss any issues that you would like brought to EAT with the following members of the committee: - Ellen Cavalier
- Michelle Coote
- Kelly Frew
- Jenny Highland
- Mary Helen Mahoney
- Becky Manning
- Susan Marlin Procter
- Annemarie Martin
- Mary McCarthy
- Ilona O'Connor
- Mae Powers
- Maria Rodrigues
- David Rose
- Chris Schultz
- Danny Yan
EAT is also on the lookout for new members. If you're interested in participating, or for more information on what EAT is all about, please reach out to any of the members listed above. Meetings are held monthly and alternate between the Charlestown and Braintree offices.
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Clinical Application Specialist Positions
We have two exciting opportunities for clinicians, with one position located in Danvers or Needham, and the other position located in Worcester.
In this role the clinician will oversee and provide support and efficacy of all clinical information applications, clinical informatics and IT utilization. The successful candidate will also provide instruction and support to all staff in order to reach and maintain a high level of competence in using clinical applications. They will act as a liaison between clinical and all other departments as it pertains to clinical software application issues.
Please contact Cheryl Milas, Bev Riley or Ann Bohac if interested.
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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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INFORMATION SYSTEMS
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VNAB Network Interruption
By Dave Hanley, Computer Operations Manager
Please be advised there will be computer network maintenance taking place in Charlestown on the evening of Wednesday, April 15th between the hours of 8:00 PM and 10:00 PM. During this service, you may experience outages or unavailability of these services and technologies:
- VPN access to VNAB network
- iPad access to VNAB network
- Network connections between VNAB and VNACN and all programs dependent on those connections, e.g. McKesson access from Rose Monahan or other VNACN sites
- Email for VNAB-based email users (e.g. XX@vnab.org)
- Local access to systems within the Charlestown office, including McKesson Horizons, email, network file shares, etc.
Please plan accordingly and feel free to contact the MIS department with any questions or concerns.
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QUALITY AND RISK MANAGEMENT
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Attention Clinicians: Change in the Way M0110 & M2200 Answered
By Maria Dunn, Patient Care Manager
Please note that effective immediately, these OASIS questions will be answered the same for ALL INSURANCES. We will no longer be choosing the answer based on the patient's insurance type. Contact your office's Patient Care Manager OR utilize the F1 HELP feature in Encore with any questions regarding which answer to choose. There is also information below to assist with this change. Thank you for your help.
- M0110 - EPISODE TIMING Early/Later
- Choose either "Early" or "Later" (please do not choose "UK" or "N/A")
- M2200 - THERAPY NEED
- o "000"when no therapy anticipated
- o "008" when nursing conducting assessment and therapy ordered
- o "###" when therapy conducting assessment, answer according to number of therapy visits anticipated in POT
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M2015: Patient/Caregiver Drug Education Intervention
By Marilyn Bowden, Patient Care Manager
The agency goal is to be in the top 20% of agencies for all publicly reported Outcomes and Process Measures. One process measure where VNACN is well below the top 20% is M2015 Patient/Caregiver Drug Education Intervention. Improvement in this score is critical because, in addition to being a publicly reported Process Measure, starting in July 2015 CMS will publish publicly the new Star Rating System and M2015 scores are part of its calculation.
CMS just released to agencies a preview of what their rating will be in July. VNACN scored only TWO out of FIVE stars for "Drug education on all meds" for the year ending December 2014.
The table below shows the percent of YES responses for January 2015.
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M2015
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VNACN
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VNAB
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National Avg
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Top 20%
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At the time of or any time since the previous OASIS assessment, was the patient/caregiver instructed to monitor the effectiveness of drug therapy, adverse drug reactions, and significant side effects, and how and when to report problems that may occur?
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94.5%
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99%
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93.5%
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99%
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An audit of January M2015 responses showed 50 responses scored NO (5.5%) and all of these were scored correctly based on the lack of medication teaching documentation in the time frame for M2015.
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Time Frame: At or any time since the previous OASIS assessment
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Number of Times ALL Meds not Taught
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SOC->Transfer
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12
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SOC->DC
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22
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ROC->Transfer
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6
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ROC->DC
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6
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Recert ->Transfer
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3
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Recert->DC
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1
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I know VNACN is better than TWO stars for Medication Teaching! Make your documentation show the FIVE star teaching you provide. Teamwork can help improve our scores. Here are some recommendations for improvement:
- In multidiscipline cases Nursing should not discharge until Medication Teaching complete-that is, ALL medications have documented teaching (using teach-back) about:
- How to monitor effectiveness
- Potential side effects and adverse drug reactions (as well as special precautions for high risk meds), and
- When to contact the appropriate provider
- When patient/caregiver are unable to be taught, document the inability to learn and the notification to MD per agency policy
- In therapy only cases:
- Therapy is responsible to see required medication teaching is documented
- When patient's education requires knowledge beyond PT's educational preparation, Therapy is responsible to contact CSM to determine if office nurse can handle required teaching or if nursing referral is needed
- Check at each visit for medications that need to be taught and include teaching not completed in plan for next visit
- Use the new abbreviated check off "Verbalizes re knowledge ALL meds at/since Rcrt/ROC/DC" to document assessed knowledge retention at Recert, ROC and DC when not done prior to DC. When knowledge is not retained, reteach using teach-back and document
Together we can move in the right direction!
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Patient Care Managers
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Office
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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
|
Carol Morris
|
617-886-6435
|
617-913-3006
|
Patient Care Manager
| |
Charlestown
|
Elaine Gardner
|
617-886-6464
|
617-680-1105
|
Patient Care Manager
| |
Danvers
|
Marilyn Bowden
|
888-663-3688 X1271
|
774-502-7478
|
Patient Care Manager
| |
Gloucester
|
Marilyn Bowden
|
888-663-3688 X1271
|
774-502-7478
|
Patient Care Manager
| |
Leominster
|
Terry Dancewicz
|
888-663-3688 X1341
|
774-502-7481
|
Patient Care Manager
| |
Needham
|
Maura Vitello
|
888-663-3688 X4536
|
774-502-7475
|
Patient Care Manager
| |
Southborough
|
Maria Dunn
|
888-663-3688 X1317
|
508-688-2449
|
Patient Care Program Manager
| |
Worcester
|
Christine Gill
|
as of 3/30/15
|
TBD
|
Patient Care Manager
|
|
|
|
|
|
