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June 1, 2015
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Volume 4, Issue 22
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SERVICE EXCELLENCE
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Service Standard of the Week
Service Recovery:
We ensure complaints are acknowledged, addressed, and proper action is taken by utilizing LEAP.
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Attributes of Service Recovery
- If a complaint arises, respond with a sense of urgency; listening carefully and empathically with your eyes, ears, and heart; and resolving the issue to the customer's satisfaction.
- Anyone who receives a complaint will own it, resolve it to the customer's satisfaction and record it. We track customer complaints to assess for process improvements.
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Service Recovery is a Team Sport
By Geri Spina, Clinical Services Manager and Service Excellence Champion
We may think that home care and sports do not seem to go together - and at first glance - there does not seem an immediate understanding of how they are correlated.
But, let's look at this a little closer
All great teams - championship teams - operate as a team. There is no one person who monopolizes the game. Each player has a strength, each player has a weakness and the coaches look for who they are - and organize the players on the team to execute the best possible outcome: which is to win that game - whatever that game is.
Here in home care we have a "game" of sorts: That is to provide the best possible outcomes and care for our patients and to deliver that care with service excellence.
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That is NOT an individual sport. It requires everyone's strengths coming together. It requires each person taking responsibility for what is expected of them, it takes keeping the patient in mind at all times. It also takes looking ahead at what might become a problem and cutting that off at the pass.
I received a call from a liaison requesting an evening IV admission. We worked back and forth and eventually set up for an AM discharge from hospital, change in dosing time and a 12pm SOC the next day that would work for all involved. The vendor was set up and would deliver the antibiotics at 12pm.
The next day all things broke down: The coordinator says the patient is still in the hospital and doesn't know when he will be going home, the Walgreen's representative says they can't deliver by 12pm, the person assigned for the admission calls in sick. Sound familiar....
Okay - one could say, we are down at half time and now need to make some adjustments. The team needs to kick it up a notch.
I pick up the phone and ask the liaison to follow through at the hospital and find out about discharge. I call the IV coordinator and ask that she speak with the vendor.
I talked to the coordinator and sort out who is going to see this patient. I speak with the clinician who eventually is set up to ensure the admission goes smoothly.
The plan gets executed, the moves on the field are made, everyone takes action. In less than one hour - with that team effort - the patient is ready for admission and is not left dealing with vendor delivery issues or missed dosing or lack of coordination with the transition home.
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The plan gets executed, the moves on the field are made, everyone takes action. In less than one hour - with that team effort - the patient is ready for admission and is not left dealing with vendor delivery issues or missed dosing or lack of coordination with the transition home.
My strengths as manager could not do this alone. I am as good as the team around me. Kudos to my Championship Team:
- Nadine Silver
- Elizabeth Dow
- Kaitlin Federico
- Anne Hourihan
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Submitted by Lori DeRosa, Clinical Services Manager from a grateful patient
I had a total knee replacement on May 1st. It was a bit frightening not knowing what to expect. I've never had a hospital stay and certainly never needed PT. But I'm so pleased with the way everything has turned out. Not only did Dr. Talmo do a great job, and NEB also was terrific but the aftercare made all the difference in my recovery.
I just wanted to write and tell you how wonderful Nigma and Richard were to me over the past 4 weeks. Nigma was amazing, she was so supportive, gave me great guidance, kept me on track and was truly a sweet and wonderful person. I looked forward to seeing her each time - and that says a lot. Having the 5 days per week was extremely helpful to me. I saw the progress every day and she was so encouraging that I wanted to do well for her. I had some difficulty with my blood pressure and some anxiety and both of them stayed right on it for me. Calling my personal physician to get information and ask questions. Keeping me calm and helping me understand what was happening.
I'm feeling great at this point and want to make sure that they are rewarded for taking such good care of me. Living alone, I truly relied on them and they really came through. Thank you so much for the great care.
Submitted by Michele Mercuri, Clinical Services Manager from CSA Brandon Plainte
Two people that allow me to do the best I can are Nancy Mandeville and Karen Larsen. Nancy is a walking encyclopedia of all things VNA and has consistently proven to be able to answer policy/procedure questions with unerring accuracy. Being a little OCD it helps when I know why something is done a certain way, so I often have questions, and Karen has ALWAYS taken the time to show me what I need to know and always with a good attitude.
You are an easy group to work for. You do important, heart-driven work that impacts grandmothers, fathers, aunts, daughters etc. that we all can relate to. You are an inspiring lot and I appreciate your dedication and ability to truly make a difference.
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AGENCY ANNOUNCEMENTS AND UPDATES
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Moving Forward Update
Issue 24 - May 27, 2015
| I am thrilled to tell you that, after an extensive nationwide search, the Board of Trustees has unanimously chosen Steven Strongwater, M.D., Chief Transformation Officer and Chief Medical Executive for Acquisition Integration at Geisinger Health, to lead our organization as we move forward into the next chapter of our pioneering work to improve the way health care is delivered. Steve clearly impressed the Trustees, senior managers, and many physician leaders who participated in the interview process with his vision, communication skills, professionalism and extensive experience as a high-performing physician executive in several large organizations.
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Steve started his medical career as a rheumatologist in Massachusetts, and then served in a number of progressive positions over 13 years at University of Massachusetts Medical Center, including as Medical Director and Assistant Chancellor. I am very excited that we were able to lure him back to Massachusetts. We are truly fortunate to have found someone who has such an outstanding record of driving cutting edge change in healthcare. I am confident that Steve, working together with the many talented individuals who comprise Atrius Health, will be able to continue to innovate and improve our model of health care delivery.
His innovation background and impressive experience makes Steve a great fit for our organization. The Atrius Health Board was impressed by Dr. Strongwater's prior experience from 2007-2011 as Chief Executive Officer of Stony Brook University Hospital, a 591-bed academic teaching hospital and the only tertiary care hospital and Level 1 Trauma Center in Suffolk County, Long Island. Currently, as Chief Transformation Officer at Geisinger, Steve has been responsible for identifying and implementing innovations to re-engineer care, redesign work processes, and improve overall value across all of Geisinger's business units, including its 500,000 member health plan, six hospitals, more than 1,200 physicians, 700 advanced practitioners and Geisinger Support Services. As Chief Medical Executive for Acquisition Integration, he developed programs and served as a liaison for newly acquired hospitals and physician practices.
Among his accomplishments, Steve initiated a system wide reengineering initiative for Geisinger Health System: Proven Innovation Drive for Excellence or "PRIDE," which realized over $70 million in improvements over the past two years. Examples of transformational projects include:
- Enterprise Pharmacy. Integration of five distinct pharmacy business units into one, saving $8.9M in the first year;
- Care Support Services. Integration of the Enterprise Pharmacy with Supply Chain, to form Care Support Services. First year Supply Chain savings totaled approximately $3M as well as $4M of capital cost avoidance;
- Model Development. Developed and deployed an outpatient "no show" risk prediction model. Proactive outreach reduced no show rates by 30% for patients contacted.
Dr. Strongwater has also served as an Advisor to the Association of American Medical Colleges; held a number of positions at the University of Connecticut Health Center, including as Associate Dean; and also served in a number of positions at UMass Medical Center, including as Medical Director, Director Clinical Resource Management, Case Management and Utilization Management, and Associate Chief Medical Officer/Associate Administrator for Quality Management.
He received a Bachelor of Arts degree in Biology from the University of Rochester and a Doctor of Medicine from SUNY Upstate Medical Center. He was a resident in Internal Medicine at SUNY Upstate Medical Center and completed a Rheumatology Fellowship at the University of Michigan.
We have been through a lot of change in the past year and have emerged as a strong, vibrant organization ready to take on the challenges of improving health care. We are confident that in Steve we have found a leader who can help us write our next chapter of breakthrough performance and build on our long legacy of healthcare excellence.
We expect that Steven will join us in late July or early August 2015. I know you will welcome him warmly.
I want to thank our Board search committee for their hard work during this search process, ably assisted by Laurel Martino, Director of Organizational Learning and Development, and our Board of Trustees for their diligence in making this important decision.
We will recognize Dan Burnes more formally before July, but I also want to take this opportunity to thank him for his outstanding service as our Transition CEO. Over the past 18 months, Dan kept Atrius Health moving forward with a real sense of mission and purpose, and we all owe him a debt of gratitude.
Sincerely,
Guy Spinelli, MD
Chairman, Board of Trustees
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Moving Forward Update
Issue 24 - May 27, 2015
As the financial areas within Atrius Health move forward with their integration work, I am pleased to announce that Rich Russo has agreed to take on a new leadership role in the newly merged Atrius Health Finance department. Rich has accepted the position of Senior Director of Finance reporting to me. Rich has been an invaluable resource for Dedham Medical Associates over the past 13+ years, and Atrius Health will be well served having Rich in this new position. Rich will be responsible for financial planning & analysis, business unit financial reporting, managed care finance, regional financial staff, and physician compensation support across Atrius Health.
Rich has been the Chief Financial Officer of DMA since September of 2001, serving as a member of the senior management team and responsible for DMA's financial and billing functions. Rich has over 30 years of experience in the physician practice and health insurance industries. Prior to joining DMA, Rich worked as an independent financial consultant and served for 10 years as the CFO of a staff and group model HMO in Rhode Island. Rich has a broad range of experience in physician practice operations, provider capitation and risk sharing, and developing physician compensation plans. Rich began his health care career at Harvard Community Health Plan in the Internal Audit department. He received his B.S. degree from Boston College in economics and operations management and his M.B.A. in accounting and finance from the University of Chicago. Currently Rich serves as a board member of the Massachusetts-Rhode Island Chapter of the Healthcare Financial Management Association.
Please join me in congratulating Rich in his new role.
Bud Stacy
Chief Financial Officer
From the Integration@AtriusHealth.org inbox and/or site comment boxes:
Question: Is VNA Care Network Foundation also merging into Atrius Health?
Answer: VNACNF remains a subsidiary of Atrius Health, working closely with the medical practices to improve patient care. Question: Will the organization continue to be an ACO after we are merged?
Answer: An Accountable Care Organization (ACO) is one that takes responsibility for both the financial and quality aspects of the care of a population of patients. This is fundamental to the way that we work at Atrius Health. We are currently planning to be part of the Pioneer ACO program or a similar new program from CMMI in 2016. Question: How do we know if specific benefits are changing and if so what the changes are? CME reimbursement, vacation/sick day time and policies, retirement benefits, etc. Answer: In 2015, each legacy organization continues to follow its own practices, as payroll, benefits, and HR systems are not integrated. In 2016 these functions will be integrated, and one consistent practice will be followed under the Atrius Health umbrella. The new benefits plan for 2016, including medical, dental, time off, retirement, etc. will be announced later this summer prior to the fall open enrollment period.
Question: When integrated, will there be tuition reimbursement?
Answer: Yes, there will be tuition reimbursement.
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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CLINICAL SERVICES
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Clinical Services Announcements and Updates
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Ethics Committee Update
I am pleased to announce the Ethics Committee membership which spans across the entire organization. New members include:
- Vicki Falcon, RN, Hospice Nurse, Needham office
- Christine Bauler, RN, Admission Nurse, Southborough office
- Nancy Hazeltine, RN, Hospice Case Manager, Needham office
- Beverly Salate , RN, Clinical Service Manager, Leominster office
- Meryl Johnson, MSW, Hospice Liaison, Woburn office
- Michele Rosenthal, RN, Manager of Clinical Orientation and Education, Southborough office
They will be joining the current Committee members:
- Elaine Buckley, RN, (Chairperson) Patient Service Manager, Charlestown office
- Patti Darling, RN, (Co-Chairperson) Office Nurse, Charlestown office
- Gaille Anderson, RN, Staff RN, Charlestown office
- David Quemere, MSW, Psychosocial & Spiritual Manager, Needham office
- Karen Patterson, PT, Rehab Services Manager, Needham office
The members will be able to support the entire organization by discussing difficult ethical dilemmas that clinicians are experiencing in providing clinical care. The group meets every other month and can get together quickly if an ethical issue arises sooner.
To activate the committee please email ebuckley2@vnab.org or pdarling@vnab.org.
The meetings are held in the Charlestown office and others can participate through a conference call. The next meeting is June 25 from 2:30 to 4pm.
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Safe Side Committee Reminder
To all discipline admitting clinicians
The Safe Side Committee would like to remind you that it is an agency expectation at Start of Care to:
- Notify the patient's physician that we have admitted their patient to our service
- Ensure the physician will be physician of record and will sign 485 for follow up services
- Describe the patient's current health problem and your Plan of Care including Best Practices, visit frequency and any issues with medication reconciliation
If this cannot be completed at the time of admission, then a plan must be made for the physician to be notified the next business day (Mon- Friday).
Members of the Safe Side Committee include: Maureen Beauregard, Marilyn Bowden, Jeanne Callahan-Lydon, Sandra Cotanche, Kathy Duckett, Shannon McInnis, Mary Ann O'Connor, Karen Patterson, Joan Roth, Beverly Salate, Paula Schultz, Geraldine Spina, Caroline Walton, and Anne Zettek-Sumner.
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Hand Hygiene and Bag Technique
By Susan Stiller, RN
Hand Hygiene and Bag Technique go "hand and hand" to promote patient safety!
Did you know infectious pathogens can live on and inside your clinical bag? A study done in 2009 found 84% of the outside of bags and 48% of the inside of bags cultured positive for human pathogens. Some of these were multidrug resistant organisms like MRSA.
It is important, on a periodic basis, to remove all contents of your bag, cleaning the inside and outside with a disinfectant wipe to reduce microorganisms that could spread to your patients or yourself. It is also paramount also to perform hand hygiene at key times to reduce infection transmission. These are the times:
- Before entering the inside of the clinical bag - be sure to have the alcohol hand gel in an outside compartment of the bag so it is readily accessible. Perform hand hygiene, and then enter the bag to remove needed supplies.
- Before reentering the clinical bag during patient care - "OOPS I forgot my tape measure and I am in the middle of a dressing change" - use the alcohol hand gel first to clean hands, and then go into the bag. Otherwise, you will transfer pathogens from the patient's skin and wound into your bag which will be ready to take a hike to another patient via your hands or supplies.
- After cleaning and disinfecting reusable supplies and returning them back into the bag, perform hand hygiene.
Consistently practicing these steps will help to keep your patients and you safer from infections.
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HHA Corner
By Elaine Buckley, Patient Services and HHA Manager
I have recently attended a few team meetings and received some great feedback around home health aide services. Over the next few weeks, I will be communicating important HHA information through the Connecter. Please let me know if you have any questions at 617-886-6550 or EBuckley2@vnab.org.
HHA Assignments
- The patient should receive the HHA assignment in the mail. It is sent in a VNAB envelope with a HHA department stamp under the VNAB logo.
- Please be detailed when filling out the HHA assignment sheet. Suburban does a nice job to match the skill of the aide up to the patient's needs. When filling out the assignment, think about what you want the HHA needs to know to take care of the patient
- Use direct intros when you anticipate any problems that may occur. Patient satisfaction improves significantly if the HHA and pt/family member hear the same information at the same time.
- During visits, please ask the family if they have received the HHA assignment and make sure it is kept in the VNAB folder.
- Try to make contact with the HHA. One suggestion is to ask the family to have the aide call you when they are at the house. If any clinician discovers a HHA is not in the home at the time of the schedule, please let Elaine or Merle know. The HHA schedule can be found under notes in the "customer/patient" section
HHA Supervisions
Our April audits are showing a lapse in HHA supervisions every 14 days. Please remember to supervise the HHA every visit. We are finding when this gentle reminder goes out on a regular basis, the HHA Supervision compliance improves.
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FUND DEVELOPMENT
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North Shore Spring Event Raises Over $37,000 for Home Health Care
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The North Shore Community Cabinet of VNA Care Network recently raised over $37,000 for home health care services during their third annual spring benefit at a private Danvers residence.
The evening featured music by Just In Time and pianist Nathan Johnson. Dance demonstrations in salsa, waltz, rhumba, and cha-cha inspired guests to get on the dance floor, where they received informal lessons from the evening's performers.
(Photo: Paula Schultz, director of clinical services and Mary Ann O'Connor, president and CEO)
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The third annual spring benefit for VNA Care Network was generously supported by:
Gold Sponsors
Byram Healthcare
Mutual of America
TD Bank
Silver Sponsors
Institution for Savings
Ropes & Gray
Bronze Sponsors
Donald E. Kowalski, DDS
Mohr Partners
National Grand Bank
Windstream
Friends
Melick & Porter, LLP
Salem Five
Senior Helpers
Elizabeth Sobezenski, development assistant, and Jane Woodbury, vice president of fund development, worked with the all-volunteer North Shore Community Cabinet to organize the event. View more photos on Facebook: www.facebook.com/VNACareNetwork
Grateful Patients and Families Can Get Involved
Many members of our Community Cabinets and Friends groups have directly benefitted from our home health and hospice care. If you have a former patient or family member who wants to give back, please contact Jane Woodbury at 888-663-3688, ext. 1360 or jwoodbury@vnacarenetwork.org. Volunteers help raise awareness of and funds for our services across Eastern and Central Massachusetts.
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HUMAN RESOURCES
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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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Job Postings - VNA Care Network and VNA Hospice Care
To learn more about career opportunities, contact a human resources representative:
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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
- Kelly Frew
- 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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INFORMATION SYSTEMS
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IS Maintenance
The IS Department is scheduled to perform routine maintenance on VNA Care Network's computer network Wednesday evening (June 3) from 8-10pm.
During this time, you may experience brief interruptions or unavailability of the following services and technologies:
- Access to Encore
- Access to network folders and files
- Email for VNACN-based email users (e.g. XX@vnacarenetwork.org)
Please plan accordingly and feel free to contact the MIS department with any questions or concerns.
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Changes to the Expiring Password Process
Great News! We have improved our expiring password(s) notification system. As of June 1, 2015 we will be eliminating the reminders sent out via voicemail and interoffice mail. This will be replaced with two emails - one at least 14 days prior to expiration and then a second 1 week later.
When you receive this email, you should update both the network password and your smartphone password as soon as possible, but no later than 5 days after the final notification.
The goal is to make sure all employees receive advance notice that the password will expire and have the opportunity to update it to a new one. Please remember, that all laptops must be communicated at least once every 14 days or they will be made inactive.
Please see below for a sample of the message you will receive. If you have any questions please contact MIS.
Dear George Richardson,
Your Windows password will expire in 5 days.
This message is a reminder that your VNACN network password will be expiring soon.
Please come into the office to change your VNACN network password within the next X days to avoid being locked out of your network resources. This would prevent you from connecting to the VPN and being able to communicate your laptop and/or affect your ability to check email from your Smartphone, iPad or laptop.
If you have an iPad and/or an iPhone, you must also update your password on each device under Settings --> Mail, Contacts, Calendars --> Exchange ActiveSync --> Your email address --> Password. This must be done after you update your Network Password.
If you need instructions on how to change your password, please contact your local IT support person.
Thank you
VNA Care Network MIS department
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QUALITY AND RISK MANAGEMENT
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When is a Surgical Wound Healing by Primary Intention Considered Healed?
By Marilyn Bowden, Patient Care Manager and Carol Morris, Patient Care Manager
Throughout the month of June, OASIS education classes will be held across the organization and this question will be discussed at length. In preparation for this education session, the QA Department wanted you to have information ahead of time to become more familiar with the answer.
CMS guidance notes that a surgical wound healing by primary intention is considered healed when the surface of the wound has been epithelialized for approximately 30 days.
How does one measure approximately? With the guidance of Judy Sojack, RN, WOCN and Carol Jones, RN, WOCN there is now a more simplified method for answering M1342 Status of Most Problematic Surgical Wound that is Observable.
For VNAB clinicians, this information has been altered but the concept is unchanged. For VNACN clinicians this is new information.
When trying to answer M1342 both at SOC/ROC and DC, use the guidelines below and you will be well on your way to an accurate answer.
Questions? Contact Marilyn Bowden at 978-777-6100 x1271 or Carol Morris at 617-886-6435.
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2nd Quarter OASIS Education
Below is the Quarter 2 OASIS education schedule for all offices. Our topic this quarter is Wounds. Mandatory attendance is expected for all clinical professionals. You may attend any site but be sure to sign in on the attendance so you will get credit for attendance. If you do not attend any of the sessions, you will need to complete the makeup test and have a meeting with the PCM in your district to be sure you are understand the Q2 content.
The Quality Department is committed to ensuring the CMS guidelines are used in our clinical practice to our patients. Thank you to all our staff for their continued clinical commitment to understanding OASIS and reaching for the best outcomes for our patients.
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VNA HOSPICE CARE
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How is Palliative Care Different from Hospice Care?
Many people confuse hospice and palliative care, thinking they are one and the same. Although they share a similar philosophy, the delivery of care is different.
Palliative care services do not depend on life expectancy, are best introduced early in care, and may be pursued at the same time as curative efforts. Palliative care is an option for a person of any age who has a serious illness. For example, someone may want palliative care while getting treatment for heart failure. Palliative care could also help someone manage symptoms or side effects of treatment so that they will feel better. (Source: WebMD)
Hospice care provides medical services, emotional support, and spiritual resources for people who are in the last stages of a serious illness, such as cancer or heart failure.
You may talk about anything and everything during a palliative care visit, including:
- Treatment
- Pain and medicine side effects
- Emotional and social challenges, such as helping your family get along better
- Spiritual concerns
- Goals and dreams
- Hospice care
- Advance directives
For questions regarding palliative care, contact Robin Wilson, Palliative Care Services Manager, at 781-569-2869 or rwilson@vnab.org.
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