June 2008 e-Bulletin

Welcome to the Home Health QIOSC monthly e-Bulletin, your source for the latest updates in home health quality improvement. You may either browse the newsletter or use the icons at the top of the page to jump to a specific section.

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The Home Health Quality Improvement (HHQI) National Campaign Best Practice Intervention Packages (BPIPs) can be accessed at www.medqic.org.

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There are no pending deliverable dates at this time.

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CoP WebEx/Call:  Tuesday, June 17, 2008, 3:00 p.m. (ET)
1.877.260.8899; ID: 898687

• Speaker:  Anna M. Wodlinger Jackson, Pharm.D., BCPS, Temple University
• Topic:  Pharmacological Interventions for Heart Failure *
• WebEx instructions will be sent via the listserv

National HH QIO Call:  Tuesday, June 24, 2008, 3:00 p.m. (ET)
1.866.861.5389; ID: 898993

• Speaker:  Irene Cole, MSN, CDE, Lumetra
• Topic:  Diabetes: Review and Interventions for Home Health Professionals - Part I *
• WebEx instructions will be sent via the listserv

* Both presentations are part of the Polish Your Practice series.

The May CoP and HH National Calls were recorded and may be reviewed on Quality Insights of Pennsylvania's Web site.

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Note: For the remaining HHQIO e-bulletins, we will be featuring home health agencies that have put best practices into action. Thanks to all the QIOs and home health agencies that have helped coordinate these tips and applications. This month we are featuring two agencies!

Agencies in Action

Missouri Home Care
“Our agency began working on improvement in oral medications in 2005. We tried various strategies, but held off on implementing any other changes when we heard that medication management would be one of the featured packages of the Home Health Quality Improvement campaign. We utilized the package extensively to develop resources for our nurses, therapists and home health aides. We developed a ‘suggested clinical visit guide’ for nurses, a kind of cheat sheet of oral medication management tips appropriate for therapists and a medication guide for home health aides. Addressing management of oral medications was a tough issue for our agency and not necessarily one we wanted to address, however, we have been successful in our quality scores, and the staff has responded positively to the tools. We are now ready to begin work on medication simplification! We will, once again, revisit the Medication Management BPIP for resources.

We have also initiated work on patient self-management. This was important to us, because we often hear from our staff, 'The patient wants to quit smoking or exercise or eat better, and how do we help them with that?' We are currently trying out My Action Plan as a tool for our staff. (My Action Plan, from Thomas Bodenheimer, MD, of UCSF Department of Family and Community Medicine - page 65 in the Patient Self-Management BPIP) We find that trialing a new tool with a small group is effective, and after implementing My Action Plan with a group at one of our branches, we will then expand to all staff.” - Karen Weber, RN, BSN, QI Manager/Educator, Missouri Home Care, Rolla, Missouri

(Missouri Home Care will also be the featured agency in the June 16 Tip of the Week)

Vanderbilt Home Care Services
“Our approach to improving care transitions has been to educate and improve awareness of breakdowns in patient transitions. Our initial strategy was to communicate with hospital case managers, and we began by sharing which patients are appropriate (and not appropriate) for home care. We have continued to share with hospital case managers when something is working and when something doesn’t work with transitions. Additionally, aligning goals with the hospital setting to prevent unnecessary rehospitalizations is essential. Discharging the hospital patient to the right setting is imperative, and both the hospital case managers and our staff understand that poor patient outcomes impact both providers.

We have experienced other successes by meeting with residents at our hospital, which is a teaching hospital. One of the results of these meetings was getting discharged patients earlier appointments with their PCP when they were at a high risk of hospital readmission. Another intervention we are working on is providing a flag on the medical record when a patient is a home health agency client (no matter which home health care provider they use). This has already been implemented for hospice. Another strategy we have implemented is to hold meetings with the hospital emergency department staff so they understand the need to communicate with home care regarding active home care patients. This allows some patients to avoid a hospitalization when home care interventions can keep the patient safely at home.

Keys to improving transitions are to educate and communicate with provider settings, and focus on mutual goals and outcomes” - Janie Parmley, Administrator, and Kathy Ramsay, Director of Patient Care Services, Vanderbilt Home Care Services, Nashville, Tennessee

(Vanderbilt Home Care Services will also be the featured agency in a July 2008 Tip of the Week)

The leadership at Missouri Home Care and Vanderbilt Home Care Services exemplify the “building upon the basics” approach for improving quality outcomes. Thanks to Karen Weber at Missouri Home Care and Janie Parmley and Kathy Ramsay at Vanderbilt Home Care Services for their commitment to improving patient care.

Tips of the Week

View the May 2008 Tips of the Week.
View the April 2008 Tips of the Week.
View the March 2008 Tips of the Week.
View the February 2008 Tips of the Week.

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