[mom of one]

Hi,

I am desperate to find info regarding setting up a QA/QI program in our agency. Apparently, what has been in place is now obsolete. How would I go about it and what areas should I initially target. I also am wondering if the quality indicators from the OASIS data can be obtained from a CMS website. Thank you.

Mom of one

[homehealth43130]

You get your quality indicators from CASPER for the OASIS. Someone - usually the person who submits the data for the agency - has access to pull the CASPER OBQI and OBQM reports. You should be looking at all OBQM adverse events - there is a patient listing report - I do this quarterly - but you could do it more frequently. I also gather data on our OBQI projects - Improvement in oral medicaitons, improvement in transfering and all hospializations and emergent care. If you are Joint Commission certified you need to look at patient satisfaction, your FMEA that you picked, citical labs and tests, any thing that you identified in your PPR that was not satisfactory, infections patient and staff. For CMS you need to do a quarterly chart audit - we do 10% of the unduplicated census - must be interdiciplinary team. We look at some agency specific things - like how long it takes a 485 to get out to the physician, I look at all incident reports, our referral conversion rate - the percentage of referrals that we admit. You can always look at you medicare payments vs cost.

The key is to find what your agency needs and to use the data that you get. Just collecting a bunch of data doesn't do anyone any good.

[mom of one]

HomeHealth 43130,

Thank you so much for your help. I have a lot to learn. I will look at the CASPER report. How do you randomly pick charts to audit from a list of patients served? Does the audit part done by nursing need to be done by different nurses or can the QI person do the nursing part? Thanks again.

[homehealth43130]

The nursing audit can be done either way. I do pick a random list of patients - sometimes pick a number and then choose a certain number from there - i.e. start with patient number 15 and audit every 5th chart after that or if I really want to be random I use www.random.org which will generate a random sequence of numbers. I do it that way so I am not influence by the case manager as I know who has more difficulty with their charts than others.

[mom of one]

Homehealth 43130,

Thank you so much for all of your help. I really appreciate it. I will go to the website recommended.

[NRSKarenRN]

Contact your states QI organization and sign up for workshops/programs: QIO Directory

Visit the HHQI National Campaign Web site at www.homehealthquality.org.


Other sites to help
Quality Net
MedQIC
AHQA

[mom of one]

Thanks for your help. I appreciate it.