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April 27, 2015
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Volume 4, Issue 17
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In case you missed it, check out the Culture Design survey video...and be sure to fill out a survey so your voice will be heard! www.surveymonkey.com/s/VNACulture
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SERVICE EXCELLENCE
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Service Standard of the Week
Professional Image:
We uphold the reputation of our company by demonstrating a professional appearance.
Professional Image Themes:
- Take pride in and care of your personal appearance
- Everyone is responsible for conveying a professional image at all times, in all places
- Wear your ID badge and adhere to our dress code standards
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Warmer weather is here. The warm sunny days, the weekend trips to the lake, and...the sound of flip-flops in the hallway?
Please review our standards regarding professional image printed below in this week's huddle.
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EXCEEDING EXPECTATIONS... 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. Please see the list below of acceptable/unacceptable attire that was reviewed during Service Excellence workshops and that went into effect at the beginning of the year. |
Acceptable Attire
- Staff who wear scrubs are expected to keep them clean, neat and pressed.
- All other staff working in clinical and administrative areas will wear business or professional attire.
- Appropriate clothing that may be worn while working includes: skirts, skorts, shorts (knee length), dresses (knee length), suits, pants, capris, shirts, blouses and tops (not low cut).
- All staff will wear ID badges that are visible at eye level and include, at a minimum, the employee's first name and title.
- Shoes must provide safe, secure footing and offer protection against hazards. Closed-toe shoes are required for all staff. Closed-heel and toe for field staff.
- Large or conspicuous tattoos, body piercings, other than earrings or those related to religious norms must be covered or removed while at work.
- Clinical staff is prohibited from wearing artificial nails (e.g. acrylic) and nail tips. No nail jewelry is allowed. Clinical staff is required to keep natural nails short to medium length if they perform any patient care. Nail polish should be light colored to permit careful cleaning and, if worn, free of cracks and chips.
- Hair must be neat, clean and appropriately secure while on the job. Beards, mustaches and sideburns must be clean and neatly trimmed.
- Jewelry that may injure the patient during treatment or could collect materials that may harbor organisms should not be worn.
- Strong scents may cause problems for people with allergies or other sensitivities. Perfume, cologne or scented products should not be worn. If you smoke, be aware that the odor may be offensive to others.
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Unacceptable Attire
- Denim pants, skirts, dresses and jackets, with the exception of designated staff and events.
- Leather pants, skirts, dresses and shirts. Exceptions include jackets and shoes.
- Fatigues.
- Spandex or stretch clothing. Sweatpants, sweatshirts, yoga pants and jogging or track suits. Leggings, unless worn with a skirt or dress.
- Pajamas.
- Mini-skirts.
- Tank, spaghetti strap, halter, crop or strapless tops; Sheer, See-Through fabrics (unless layered with non-see through clothing).
- T-shirts, hats, any garments with slogans.
- Unacceptable footwear includes very high heels (over 3 inches), flip-flops or slippers.
- Low-cut or other types of revealing apparel.
- Undergarments must never be visible.
- Open-toe shoes.
- Open-toe and heel for field staff per DPH
NOTE:
An employee who reports to work inappropriately dressed, will be asked to go home and change and may be docked for the time not worked.
The standards outlined above will be reviewed and revised from time to time. Management may address grooming issues, with the assistance of HR, which may not be included in the standards outlined above.
If you have any questions about the appropriateness of a particular item or about these dress code expectations, you should be directed to the appropriate supervisor.
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In response to a huddle question posed by manager Geri Spina, Julie Dwyer, RN in the Needham office had this to say about professional image: I remember working in the field and it could be soo hot sometimes in the summer in those houses with all the windows closed!! I wanted to wear sandals as it made me feel so much cooler. However, I didn't because it looked too casual, and wasn't safe. I think if we want our patients to take us seriously and treat us like the professionals we are, we need to look the part. Now, as someone who works in the office and there are so many people here from all over-I still want to be respected as an RN, so I dress accordingly. - Julie Dwyer, RN
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SPOTLIGHT on Service Excellence will return next week with more amazing stories from around our organization. Stay tuned!
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AGENCY ANNOUNCEMENTS AND UPDATES
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Senator DiDomenico Sends Letter of Thanks to VNA
Please see the note below sent to us by State Senator Sal DiDomenico who represents the Middlesex and Suffolk district.
Senator DiDomenico has been a longtime supporter of our organization and routinely requests to participate in joint visits with our field staff. (Photo: the Senator joined Charlestown RN Holly Hughes this past winter to visit with a local senior)
His note mentioned wanting to welcome spring by recognizing all the efforts of the VNA in helping get the community through this past winter. Great work!!!
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"I would like to sincerely thank all of you for your efforts and dedication to those in need. Despite the severe conditions and numerous obstacles created by this past winter's historic snowfall, you have still managed to care for the members of our community who need it most.
We are very lucky to have people like you in our community. Feel free to reach out if I can be of any help in the future."
Sincerely,
Senator Sal DiDomenico
Middlesex and Suffolk District
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VNAA National Awards
(l-r: Mary Ann O'Connor, Jeanne Callahan-Lydon, Donna Peters, and Kathy Keough) | One more BIG congratulations to Adele Pike, Donna Peters and the entire Quality Team, and Kathy Keough for being recognized with national VNAA awards!
The awards were presented to each honoree at the VNAA Annual Meeting held last week in New Orleans.
Innovation Leader
Adele Pike, EdD, RN
Director of Education
Outstanding Quality Team
Donna Peters, RNC
Director of Quality & Risk Assurance
& the entire VNA Quality Team
Public Policy Advocate
Kathy Keough
Director of Government Relations
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Donna Peters accepted the award on behalf of the entire Quality Team and wanted to share her remarks from the event:
This is just an awesome award. Thank you to the VNAA awards committee. Most of all I would like to acknowledge the hard work and dedication of my staff in the quality department. Together we have made great accomplishments and improved outcomes in a short period of time. This is done by the dedication we have to the patients we service and the agency staff.
At VNACNF, quality was the first department to truly integrate and collaborate. Under the senior leadership of Jeanne Callahan Lydon and Mary Ann O'Connor, needs were identified, goals defined, new and current QA staff were on boarded and educated - clear expectations were set.
Together as a team we set the stage for a positive working environment, engagement in quality initiatives and team collaboration. It is an honor and I am so proud to work with such a committed group of individuals....Thank you so much for this recognition.
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Moving Forward Update
Issue 19 - April 22, 2015
On April 27th, we will transition from working in our medical group reporting structure to working in our new regional structure. This is the next step towards creating a sense of "Us, Atrius" and creates the foundation upon which to build our future. Working in regions will allow us to begin planning for growth, reducing total medical expenses and enhancing patient experience. We are announcing this step before the formal merger occurs on July 1st in order to reduce confusion over who is responsible for what and reduce duplication of effort.
As we have discussed previously, organizing into four regions - North, South, West and Urban/River - will be the way we will continue to provide exceptional care to our local markets. Instead of working in our legacy groups, the Senior Vice President (SVP) and Regional Medical Director (RMD) will lead the Regional Management team.The regional leadership is:
West
- Kathy Gardner as interim Senior Vice President, West Region
- Michael Querner, MD as interim Regional Medical Director, West
South
- Bob Calway as Senior Vice President, South Region
- Regional Medical Director search in progress
Urban/River
- Steve Lampert, MD as interim Senior Vice President, Urban/River Region
- Jennifer Childs-Roshak, MD as Regional Medical Director, Urban
- Eleanor Hobbs, MD as Regional Medical Director, River
North
- Bill Boyd, MD as Senior Vice President, North Region and currently as Regional Medical Director with future RMD to be determined
It is important to note that:
- Most people will not see any changes at all.
- Some people will see change, mostly in reporting and meeting structure.
- Integration work as previously described is still in progress.
Within the region, all site operational leaders will report to the SVP and all site medical directors will report to the RMD if they are in place or to the SVP until the RMD position is filled. Sites will begin working as part of Regions. Planning, Hoshin initiatives, tracking and corrective action will be done in Regions and specialties, and not in legacy medical groups. Decisions within Regions and between Regions and system functions will be made following agreed-upon decision-making roles and processes (some still in process).
What will not change on April 27:
- Employer, compensation, benefits
- Titles and job descriptions of operational and clinical leaders in sites
- Composition and roles of regional councils, where they exist
- Relationship between specialties and regions
- Reporting relationship for the site and specialty nurse leaders
- Lab, radiology, pharmacy and PT will continue to report centrally.
- Financial systems, IT systems, reports, etc. will be in process of integrating.
- We continue to use our legacy group names externally; patients will not see any difference.
New Surgeon General received training at Atrius Health
Atrius Health residency program graduate Vivek H. Murthy, MD, MBA, will be sworn in as the 19th Surgeon General of the United States today. In 2006, Dr. Murthy graduated from our Residency Program in Primary Care and Population Medicine, a training program based on a unique and innovative 25-year collaboration among three institutions: Harvard Vanguard Medical Associates, Brigham and Women's Hospital, and the Department of Population Medicine at Harvard Pilgrim Health Care Institute and Harvard Medical School. As demonstrated by the outstanding accomplishments of Dr. Murthy, residents in the program learn the clinical, analytical and leadership skills to become outstanding primary care physicians and health systems leaders. Dr. Murthy was fortunate to complete the ambulatory portion of his training under the preceptorship of one of our own accomplished physician leaders, Carl Isihara, MD, PhD, Chair of the Innovation Institute Advisory Council, member of the Atrius Health Board of Trustees and an Internist at our Braintree Site.
Our organization's long-standing commitment to medical education extends beyond our residency program with a major presence in teaching more than 60 Harvard medical students every year in multiple required clinical courses. Residents and fellows from Beth Israel Hospital, Mount Auburn Hospital, and other partnering institutions also train here in Internal Medicine and multiple Specialty departments.
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
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Congratulations to Louise Sarofeen, PT in the Gloucester office, for running her first Boston Marathon!
Louise trained hard and raised quite a sum for a wonderful cause!
Way to go!!!
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CLINICAL SERVICES
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Clinical Services Announcements and Updates
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April is Occupational Therapy Month!
By Anne Muskopf, Occupational Therapist
Occupational Therapy is a key piece of our home care team, with patient-focused, functional goals achieved through creative, holistic problem solving! To help remind you of some of the areas OTs can address in home care, consider the following scenarios:
You might need an Occupational Therapist when...
- your patient is not drinking enough water because they cannot open a bottle of water or retrieve water from the refrigerator.
- your patient sleeps on the recliner because he/she cannot get into or out of the bed (and is at risk of pressure sores).
- your patient is wearing the same clothes every time you see them, often a housecoat or robe.
- your patient's family is wondering how much supervision they need to be safe at home.
- your patient is squinting at his/her med bottles and says "I can't tell which this one is..."
- your patient doesn't wear socks even in the dead of winter and has "increased abdominal girth."
- your patient's PHQ-9 score indicates depression and especially a decreased participation in hobbies and other activities
- your patient isn't wearing their compression stockings because they can't get them on
- you have difficulty making visits simply because your patient can't operate their phone and/or door buzzer system.
To find out how OT can help, please join the Charlestown OTs for a light breakfast and show-and-tell of our "tools of the trade" TOMORROW, Tuesday, April 28th from 8-9:30AM in the Charlestown Office.
We look forward to seeing you there and HAPPY OT MONTH to all our wonderful OTs!
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Behavioral Health Update
By Molly Lukason, Behavioral Health Manager
Do you have patients that have a diagnosis of depression, early stage dementia, or anxiety? Do you have patients that are showing symptoms of anxiety or depression? Why not call on the behavioral health team to work with you in providing another valuable resource for the patient?
We are actively involved with a number of patients across the agency from Salisbury to Dorchester, working collaboratively with patients, families, doctors and all of you. The referral process is easy and seamless. For clinicians with VNAB, please follow the referral process as you would in making a referral to any discipline. For clinicians with VNACN, please call Molly Lukason at 774-502-5545. We just need a firm diagnosis of depression, anxiety or dementia to begin. We are currently able to accept patients with Medicare and Medicaid only.
Please call or email Molly at mlukason@vnacarenetwork.org or 774-502-5545 with any questions or to set up a case conference.
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Telehealth: What's in a Name?
By Kathy Duckett, Director of Population Health
With the launch of the Remote Patient Monitoring program there has been a lot of discussion around the terms telehealth, telemedicine, and telemonitoring...and which is appropriate to use for our various initiatives.
Our certified telehealth and remote patient monitoring programs are both considered telemonitoring programs in the larger field of telehealth. By using the term telemonitoring for these two programs we will be in line with language used in the broader health care environment. It will also help differentiate these programs from future telehealth efforts, such as the virtual medical visit, which would be considered telemedicine.
Below is a graphic that illustrates what has been described above:
This terminology will begin appearing on telehealth material used throughout the organization. Please contact Kathy Duckett at kduckett@vnab.org with any questions.
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Wound Documentation and Oasis Tip
By Carol Jones, Senior Wound Care Nurse
Diabetic Foot Education must be included in POC for all diabetic patients.
- After obtaining Best Practice orders from the MD, please check off YES to DM foot care in M2250 Plan of Care Synopsis on Admission and Resumption of Care.
- You will find the DM foot-teaching tool in the DM education packet
- Please check off that you have both assessed the lower extremities for lesions and taught the Diabetic Foot Care in the POC
- On discharge check YES on M2400 Intervention Synopsis, to having done the Diabetic foot Care
- If the Diabetic patient does not have feet or legs, check off N/A (not NO)
********If the patient does not have DM, the answer is N/A NOT NO *************
This needs to be done for every admission and every resumption of care, even if it has already been done before. Questions? Call Carol Jones at 888-663-3688 X1257.
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IV Update
By the Infusion Team: Beth Mena, Donna Muscente, Elizabeth Dow, Leanne Henderson
Here are some reminders about IV Care.
- For VNACN: makeup packets for the 2014 IV Update are being distributed to those qualifying nurses that missed the presentation last year. Please return the test and competency verification form to Karen Nordstrom or Beth Mena in Worcester by the date requested on the packet memo.
- ELASTOMER DEVICES (ECLYPSE BALL) don't work well when they are cold. Tell your patients to take them out several hours before their dose is due. For example: in the PM if dose is in AM or when dosing - take out for the next dose if < or = to 12 hours.
- Check outdates:
- On blood tubes. Keep tubes out of extreme temperatures.
- On meds! Patients need to be checking before giving - teach and reteach/teachback
- DO NOT TEACH PATIENTS TO ASPIRATE FOR BLOOD RETURNS. Do teach them to call with any concerns, especially if their line becomes sluggish or their med are taking longer than expected to infuse.
- Patients on therapies like Milrinone or PCA should not be flushing their lines with saline between bag changes. We teach them: " BAG to BAG"
- Almost all PICCs need to have each lumen flushed daily in order to maintain patency. Just heparin can be used but saline and heparin are sometimes used together and taught to the patient that way in the hospital. Valved lines (Groshong, PASV and SOLO brands) only need saline but heparin won't hurt and may actually help to maintain the line better. Call an IV coordinator if you have any questions.
- Central Line (PICC/HICKMAN...) Dressings: don mask and use clean gloves to remove; wash hands and don sterile gloves to apply.
- Cap changes are done weekly with the dressing change but also after every lab draw off the line. Extensions are changed weekly with the cap, during the dressing change. All new IV patients need to have a "vendor" cap applied and an extension set(s) applied when applicable. Extensions are not needed when a caregiver always does the IVT. However, adding an extension may still be prudent to prevent tugging.
- A set of "Kelley's" is kept by the senior CSA in each office or the Facilities manager at VNAB offices. If you can't get an extension or cap off a line, direct the next nurse visiting the patient to try again - Kelley's almost always work. Remember tips too.
- Walgreens/CCS is not routinely sending Biopatches and alcohol impregnated caps (CUROS or SWABCAPS). Please request these when you know a patient will be on service for 2 weeks or more.
- IV Vendor Performance is of great interest to The IV Team. Please communicate any problems you are having or if you are really impressed; let us know that too! If any vendor sends our dial-a-flow tubing for a patient on more than 10 days of an antibiotic, please let us know - maybe we can get that changed to a more reliable method!
Stay Safe Out There!
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Update to Patient Infection Surveillance Tool
By Beverly Salate, Clinical Services Manager and Infection Control Officer
Effective May 1, 2015 there will be an update to the Patient Infection Surveillance tool.
The tool is basically the same, with the addition of UTI with Foley and Wounds. Below is the tool, which is found in every skilled visit for every discipline under RISK/ADS.
Any questions on how and when to complete the tool do not hesitate to contact Beverly Salate at 888-663-3688 X6280.
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FUND DEVELOPMENT
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When a Grateful Patient/Family Member Wants to Give Back
The Fund Development team often hears from clinicians that former patients and family members want to know how they can give back. Our spring special events are an opportunity for former patients and their loved ones to show their appreciation for the exceptional care they received.
Former patients/families can:
- Buy tickets to a special event online, over the phone or through the mail
- Tell family and friends about the fundraisers
Please "refer" your grateful patient/family member to the contact person for the special event in their area:
- 21st Annual Dine Around on May 1 - Tickets are $200 per person. For more information or to purchase tickets, call Meaghan Gangi, development associate, at 781-569-2820 or visit www.vnahospicecare.org.
- Third Annual North Shore Spring Event on May 9 - Tickets are $50. For more information or to purchase tickets, please call Jane Woodbury at 888-663-3688, ext. 1362 or jwoodbury@vnacarenetwork.org or visit www.vnacarenetwork.org. (See article in this week's Connecter for more details.)
- 23rd Annual New England Coffee Golf Classic on May 11 - Cost is $250 per player. Registration form and more details at www.newenglandcoffee.com/golf or call Meaghan Gangi, development associate, at 781-569-2820.
It would be wonderful to have more of our grateful patients and their family members attend or support our events!
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Boston Globe Print and Website Subscribers: Last Chance to Help Us Get Free Ad Space
By Jane Woodbury, Vice President of Fund Development
The deadline is fast approaching for print and online Boston Globe subscribers to vote for nonprofits to receive free ad space. Submissions are due Thursday, April 30.
Known as the Globe Readers And Nonprofits Together (GRANT) program, seven-day print subscribers can donate $100 in advertising space and all other subscribers $50. We hope you will consider designating your GRANT to our organization so we can raise awareness of our services and special events. To donate your GRANT:
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- 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.
- Indicate the name and location of the nonprofit as one of the following:
- VNA Care Network with location in Danvers or Needham
- VNA Hospice Care with location in Woburn
- VNA of Boston with location in Charlestown
Note: In step #2, please do not abbreviate agency names and people need to write the full name on the voucher.
Thank you for helping us take advantage of this incredible opportunity.
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Benefit for VNA Care Network Features Live Music and Dance Demonstrations at Private Home
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Live music by pianist Nathan Johnson and Just In Time and dance demonstrations in salsa, rhumba and more are just part of the lineup for the third annual spring benefit for VNA Care Network at 7 p.m. Saturday, May 9, in a private Danvers home.
Guests will get to step inside 10 North Street, Danvers, a private home that's been featured in The New York Times and Chronicle. The residence incorporates architectural finds from mansions and other buildings throughout the approximately 13,000 square feet.
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Just In Time will bring memorable melodies from the American Songbook to life. Pianist Nathan Johnson will also perform. Johnson has been a guest soloist with the Utah Symphony, Utah Philharmonia, New America Symphony, American West Symphony and Murray Symphony.
Salsa, rhumba and foxtrot will be among the dance demonstrations during the event. Guests may take a spin on the dance floor and receive informal instruction from the evening's performers.
Live and silent auctions, heavy hors d'oeuvres and dessert round out the evening. Tickets are $50 per person and may be purchased at www.vnacarenetwork.org or by calling Beth Sobezenski at 888-663-3688, X1361.
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HUMAN RESOURCES
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KISS108 Recruitment Ads
By Ann Bohac, Human Resources Recruiter
If you are a KISS 108 listener let me know if you hear one of our ads that will be running now through April 28th for our Career Fair in Rockland, MA on April 30th. There will be more than 80 spots running between live radio and streaming so you will have plenty of opportunities to catch our ad!
The upcoming career fair is just one of the many ways we're working to recruit the very best clinicians to our organization. For more information on the April 30 event, please contact the HR Department.
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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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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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Computer Network Maintenance This Friday Night into Saturday
We have been notified by our data network vendor of maintenance scheduled to be performed on our computer network in the Charlestown office beginning at midnight on Friday, May 1. Downtime is expected to be limited to one hour and will affect network access into and out of the Charlestown, Quincy, and Woburn offices.
During this time, you may experience outages or unavailability of the following 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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The Patient & The Practice: What does OASIS Risk Adjustment have to do with this? (Part I)
By Elaine Gardner, Patient Care Manager
Practice and documentation are intertwined; the patient's condition and our care of the patient are reflected in the words we write and the boxes we check. We may feel challenged to find meaning and purpose in these words and boxes; Risk Adjustment aids in this quest.
Let's examine Risk Adjustment. The "raw" (non-adjusted) rehospitalization rate is 25% for one agency (A), and 15% for another agency (B). On the basis of these percentages, one might conclude that the care at Agency A is inferior to the care at Agency B by 10 percentage points. However, if Agency A has a larger percentage of patients who are older, have impaired vision or hearing, and/or have more frequent confusion or anxiety - to name just a few factors - then Agency A's Risk-Adjusted rehospitalization rate would be more reflective of the population served. In other words, as Agency A cares for patients with increased risk factors, the rehospitalization rate is adjusted appropriately and becomes a lower number.
Why does this happen? It occurs because in the mathematical process of Risk Adjustment, the outcomes are predicted to be impacted by the above risk factors and many others associated with disease and disability, and not only by the care of the agency.
Acute Care Hospitalization is one outcome that may be risk adjusted and thus reflect an outcome related to the natural progression of disease and disability rather than simply related to the care provided by the agency. There are many others. In fact there are 33 Risk Adjusted Outcomes (Chisholm & Krulish). You are familiar with many of these: Bathing, Ambulation, Medications, Pain, Eating, to name a few. When such outcomes are risk adjusted, many and various OASIS questions are used to "adjust" what happened with these patients over time. Thus, risk factors associated with challenges in achieving the best outcomes are embraced statistically.
Thirty of the 33 Risk Adjusted Outcomes rely heavily on the conditions of Cognitive Functioning (M1700), Confusion (M1710), and Anxiety (M1720). Answering these questions accurately gives meaning and purpose not only to these three questions but to the 30 Risk Adjusted Outcomes. This makes sense from a Practice Perspective. The patient who is anxious or occasionally confused, not only during your visit but also at some level over the past 14 days, may require extra time and attention in terms of safe transferring, or optimal bathing, or an error free method of medication management, or when to call you vs. calling 911 for a change in condition. Risk Adjustment allows us to validate the population we service, and accuracy is the key.
In 4 weeks we will provide some additional information regarding these three OASIS questions in particular: Cognitive Functioning M1700, When Confused M1710, and When Anxious M1720.
If you have any questions, please contact your Patient Care Manager in the QI Department.
Reference: Chisholm, D.L, & Krulish, L. H. (2014). INSTANT OASIS Answers 2015. Redmond, WA: OASIS Answers, Inc.
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When to Fill Out a Discharge, Transfer or Death Oasis Tool
By Maria Dunn, Patient Care Manager
Here is the guidance for answering some FAQs for these OASIS tools: M0090 -DATE ASSESSMENT COMPLETED - Transfer to Inpatient Facility - The date the agency completes the assessment after learning of the event (remember that the OASIS tool must be completed within 48 hours of learning of the event).
- Planned Discharge - Date of the discharge assessment (remember that the OASIS tool must be completed within 48 hours of learning of the event).
- Unplanned Discharge - Date of the discharge assessment (remember that the OASIS tool must be completed within 48 hours of learning of the event).
- i.e. telephone discharge when requested by patient or physician
- This date should be the last date that data necessary to complete the assessment is collected.
M0903 -DATE OF LAST VISIT - This is the date of the last visit by agency personnel (any discipline including HHA, MSW, etc.).
M0906 -DISCHARGE/TRANSFER/DEATH DATE - Discharge Date - the date patient discharged from agency per physician order (typically the same answer as M0090, the date clinician found out about the discharge).
- Planned Discharge - Date of the discharge and discharge assessment
- Unplanned Discharge - Date of discharge and discharge assessment
- Transfer Date - the actual date that patient was admitted to an inpatient facility
- Death Date - please contact your Patient Care Manager for guidance on answering OASIS questions for an OASIS Discharge due to Death.
In unusual situations or for more guidance with these or any other OASIS or QI related questions, please contact your Patient Care Manager. OASIS regulations state that the OASIS must be completed within
48 hours of learning of the event (discharge, transfer or death). |
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VNA HOSPICE CARE
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All Staff Invited to Attend Hospice Memorial Service
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