Fact Sheet: QIO Home Health Training

QIO Training For Better Home Health Care WHAT SOME HOME HEALTH AGENCIES ARE SAYING As part of the federal Home Health Quality Initiative, Quality Improvement Organizations (QIOs) are training home health agencies nationwide in a process known as Outcome-Based Quality Improvement. The OBQI process uses collection, analysis, and feedback of data measuring patient progress to help agencies identify and address areas of treatment for improvement. OBQI gives home health care providers a well-structured and effective way to create and implement step-by-step plans designed to improve care and to integrate continuous quality improvement into ongoing staff training. QIO training in OBQI is voluntary and offered at no cost to home health agencies. From mid-2002 through October, 2003, QIOs trained more than 70% of Medicare-certified home health agencies nationwide. Some comments: Memorial Home Health, Las Cruces, New Mexico is the largest home health agency in southern New Mexico, making more than 23,000 patient visits per year. Memorial is using OBQI to improve treatment of pain interfering with patient’s daily activities. “There is so much to learn in home health and if you don’t get the QIO training you are going to flounder. Most agencies are feeling like they don’t have the time to look at their data or to do something about it, but they need the training to improve faster, easier, and have more of an affect. Process improvement and quality assurance have been things we had to do in past, now you can see the benefit of doing it,” said Linda Anderson, RN, Clinical Director for Memorial Home Health. “We found the training very informative. It provided us with the tools to use our OBQI data to focus on workable quality improvement plans. These plans will allow us to address the specific needs of our patient population,” said Anderson. “We learned that the OBQI data identifies not only the weaknesses of an agency but its strengths as well. This will be useful in maintaining a high quality of care.” “We’ve been looking at our data and formulated some plans in the past. But the training by NMMRA (New Mexico Medical Review Association, the New Mexico QIO) helped us focus on statistically significant areas that would be most beneficial to our particular patient population,” Anderson said. “Because the training looked at developing a plan to work for your agency and your patients, it will help staff feel like they can make a difference,” Anderson said. “Our data has always been a good morale booster because it’s very good. But there is always room for improvement.” For more information, Linda Anderson, 505-556-6500. St. Francis HomeCare, Greenville, South Carolina makes about 30,000 home care visits per year across four counties in the northwest portion of the state. St Francis is using OBQI to improve its performance on oral administration of medication to patients. St. Francis also participates in a Quality Task Force comprised of about 12 South Carolina homecare agencies, which regularly share OBQI best practices among each other with assistance from the South Carolina QIO (Carolina Medical Review). “I was very pleased with the (OBQI) training I received from Carolina Medical Review,” said Mary Ashmore, RN, Quality Management/Staff Development Coordinator at St. Francis HomeCare. “After months of reading about OBQI and not quite having a feel for the complete picture, I came away from the training with the practical knowledge and tools I needed to implement OBQI in my agency.” “The training helped me get organized for what I had to present to my staff and then to begin the process with my staff. I feel that our QIO gave me the tools I needed to proceed using the outcome (OASIS) reports for quality improvement activities,” Ashmore said. “The information we are getting from the training is practical and applicable to improving patient care. The project we chose to work on first is oral medication administration, which has a direct applicability to helping patients become more independent.” “I think we will definitely see improvement thanks to our team. They have come up with doable best practice ideas to share with the agency and we definitely think patients will benefit from it.” “OBQI has affected the morale of our team. It hasn’t affected the whole agency yet, but that is the goal and I think it will happen because our caregivers want to give good patient care and everything that comes from OBQI can help them do that,” Ashmore said. “It all adds up to a better product and better care for the patient.” For more information, Mary Ashmore, 864-233-5300. Samaritan HomeCare, Albany, Oregon is part of a three-agency network serving residents of the mid-Willamette Valley and Central Oregon coast. The agencies are using OBQI to improve treatment of pain that interferes with daily activities. “The educational programs, written materials, and teleconferences have proved to be very helpful for home health agency managers and staff negotiating the (at times overwhelming) OBQI information. Acumentra’s (the Oregon QIO) assistance ranges from helping us interpret reports, understand statistics, identify care behaviors and best practices, plan process improvements, and identify resources. We really feel Acumentra is on our side in helping us to deal with OBQI in a positive way,” said Barb Hansen, RN, Administrator of the Samaritan HomeCare Network. “I think now we can better examine what we are doing and do it more effectively and efficiently. Then we will have better patient outcomes, more satisfied patients, and more satisfied clinicians because it will help them get feedback that what they are doing really makes a difference,” Hansen said. For more information, Barb Hansen, 541-812-4669. BayCare Home Care, Largo, Florida operates 14 agencies across the state. “The OBQI training was excellent. The approach (FMQAI, the Florida QIO) used was great as far as explaining what OBQI is, then interpreting the outcome reports, and then really getting into helping the agencies. The support and assistance they offered was very helpful. It is so much better than getting a program memorandum or a regulation where you read it and then you are left on your own,” said Roberta DiZinno, RN, compliance coordinator for BayCare Home Care. “Overall as OBQI gets going it will be a really good thing,” DiZinno said. “We were always looking at performance and outcomes. But this is an easier, condensed report that will help focus improvements.” “Hopefully, we’ll show improvement in the areas where we fall below benchmarks and improve our outcomes,” DiZinno said. “Certainly, if we are showing improvements then we’ll know we’ve done our job. It would show that we are delivering quality care and getting our patients at a higher functional level.” For more info, Roberta DiZinno, 727-461-4481. Lee Regional Visiting Nurses Agency in Lee, Massachusetts makes about 30,000 patient visits per year for residents in the western parts of the state. “The training provided by MassPRO (the Massachusetts QIO) was excellent; more understandable then other programs I have attended. The speakers made a very complicated process, particularly statistical significance, easy to understand,” said Suzanne Hatch, Quality Manager for Lee Regional VNA. “We’re particularly interested in working with the QIO (MassPRO) after the training to identify best practice examples and to work collaboratively with others. We do not have as much time as we used to for discussing issues, so working with others will be very valuable,” Hatch said. For more information, Suzanne Hatch, 413-243 5604. Ministry Home Care in Marshfield, Wisconsin, made more than 63,000 patient visits last year. The agency’s seven offices serve patients across a large portion of the state, including rural and urban areas. “We are very excited to have this opportunity for evaluation and continued improvement.,” said Linda Bodien, Director of Clinical Services for Ministry Home Care. “Our whole industry has been asking for this feedback and the ability to benchmark ourselves against others.” “Now we will have a baseline,” said Dorothy Flees, Manager of Quality Services for Ministry Home Care. “We'll be able to know where we are and where we want to be as we continue to improve the quality of the services we provide to individuals and their caregivers.” “People here are truly excited about this. We are excited about working with Meta Star and the assistance and comfort they are giving us,” said Liz Sheahan, Community Outreach Coordinator for Ministry Home Care. “Our staff are confident that MetaStar (the Wisconsin QIO) will help them grow.” For more information, Liz Sheahan, 715-389-3963.

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