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CONNECTER
ARCHIVES
Below is this week's issue of the Connecter newsletter, which is required reading for all employees. The next edition will be published on Monday,
May 23, with articles due to connecter@vnacarenetwork.org by Friday, May 20.
IN THIS ISSUE:

SERVICE EXCELLENCE
May 16, 2016
Volume 5, Issue 20
SERVICE EXCELLENCE
SEStandard
Service Standard of the Week:
Service Standard #8: Workplace Safety

We assess and maintain a safe work environment.

Here are some behaviors that demonstrate standard #8:
  • Think safety first. Each employee is responsible for assessing and maintaining a safe work environment for staff and patients.
  • Be aware of all safety procedures, and report unsafe situations to your manager immediately.
Huddle Topic Suggestions:
SEGroup
Service Excellence Champion Group

The Service Excellence Champion group meets monthly to discuss ways to further our organization's commitment to exceptional service excellence.

Key Initiatives Being Worked On:
  • Improving patient experience
  • Initiatives to improve patient CAHPS outcomes
  • Town Hall Meetings
  • Streamlining communication methods and tools
  • Huddle strategies
  • Ongoing Service Excellence training
  • Staff professional growth opportunities
Please contact the Champions listed below if you would like to have an initiative or issue reviewed at the next meeting. Thank you!
  • Ann Bohac
  • Debbie Brown
  • Katie Callahan
  • Jen Casper
  • Simone Charpentier
  • Lori DeRosa
  • Wendy Drake
  • Jill Enwright
  • Kelly Frew
  • Dave Hanley
  • Brielle MacDonald
  • Cheryl Milas
  • Mary Ann O'Connor
  • Adele Pike
  • Lorraine Potter
  • Dave Rose
  • Geri Spina
  • Charlvic Williams
Spotlight

Submitted by Tracy Gorham, RN in the Southborough office

I would like to say a thank you to Sean C. in the IT department. He is always so helpful when I have issues with my computer or my iPhone. I feel like there has not been a time that when I have needed a question answered or a problem fixed that he has not been able to help me. Thank you Sean for all your help!


Submitted by Maryam Lempke, RN in the Worcester office

I wanted to take a moment to express my deepest appreciation to two special people who happen to be amazing nurses and wonderful co-workers. I am relatively new to nursing (five years, this summer), and even newer to home care. I started with the VNA last June, and up to that point my only experience in home care was pediatric private duty cases.

You know how they say the teacher makes all the difference? It is so true. Michele Flanagan has been my preceptor since last July and she has made all the difference in the world to my success with the organization. Michele not only knows the job and does it exceptionally well; she also has a passion for the work that is inspiring to others. She lights up the day of anyone who she meets with her positive energy and upbeat spirit. I have been so lucky to have been able to spend much one-on-one time with her and although I am now seeing my own patients, she is always available if something I am unsure about happens to arise.

The other person who has been pivotal to my success is Linda Korczynski, the weekend coordinator. Linda goes above and beyond to ensure that the needs of the patients, the organization, and her nurses are met. She has a hard job and she does it well. She genuinely cares for others, especially her weekend staff and I couldn't be more appreciative. We all have hard days and tough schedules at times, but it makes all the difference knowing that someone like Linda has your back. I love my job, and this is in no small part due to these two ladies. So, with sincerest appreciation, thank you.


Submitted by Maria Dunn, Patient Care Program Manager

Kendra Abreau, Worcester clinician, recently thanked Shamala Rao, QI Nurse, for her assistance with providing direction with fee source change documentation.


Submitted by TylaAnn Burger, Hospice Clinical Services Manager

Early Friday evening (shortly before 5:30PM) our triage RN was locked out of access to all clinical information when her iPad reset. This meant she had no access to the clinical records of approximately 200 families she was responsible for triaging. As you know, hospice triage is an active 24-hour service and 5:30PM is generally a peak period. What could have been a very difficult situation was responded to by a group of VNA Care staff members. As admin-on-call, I would like to thank them all for the following:

When Bev Robinson found herself locked out she immediately called IT on-call. John Severin reported he could do nothing to rectify this situation, but would check on options. Bev called me to report the situation and headed for the office. John confirmed that the iPad would have to be rebuilt by an IT staffer. He reached out to Cathy Langone who volunteered to come in to Woburn and rebuild the iPad. She was not on-call and did not have any obligation to come in. She was here before Bev arrived. She was positive about her ability to help the situation and the need to come in.

In the meantime, Clinical Ops staff members: triage nurses Nancy Monaco and Theresa Gilbert, as well as CSA Linda Verdeja immediately responded to both wrap up the day and cover triage simultaneously. They arranged to transfer calls from the service and started to handle calls even while they completed the days status reports and arranged follow-up for day time issues.

Bev arrived at the office, Cathy immediately went to work. I set Bev up on a desktop machine and she started back on triage. She was a little disconcerted by the unfamiliar setup and the events - so the office staff continued to clean up a few of the issues while she took new calls. All three Clinical Ops staffers stayed well after their time ended, were positive in their response to Bev and the situation. All calls that came in during this time were professionally managed by either Bev or the Clinical Ops staff.

When work on the iPad was completed, Cathy stayed to make sure Bev was fully operational. Calls had quieted and she left the office with triage active shortly before 7PM.

The staff members made what could have been a major disaster into an excellent team experience. John Severin started the process by quickly identifying a needed resource. Cathy responded when she did not have to - and made it a positive experience. Nancy, Theresa and Linda showed how the Clinical Operations staff do indeed know what team work is. Bev responded appropriately to an unexpected situation and, afte a short hiatus, returned to her work with the clear support of her fellow staff members.

I am pleased and proud to work with these individuals.


Please send your notes of praise and recognition to connecter@vnacarenetwork.org.


SCENES
Scenes from the Street

Share your pictures from the office or the field with us by sending them to connecter@vnacarenetwork.org!



Folks are loving their new VNA Care vests and wearing them with pride!

Nick Wildi, Physical Therapist out of the Needham office, modeling his new VNA Care! Pairing it with his VNA branded clinical bag, Nick is no doubt inspiring confidence of his ability to all his patients...nice work Nick!

Cathy Langone, PC Tech
Hospice Medical Records: (L-R) Joanne Burke, Sandy Hardy, Marj Doyle, and Amy Murgida

Hospice Clinical Operations: (L-R): Pat Krupcheck, Nancy Monaco, Susan Higgins, Linda Verdeja, Colleen Lisacki, Cheryl Bettencourt, and Theresa Gilbert

Hospice Referral Center, Coding, and Clinical Documentation Analysts: (L-R) Irene Chege, Tom Wood, Leanne Mytych, Ali Greenstein, Donna Merritt-Jackson, Juliet Chitanda, and Tracey Lisacki

Patient Accounts in Southborough!

Hospice Operations: (L-R) Mary Downs, Carol Muse, Paula Gaboury, and Dan Berger

Stephanie Premo in the Leominster office created a sign to celebrate Speech Therapy month!
Karen Johnson, RN and Kristene Isaac, RN, enjoying a Nurse's Week luncheon at New Horizons.


ANNOUNCEMENTS AND UPDATES
Chronicle
Chronicle Segment Making a Difference for Patients

We received this note from Paula D'Anello, liaison, who alerted us to a patient who saw the Chronicle segment on end of life planning and was able to communicate her wishes for a happy outcome. Thanks to all who make this happen each and every day!

Just screened a patient at Leominster Hospital who saw Rose Monahan featured on Chronicle. She said she told her son that when her time came, Rose Monahan was where she wanted to spend her final days. The family was happy they could make her final wish come true. She is being transferred at 4pm today.


CERTIFIED CLINICAL SERVICES
wound
When to Take a Wound Photo

Nurses must take a wound photo on admission of ALL wounds except for Newly Epithialized Surgical Wounds (if the wound has erythema, swelling, scabbing, or drainage, it is NOT Newly Epithialized and will need a photo).
 
Photos should be taken of any new wounds that patients get while on the VNA service.
 
Photos should thereafter be taken if there is a deterioration in the wound or if the wound isn't making progress.
 
Please call/email the WOC to let them know you have taken the photo (we do not know unless you tell us). We will do a photo consult and put a Doc.Com in the record and let you know that we did so.
 
If you have any questions about this process you are welcome to call Carol Jones, CWOCN 978-777-6100, ext. 1257.


Speech
Speech Therapy Referrals

If one of your patients has experienced a recent onset or exacerbation of a problem in any of the areas below, he/she may benefit from a speech therapy referral. Please click the FULL ARTICLE button for the process to refer patients to Speech Therapy.



SafeSide
SafeSide: You can do something about it

A few Connecter issues ago we asked for input from our field staff: "What do you do as a clinician to prevent rehospitalization?"
 
Congratulations to our gift card winners, and thank you for the tips!
 
At the very first visit, evaluate the patient's function (this is also an OASIS requirement) and assess the need for rehab (PT, OT, and/or ST). You can use the MAHC 10 Quick Reference Guide to determine what discipline(s) is/are needed. If rehab is recommended, put in the referral at the first visit. Why is this so important? Recent evidence has proven that patients with impaired function are at higher risk for re-hospitalization as compared to those with multiple co-morbidities but high function.
 
- Submitted by Kyra Mihalick, PT, DPT, PCM, Charlestown
 
 
I always mention to the patients at eval or admission that it is the VNA's mission to keep them out of the hospital. I also tell them to call the VNA number 24 hours/day with any questions or concerns before they even consider the ER. Most patients will respond with a big smile, "That's my mission too!" It makes they feel like we have an immediate goal!
 
- Submitted by Katie Cullen, PT, Southboro
 
Please continue to share any tips for preventing rehospitalization with us by emailing the Safeside Improvement Committee.
 
Remember, you can do something about it!


falls
Focus on Falls Prevention

How are we doing?

March Falls:
During the month of March, there were 72 unwitnessed falls reported, out of 4,563 patients served, for a falls rate of 1.6%.
 
We are below national benchmarks for Emergent Care Due to a Fall for the month of March.

The SHP national average percentage of patients seeking emergent care due to falls was 1.97%, with VNACN at 1.78% and VNAB at 1.48%.

We will continue to report and trend this data monthly, and the falls committee is reviewing causes of falls, so that we may focus our strategies based on observed trends on an ongoing basis.

Tips and Tidbits: Initial Care Planning and Ongoing Interventions
As many of you have heard me say, Fall Prevention is a team sport!

We all play a role in reducing our patients' risk of falling.

Every patient is assessed for fall risk using the MAHC-10 tool upon admission and it is up to the admitting clinician to address priority items during the admission visit, and to create an individualized plan tailored to the clinical findings which place the patient at risk of falling. This includes referrals to appropriate disciplines.[Click Here to access the MAHC 10 Referral Guide]

But that's not enough. We need to be sure that the patient and family members understand specifically what puts the individual at risk and why we are recommending certain interventions to reduce that risk. For example, if the individual is exhibiting cognitive deficits, you may consider a referral to OT or ST to work on strategies to improve safety. It's imperative to make this plan WITH the patient, so that they understand and are in agreement with the interventions. The most successful interventions are the ones that are chosen by the patient during this educational discussion.

Remember that the newly updated Patient Education Handbooks are invaluable resources. Review pertinent sections at each visit, and initial/date the page reviewed. Some items will bear repeating, and remember to ensure retention of the information via teach back.

At every visit, each clinician should review specific fall risk reduction education with the patient and family and revise the interventions if needed based upon updated assessment information obtained during the visit.

If your patient does experience a fall, be sure to notify the physician and document this in the record. This is necessary EVEN IF THE PATIENT IS GOING TO THE ED or urgent care. Be sure to notify your team members and manager as well, and document your assessment of the patient, the cause(s) of the fall and any new interventions. The interventions which were initially in place should be reassessed and modified as appropriate after a fall or near fall event. If it's unclear as to what might be appropriate, reassess the patient using the MAHC 10 tool and review with your manager, request a case conference if needed.

We may not be able to prevent every fall, but with a consistent focus and patient engagement, we can reduce the risk factors which put our patients at risk of falling.



FUND DEVELOPMENT
NorthShore
North Shore Spring Fling Raises Over $40,000

The North Shore Community Cabinet's fourth annual North Shore Spring Fling recently raised over $40,000 to support the future of home health care. John Archer, a member of the cabinet, hosted the benefit at his Danvers home. The evening featured live music and dance demonstrations in salsa, tango, and more. Our gratitude to the following businesses that generously sponsored the fundraiser:
 
Gold Sponsors




Silver Sponsor
Institution for Savings
 
Bronze Sponsors
Best Home Care
Beverly Bank
Clement C. Archer Insurance Agency, Inc.
Donald E. Kowalski, DDS
Mohr Partners
National Grand Bank
North Shore Home Care Resources
 
Friends
North Shore Bank
Melick & Porter, LLP
PineBrook Landscaping LLC
Ropes & Gray
Salem Five
Carol Jones, a member of the Community Cabinet, and Lori Derosa
Beth Sobezenski and pianist Nathan Johnson

HUMAN RESOURCES
BONUS
Employee New Hire Referral Bonus Program

The new hire referral bonus program includes employee referrals for RNs, LPNs, PTs, PTAs, OTs, COTAs, and SLPs. If you would like to refer a friend, family member, or colleague, please inform the appropriate Human Resources Representative at your location prior to the applicant coming in for an interview. Please note, when two or more employees refer the same applicant, the referral bonus will be split equally amongst the employees.

Referral bonuses are paid out after the referred employee's three and six month anniversary, as long as they are in a paid status at those intervals.

Please contact Cheryl Milas at cmilas@vnacarenetwork.org or Debbie Brown at dbrown@vnab.org for more information.

JOBS
Job Postings - VNAB and VNAHC
Job Postings - VNACN and VNAHC
To learn more about career opportunities, contact a human resources representative:
EAT
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:
  • Liz Bourne
  • Ray Brackett
  • Linda Britt
  • Kim Dio
  • Kelly Frew
  • Mary Helen Mahoney
  • Susan Marlin Procter
  • Mary McCarthy
  • Ilona O'Connor
  • Mary Ann O'Connor
  • Mae Powers
  • David Rose
  • Danny Yang
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 in the Charlestown office.
 

INFORMATION SYSTEMS
MIS
One Number for After-Hours Technical Support

Please note that the IT department now provides 7X24 on-call service for technical support across all divisions of VNA Care whether you use the Delta Encore or McKesson Homecare system. After-hours technical support can be obtained now by simply calling one number: (508) 751 6822. IT staff on-call will vary, but the contact number will always remain the same.
 
This week, John Severin is on call through Thursday morning, May 19th , Cathy Langone assumes the duties beginning that same afternoon at 4:30 PM. Again, for after-hours on-call IT support, please always call (508) 751 6822.

 
QUALITY AND RISK MANAGEMENT
Flu
Flu is Winding Down in US, but in OASIS Terms it is Over!

Steve Fleming at the Massachusetts Department of Public Health reports that for week 18 (May 1 to May 7, 2016) the flu activity has decreased in United States and in the state. At present the most prevalent strain reported is Influenza B which is different than earlier in the season when Influenza A was most prevalent.

OASIS defines the data collection period for the flu season is from October 1st through March 31st. So in OASIS terms - the data collection for flu season is over! We answer the flu question on transfers and discharges. Right now we are in a transition period when patients may have part of their service in the flu season and part outside the flu season. It can be confusing. As a reminder, M1041 is answered YES if the patient was cared for in any part of the flu season, even March 31st. But, answered M041 NO if the patient has a SOC/admission after April 1st, or a most current ROC /resumption after April 1st. We want to take credit for all of our hard work tracking and recording patient flu shots. By answering correctly we improve our home health compare outcomes and our STAR ratings. Answering M1041 incorrectly will have a negative impact on our quality outcomes and value based purchasing scores. We do a good job....now it is time to move to doing a great job!! Thank you.


Abilify
Recently Released FDA Warning on Abilify
By: Medication Management Committee

Aripiprazole (Abilify, Abilify Maintena, Aristada) is a medication sometimes seen on a patient's medication list. It is prescribed to treat certain mental disorders, including schizophrenia, bipolar disorder, Tourette's disorder and irritability associated with autistic disorder, and can be used in combination with antidepressants to treat depression. A known side effect is pathological gambling. FDA is now warning, in addition, that compulsive or uncontrollable urges to binge eat, shop, and have sex have been reported with its use.

FDA recommends that health care professionals should specifically ask patients about any new or increasing urges while they are being treated and closely monitor for new or worsening uncontrollable urges in patients with history of obsessive-compulsive disorder, bipolar disorder, alcoholism, drug abuse or other addictive behaviors. If a patient experiences this, he/she should contact his/her health care provider as soon as possible, but should not suddenly stop the medication without talking to the health care professional.

OASIS
Q2 OASIS Sessions

Office
Day/Date
Time
Presenter
Charlestown
Sunday, June 5
8-9:30am
Kyra
Charlestown
Tuesday, June 14
8:30-10am
Elaine
Charlestown
Thursday, June 16
2-3:30pm
Elaine
Charlestown
Wednesday, June 29
2-3:30pm
Elaine
Danvers/Gloucester
Wednesday, June 8
8:30-10am
Marilyn
Danvers/Gloucester
Thursday, June 9
8:30-10am
Marilyn
Danvers/Gloucester
Tuesday, June 21
8:30-10am
Marilyn
Danvers/Gloucester
Tuesday, June 28
2:30-4pm
Marilyn
Leominster
Wednesday, June 1
8:30-10am
Surabhi
Leominster
Monday, June 13
2:30-4pm
Surabhi
Leominster
Tuesday, June 28
8:30-10am
Surabhi
Needham
Wednesday, June 1
8:30-10am
Maura
Needham
Sunday, June 5
8:30-10am
Maura
Needham
Tuesday, June 7
8:30-10am
Maura
Needham
Thursday, June 9
8:30-10am
Maura
Needham
Wednesday, June 22
8:30-10am
Maura
Quincy
Thursday, June 2
8:30-10am
Carol
Quincy
Tuesday, June 28
2-3:30pm
Carol
Southborough
Friday, June 10
8:30-10am
Surabhi
Southborough
Monday, June 13
8:30-10am
Maria
Southborough
Tuesday, June 14
8:30-10am
Surabhi
Southborough
Wednesday, June 29
2:30-4pm
Maria
Southborough
Thursday, June 30
8:30-10am
Maria/Surabhi
Weymouth
Thursday, June 23
2-3:30 pm
Kyra
Weymouth
Wednesday, June 29
8:30-10am
Kyra
Worcester
Sunday, June 5
8:30-10am
Chris
Worcester
Thursday, June 9
2-3:30 pm
Chris
Worcester
Friday, June 17
8:30-10am
Chris
Worcester
Wednesday, June 22
2-3:30 pm
Chris
Worcester
Tuesday, June 28
8:30-10am
Chris

PATIENT CARE MANAGERS
Name
Email
Cell
Position
Covering Office
Bowden, Marilyn
774-502-7478
Patient Care Manager
Danvers and
Gloucester
Dunn, Maria
508-688-2449
Patient Care Program Manager
SS02 Southborough
Gardner, Elaine
617-680-1105
Patient Care Manager
Charlestown
Gill, Christine
774-502-5725
Patient Care Manager
Worcester
Mihalick, Kyra
617-913-6823
Patient Care Manager
VNAB Therapy
Morris, Carol
617-913-3006
Patient Care Program Manager
Quincy
Saxena, Surabhi
774-463-7336
Patient Care Manager
Leominster & SS55 Southborough
Vitello, Maura
774-502-7475
Patient Care Manager
Needham

QI SUPPORT
Covering Office
Name
Email
Office Phone
Position
All VNAB
Hughes, Kim
617-886-6501 x5419
QI Support Coordinator
All VNACN
Schultz, Chris
617-886-6501 x6527
QI Support Coordinator
All VNACN
Rao, Shamala
508-756-7176 x6876
QI Nurse
May 16, 2016
The Connecter
Volume 5, Issue 20
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Confidentiality Notice: The Connecter newsletter is an internal communication intended only for employees of VNA Care and Atrius Health. Information contained within this newsletter includes confidential, proprietary, and privileged content. Unauthorized forwarding, printing, copying, distribution, and/or negligent handling is strictly prohibited and could result in disciplinary action.