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July 13, 2015
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Volume 4, Issue 28
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SERVICE EXCELLENCE
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Service Standard of the Week
Professional Language:
We communicate with respect and courtesy to colleagues and patients. We address patients, families, and customers based on their preference, using Mr., Mrs., Ms. or their preferred name.
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Understanding the Impact of Your Words
By Geri Spina, Clinical Services Manager and Service Excellence Champion
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It is pretty likely that most of you who read this would say you have either heard the phrase or the phrase was directed to you: "I am going wash your mouth out with soap"
And, while some of us might have ACTUALLY had that happen - the intent behind that action was meant to deliver a message: What you say has an impact - and that impact can be positive or negative.
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We work in an industry that is "fraught" with opportunities that can send even the most levelheaded individual to the edge of their own frustration.
We are human after all - and there will always be times we may say the wrong thing, lash out, and perhaps be insensitive to what others may need. But, then we have "language" that actually has the ability to repair, to heal, to make right what was wrong. And, not just to stay out of trouble or to look good for the boss - but because we have the ability to do the right thing and say the right thing at any time.
- Thank you
- I'm sorry
- I respect you
- I didn't understand - how can I make it right
- I acknowledge you
- Please
- Hello
- Let me help you
At any given time, these may be the exact words someone needs to hear. This week I invite you to actively take on bringing these words into action and share with each other the difference it makes. Let's all make this standard STAND out for you and others.
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Lori DeRosa, Clinical Services Manager in the Danvers office, shared this note from a very grateful patient of Steve Pallazola.
Dear Lori - It is my pleasure to bring to your attention as the VNA Care Network Clinical Service Manager that you and I are fortunate to have in your staff Steve Pallazola who guided me through not one but two knee post-surgery physical therapy processes during the past year.
I received a partial right knee replacement from Dr. Richard Scott at New England Baptist Hospital on October 9, 2014, and a full left knee replacement by Dr. Scott on June 9 of this year.
Steve cared for me at my home for most of the sessions after the first operation and for all sessions after the second. I regard both physical therapy routines highly successful and crucial to very healthy recoveries.
Steve functioned in a most professional, knowledgeable, and caring manner during all sessions He actually made them interesting and , do I dare say , fun; his dry sense of humor and encouragements were priceless---yes , even when those stair and chair stretches pushed me to my limits --- my fortune.
As I write this, my right knee is as good as new and the left knee is well on its way to full recovery by the end of this month. I am about to retire my one crutch any day ---and getting started on golf (putting and chipping for now )---and on schedule to rejoin my Monday league in August. Thank you Steve.
My thanks also to your nurses who, very professionally, setup the physically sessions and removed the sutures (Scott's knots).
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AGENCY ANNOUNCEMENTS AND UPDATES
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Virtual Medical Visit Program Launches
By Kathy Duckett, Director of Population Health
Want to speak with the patient's MD/NP in real time and truly collaborate on patient care WITH the patient as an active member of the team? Want to work on a new program to decrease unnecessary ED visits and hospitalizations for our most fragile patients? Want to learn a new and creative way of providing home health care?
An exciting new 6-month pilot program will begin in the fall in the south region of our service area. This cutting-edge pilot program is looking for nurses who are interested in a new way to provide home health care for our most fragile patients who, for many reasons, cannot get to the MD office for a visit and end up back in the ED or hospital. Now we can bring the MD/NP to them in the comfort of their home.
Working with the Atrius Health offices in Braintree, Quincy, and throughout the Granite Medical service areas, our Virtual Visiting Nurse will start with a home visit and add technology such as an electronic stethoscope, electronic spirometer, portable EKG, and a web camera to provide additional assessments which are uploaded and shared with the Atrius MD/NP. Then a real-time consultation visit occurs between the nurse, the patient, and the MD/NP to determine what interventions are needed. Finally, the nurse teaches the patient interventions discussed.
Does this sound like the way we want to provide care to our patients? If you are interested in being a part of this pilot program, please contact Kathy Duckett at kduckett@vnab.org for more information.
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CLINICAL SERVICES
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Clinical Services Announcements and Updates
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Behavioral Health Update
By Molly Lukason, Behavioral Health Program Manager
Success stories continue with the Behavioral Health Program now that we have been running strong since the beginning of March. Our Behavioral Health clinicians, all RN'S, who have been trained in Cognitive Behavioral Therapy techniques, are making incredible strides with patients who have depression, anxiety and early onset dementia. Our success stories are now part of many presentations to insurance groups, hospitals and other community collaborations who are realizing the importance of a healthy mind with a healthy body.
The Behavioral Health Program accepts all patients with Medicare or Medicaid, have a documented diagnosis of depression, anxiety or early stage dementia and are medically stable. Our clinicians can be in at the same time as Skilled Nursing, PT or OT. Please call Molly at 774-502-5545 with any questions or referrals.
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NEW Education Portal
The VNA Care Network Foundation's Education Portal has undergone a recent upgrade. I want to thank everyone for their patience during the transition. Here are a few key features of the new website. If you should run into any issues or have any questions, please contact Brielle MacDonald, Education Department Coordinator at 508-786-0693 X5633.
First Time Logging In:
You will need to reset your password the first time you log in. Click on the link that says, "Accessing the portal for the first time? Click Here". Then follow the steps.
After You Log In:
- Dashboard Tab - There are now 2 tabs that show: Required Trainings (Annual Competencies) AND Optional Trainings (new hires will find their Core Orientation modules here).
- Reports Tab - Will show all the tests that you hav completed on the Education Portal. Managers can continue to look up their staffs scores here.
- FYI - previous tests/grades will not appear, however, your history of previously taken tests are still on file with Brielle MacDonald. If you have any questions or need information regarding this, please contact Brielle MacDonald X5633.
- Training Library Tab - Will show you ALL the modules and resources that we offer on the Education Portal for your information. Categories can expand/collapse.
- Resources Tab - Information such as FAQ, Customer Service, and Events will be listed here.
We are close to merging the VNA of Boston's Home Care Central/Simmons website into the VNA Care Network Education Portal and giving all staff access to the full range of resources both agencies offer . . . so be sure to look for the announcement in the Connecter about our combined, powerful, Education Portal!
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Organization for Home Health Clinicians
By Kyra Mihalick, PT, DPT, Patient Care Manager
"I need to write down this physician's verbal order, where is my pen? Do I even have a pen in my car? I think I left my only one in my last patient's home."
"I have an admission today and don't have time to run to the office. I really hope there is an admission book somewhere in my trunk because I gave out my last one yesterday."
"Do I have time for lunch today?"
"My cell phone battery died and now I don't have my manager's phone number."
Does this sound like you? If it does, you might be a home health clinician. You might also benefit from a few hints and tips to stay organized in your office (aka your car!).
Reference: 10 Tips for Being Organized in Home Health: In Your Work, Car, and Office. OT Practice Magazine. March 9, 2015. http://www.aota.org/Publications-News/AOTANews/2015/organized-tips-car-work-office-home-health-OTP.aspx#sthash.7PbOEeX0.dpuf. Accessed June 17, 2015.
*info-graphic available for free on the above website
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Reminder: McKesson System Upgrade for VNAB Home Care THIS WEEK
By Kathy Schuft, Clinical Application Specialist
The McKesson upgrade has been scheduled for the night of Wednesday, July 15th. There are two additional articles regarding changes after the upgraded in this Connecter titled:
- Changes to McKesson for Home Care after Update - Revised
- Critical Article Regarding Password Changes - All Home Care McKesson Users MUST read
There is also a small work-around posted for rehab service orders mentioned in the first article to overcome a problem detected during testing. These are the details regarding the upgrade:
Here is what you need to know about the night of the update:
- The system will be shutdown at 9pm sharp on Wednesday, July 15th
- During the shutdown the following systems will be unavailable:
- Horizon Homecare for VNAB and Hospice
- TeleHealth Interface
- WebChart
- Web Referrals
- iPad Users and Office Staff:
- You must be signed out of the system by 8:45pm to avoid losing any documentation
- Please do not log on again before 6am the next morning
- Laptop Users:
- Full detail and instructions regarding the ESD transfer will be communicated in an email.
- As you are already aware the ESD transfer will need to be performed in the office via network cable and will take about 30-45 minutes. Further detail to follow.
If you have any questions please contact Kathy Schuft at 617-886-6968 or kschuft@vnab.org.
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Changes to McKesson for Home Care after Update - Revised
By Kathy Schuft, Clinical Application Specialist
The McKesson system will be updated the night of July 15th. Listed below are changes that will affect clinical staff in home care. Please note that I have added information about rehab service orders. Also see separate article regarding password changes.
Homebound status - McKesson has made changes to the homebound status screen in the SOC/ROC and Recert Oasis. These changes caused them to move the DME screen to the screen prior to homebound. VNAB clinical staff should continue to document homebound status in the care plans in Orders rather than using McKesson's homebound screen.
Additional Flags - McKesson has added flags to M1400, M1230, M1306, M1322, and M1330. Remember that when you answer a question in an Oasis after start of care the system will add a color to the answer to indicate whether the patient has improved (green) or the patient has gotten worse (red). No color means no change in condition. Yellow means the answer is inconsistent with a previous Oasis. Here are the titles to each question.
M1400 - Respiratory question
M1230 - Speech and oral expression question
M1306 - Pressure ulcer question
M1322 - Pressure ulcer stage 1 question
M1330 - Status ulcer question
Infection Disease Screening in Profile - McKesson has added a hyperlink in Profile that will give clinicians a place to document whether the patient has traveled to a foreign country recently and may have been exposed to an infectious disease. The Quality Department is in the process of evaluating this new screen and will let you know of any change in policy.
A1c Documentation - McKesson has added a place to document a diabetic patient's hemoglobin A1c to meet the new regulation. If you are unsure or unaware of the new regulation please read Joan Fall's article in the June 9th Connecter. The new documentation area can be found in the SOC/ROC and Recert Oasis under Endocrine.
Rehab Service Orders: When rehab staff write service orders for Medicare patients the system gives you the ability to see when the 30 day reassessments are due by allowing you to check a box marked Show due dates. This places a blue line on the dates when the reassessments are due. If you add a reassessment service code to a visit on or before that date it will add a longer blue line to let you know you now have a reassessment visit scheduled. During testing we discovered that the service code will not always assign to the red boxes that have the blue line.
Here is all you need to do: Anytime you assign the service code make sure the Show due dates box is uncheck. You may recheck it if you would like to see the due dates again.
 Password Changes - IMPORTANT: Please read article regarding password changes after the update. |
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Critical Article Regarding Password Changes - All Home Care McKesson Users MUST Read
By Kathy Schuft, Clinical Applications Specialist
ALL staff will be prompted to change their McKesson password after they sign in using their current password. For laptop users this will happen after the ESD transfer. The new password will be case sensitive. When changing the password please follow the same guidelines set by our agency as listed below.
***IMPORTANT: Only change your McKesson password at this time. DO NOT attempt to change your network password until the appropriate time (after you have received the usual email telling you it is time to change your password). All Agency staff are on a password change scheduled which cannot be interrupted. Once you have received the email to change your network password which can be anywhere from now to 90 days from now you may also change your McKesson password again at that time so that the two password match. This should be your standard procedure -anytime you change the network password change your McKesson password also. See pictures at end as a guide.
Change McKesson Horizon Home Care Password:
- Open McKesson Horizon's Home Care with your User Name and current password
- You will be prompted to change your password
- Follow the prompts: Enter old password, then new password twice using the agency guidelines:
- Must be at least 8 characters but no more than 12 characters
- Must be alphanumeric with at least one letter capitalized
- Must have at least one of these symbols: ! @ # $
- Do not use any other symbols
- Click OK
- Using the X, close the password change window
- Close out of Horizon's Home Care
- Re-sign into Horizon's Home Care using the new password
- If you are on a laptop you must transfer after you change your password
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FUND DEVELOPMENT
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Karen Webber Honored by NSCHN
| Karen Webber, development officer, was recently honored upon the completion of her tenure as the co-chair of the North Shore Community Health Network (NSCHN).
The organization is a coalition of local health and social service providers striving to reduce health disparities and to increase access to health and community resources. NSCHN represents the North Shore as part of the statewide Community Health Network Agencies (CHNAs). Karen has been involved with CHNAs since 1998 and co-chaired the NSCHN from 2012 to 2015.
The NSCHN presented Karen with a plaque in recognition of "her dedicated service and leadership."
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Get Ready to Step Out for Hospice During Annual Walk/Run
Woburn Friends of VNA Hospice Care are planning the 18th annual Step Out for Hospice on Sunday, Sept. 27, in Woburn.
Children ages 13 and under can join the 1-Mile Fun Run beginning at 11:30 am. The Fun Run is free, and kids are eligible for prizes and ribbons.
The 3-Mile Walk starts at noon, and 5-Mile Road Race at 12:30. Preregister for the Walk or Road Race now for $30 at http://vnahospicecare.kintera.org/stepout2015. Step Out for Hospice sweatshirts are guaranteed for entries received by Sept. 23. Entry fee includes the "after party" with live music and dancing, chowder, hotdogs, and more. Register on the day of the event for $40.
Walk or run as an individual or form a team. Fund Development can help you spread the word by publishing your team's info in an upcoming edition of the Connecter. Contact Meaghan Gangi, development associate, at 781-569-2820 or mgangi@vnab.org.
The Woburn Friends sport their Save the Date T-shirts. Front row, left to right: Meaghan Gangi, development associate for VNA Hospice Care, with Cathy Callahan, and Ann Mooney. Back row, left to right: Bob Maguire, Joanne O'Brien, Barbara McElhiney, Connie McGilvray, Lillian Capozzola, and Joe McDonough.
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HUMAN RESOURCES
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Mutual of America Onsite in Weymouth
Michael Maguire, our Mutual of American retirement plan representative, will be in the Weymouth office on Monday, July 20, 2015 from 8:00AM to 3:00PM.
To make an appointment to meet with him please call 508-366-2418 or email him at
michael.maguire@MutualofAmerica.com
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VNAB/MRI Benefit Eligible Staff
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Education Benefit Reminder
An Application for paid education time and reimbursement for payment of day programs or tuition/certification programs must be submitted in advance to the Human Resources Department in Weymouth for approval/disapproval. The appropriate form (available in district offices) must be:
- signed off on by your manager
- have documentation attached showing content of program/course, and
- how much the program/course will cost
All information should then be submitted to Human Resources. The employee will be notified if their request has been approved/disapproved. If approved, once program/course is finished you will need to submit proof of attendance/passing grade and payment to Human Resources.
This procedure requires planning on your part. Request approval before you sign up or pay for any program for which you plan to seek reimbursement from the company. Please contact Sue Schroepfer at sschroepfer@vnab.org with any questions.
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Employee Referral Bonus up to $5,000!
Employee referrals are often the most successful way for us to find the best candidates for open positions. Demand for physical therapists and nurses continues to be issue throughout the industry and the VNA is no exception.
In order to attract and retain new RNs and PTs, we are offering an employee referral bonus of up to $5,000!!! Certain conditions apply and the bonus will be paid in equal installments to eligible employees at the new recruits three and six month anniversaries.
Please contact Cheryl Milas at cmilas@vnacarenetwork.org or Debbie Brown at dbrown@vnab.org for more information.
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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:
- Kelly Frew
- Mary Helen Mahoney
- 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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QUALITY AND RISK MANAGEMENT
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The Following Scenario is From the April 2015 CMS Q&As
By Marilyn Bowden, Patient Care Manager
Scenario: At SOC, patient's daughter is present and reports she is leaving in three days. There will not be a regular caregiver present after that. How should M2102 - Types and Sources of Assistance be answered?
Guidance from CMS: - Answer what it known on the day of assessment about ability and willingness of caregivers to provide help in the categories listed under Types of Assistance
- [ADLs (shown), IADLs, Meds, Procedures, DME, Supervision and Safety, Advocacy]
- Use clinical judgment to determine how long the episode of care is expected to be
- If the relative is staying to care for a week, and clinician expects to see the patient for 5-6 weeks, temporary presence should not be considered when collecting a response
- If the relative is staying to care for a week, and clinician expects the patient to transition to outpatient services within a week or two, temporary presence should be considered for M2102
In the scenario above, either (3) or (4) in the red box above would be a correct response depending on the specific situation.
The same approach can be used in M1100 Patient Living Situation Row a. Patient lives alone. In this item Availability of Assistance refers to availability and willingness for the upcoming episode. Compare anticipated length of the upcoming episode with how long a temporary caregiver will be available. - If caregiver is available and willing for the anticipated episode duration, then (01) Around the clock is the correct response.
- If, as in the scenario above, the caregiver is available for less than the anticipated episode duration, then (04) b is the correct response.
Contact your Patient Care Manager via email or phone with any questions about these questions or any other OASIS related questions.
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VITAMIN B-12 INJECTION REMINDER
Vitamin B-12 injections are considered specific therapy only for the following conditions:
- Specified anemias: pernicious anemia, megaloblastic anemias, macrocytic anemias, fish tapeworm anemia;
- Specified gastrointestinal disorders: gastrectomy, malabsorption syndromes such as sprue and idiopathic steatorrhea, surgical and mechanical disorders such as resection of the small intestine, strictures, anastomosis and blind loop syndrome, and
- Certain neuropathies: posterolateral sclerosis, other neuropathies associated with pernicious anemia, during the acute phase or acute exacerbation of a neuropathy due to malnutrition and alcoholism.
Insure that one of these in your diagnosis listing for your patient receiving Vitamin B-12 injections as part of their Home Health Plan of Care.
ENCORE USERS
TO UPDATE (ADD, REMOVE OR CHANGE) ANY DIAGNOSES
INCLUDING AT ROC or RECERT
- E-mail your request to BOTH Chris Schultz and Shamala Rao (addresses below) in Outlook. Your request will be processed by one of the certified coders within one working day!
QUESTIONS?
Please contact your Patient Care Manager (listed below) for assistance!
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QI SUPPORT
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Covering Office
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Name
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Email
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Office Phone
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Position
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All VNAB
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Hughes, Kim
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kcao@vnab.org
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617-886-6501 x5419
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QI Support Coordinator
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All VNACN
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Schultz, Chris
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cschultz@vnab.org
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617-886-6501 x6527
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QI Support Coordinator
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All VNACN
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Rao, Shamala
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srao@vnacarenetwork.org
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508-756-7176 x6876
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QI Nurse
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VNA Care Advantage at New Horizons
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