Home Health Quality Improvement The Reality

1
Home HealthQuality Improvement The Reality

• Bonnie Kerns, Project Coordinator
• Quality Insights of PA

2
Objectives

• Review of Home Health Quality Initiative -
  past, present future
• Report changes in Home Health Compare MedQIC
• Identify strategies for improvement in acute
  care hospitalization

3
Past 7th SoW 08/2002

• Educate the home health community on
  Outcome-Based Quality Improvement

4
Support POA Implementation
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HHQI The reality

• 5000 HHA participated with QIOs
• Improvement rates
• .75 to 14.78

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Results of improvement
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HHQI The reality

• PA Successess !
• 68 participation
• 60 achieved statistically significant improvement

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Present 06/2005
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HHQI The reality

• Publicly Reported
• Outcomes

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HH Compare for West VA
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West VA utilization outcomes
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HHQI The reality

• www.obqi.org
• moves to www.medqic.org
• qnetsupport_at_ifmc.sdps.org
• for assistance

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PA special project
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Medication Non-Adherence Tool
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Managing Your MedicinesSelf-Assessment Tool
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Future 8th SoW 08/20057/2008

• Changes on the Horizon

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HHQI The reality

• Transformational
• Change

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Home Health Compare Changes 09/2005

• To be deleted
• Stabilization in bathing
• Improvement in toileting
• Improvement in upper body dressing
• Improvement in confusion frequency

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Home Health Compare Changes 09/2005

• To be added
• Discharge to community
• Improvement in dyspnea
• Improvement in urinary incontinence
• Imp in status of surgical wounds (2006)

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HHQI The reality

• Pay for Performance

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Acute Care Hospitalization

• National priority focus
• Average agency risk-adj rate 30.8
• Home Health Compare National rate 28
• Optimal rate??

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Acute Care Hospitalization

• In 2003
• 1/4 of all hospitalizations occurred within 7
  days of the beginning of the episode
• 58 occurred within the first 3 weeks
• 68 episodes ending with hospitalization had
  been in hospital 2 wks prior to beginning of home
  health episode

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Acute Care Hospitalization

• Chronic disease prevalent among hospitalized
  patients
• Reduce avoidable hospitalization by
• Improving home care utilization
• Improving transitions from hospital, nursing home
  or physician office

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Acute Care Hospitalization

• Successful strategies

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Telehealth

• Remote care delivery
• Phone monitoring
• Telemonitoring

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Strategy for Success

• Work with your QIO!!

This material was prepared by Quality Insights of
Pennsylvania, the Medicare Quality Improvement
Organization for Pennsylvania, under contract
with the Centers for Medicare Medicaid Services
(CMS). The views presented do not necessarily
reflect those of CMS. Publication number
7SOW-PA-HH05.150.