Update on the Home Health Quality Alliance: How Can QIOs Get Involved

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Update on the Home Health Quality Alliance How
Can QIOs Get Involved

• Mary St.Pierre
• Vice President for Regulatory Affairs
• National Association for Home Care Hospice

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Home Health Quality Improvement National Campaign

• Kick off January 11, 2007
• Participants
• Champions
• Lanes
• Providers
• Goal Home health patients will remain in their
  own home and require fewer avoidable
  hospitalizations

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The Home Health Environment

• 8500 home health agencies
• Independent and isolated (except chains)
• Insufficient resources/duplication
• Limited research to identify best practices
• Lack of vehicle for dissemination
• Competition/lack of common bond goal
• To the rescue Quality Improvement Organizations

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QIO Home Health Initiatives To Date

• Data Analysis Guidance
• OBQI Process Education
• Best Practices
• Identification
• Dissemination
• Promotion
• Support guidance

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Campaign Goal

• Reduce average ACH rate
• Across all home health agencies
• By a 5 relative improvement
• From baseline to the end of the campaign
• Why

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Campaign Goal

• Baseline rates
• Risk-adjusted agency-level rates
• 12 month period ending September 30, 2006
• Re-measurement rates
• Risk-adjusted agency-level rates
• 12 month period ending February 28, 2008

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Sample 5 Relative Improvement from Baseline
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Why Agencies Should Participate

• Overall improve quality of care
• Receive free quality improvement tools
• Receive agency specific hospitalization data
• Empower home visiting clinicians
• Improve image
• Increase patient satisfaction
• Keep their patients
• Be prepared for P4P
• Be a force in potential cost savings to the
  Medicare Trust Fund of 121.2 million

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Campaign Champions

• Role Unite home health community and recruit
  agencies
• National Homecare Associations
• NAHC
• AA
• VNAA
• State Associations
• QIOs
• HHA Representatives
• QIO Steering Committee

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Champion Commitments

• Post Campaign news
• Publish strategies and best practices in
  newsletters, etc.
• Educate members
• Offer online Telehealth Basics Course
• Develop monthly therapy specific intervention
  packets
• Provide CE credits for OT
• Provide supplemental resources for OTs

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Champion Commitments

• Correct OASIS scoring
• 101 things a PT can do
• Offer CHAMP support (VNAA program)
• Share the most recent clinical information
• Provide CHAMP evidence-based geriatric home care
  course materials
• Share hospice resources and tools
• Specialty organizations serve as consultants
• Share REACH strategies and tools

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Current Status

• Over 4,128 agencies registered
• 49.2 of Medicare Certified
• QIOSC Goal 50
• Local reports
• New Mexico 90
• Texas 75 of association members

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Best Practices

• Hospitalization Risk Assessment
• Patient Emergency Plan
• Medication Management
• Phone Monitoring Front-Loading Visits
• Teletriage
• Telemonmitoring
• Immunization
• Physician Relationships
• Fall Prevention
• Patient Self-Management
• Disease Management
• Transitional Care Coordination

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Intervention Packages

• Tracks
• 1 agencies not using best practice
  interventions
• 2 wishing to improve their best practice
  strategies
• Sections
• Administrators Managers
• Clinicians (SN, PT, OT, SLP, MSW, Aide)

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Intervention Packages

• Content
• Description
• 15 minute audio
• Sample tools
• Guide to Practical Application (checklist)
• Multi-discipline success stories
• Supporting resources

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Successful Activities

• Resources
• Home Telehealth References (2005/6/7)
• ACH Promotion Package
• ACH Clinical Resource Kit
• SBAR Home Health Package
• Immunization Toolkit 2006
• POA Tool (assist submission/feedback POA)
• STAR (monitor outcome targets for POA)
• Best Practice Monitoring Tool (electronic-complian
  ce with clinical interventions POAs )
• OBQI Web-Based Training

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Recruitment Strategies

• Multimedia
• E-mail
• Fax
• Phone
• Mail
• Newsletters
• Joint letters
• Cooperative efforts with State Home Care
  Association

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Future Challenges

• Recruit
• Retain
• Access packages
• Implementing packages
• Ongoing use
• Future trends

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Dissemination/Implementation Strategies

• Workshops through State Associations
• Web programs
• Newlsetter
• ReACH (best practice implementation/data
  collection via networked learning)
• CHAMP (E-learning, Face-to-Face workshops, Group
  coaching calls)

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Dissemination/Implementation Strategies

• Monthly calls
• Agency visits
• E-mail notices
• E-mailed packages
• E-mail reminders
• How-to messages
• Tool development assistance

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Organizational Culture

• Agency Branding
• Culture Change
• Patient Centered
• Work force Improvement
• Selection
• Training
• Support/Nurture/Sustain
• Continuous Quality
• Clinical/technical