Best Practice Intervention Package:

1
Best Practice Intervention Package

• Hospitalization Risk Assessment

2
Objectives

• Recognize the individual tracks in the package
  for leadership and disciplines
• Acknowledge that each agency can customize the
  monthly packages to fit the agency's needs
• State two ways to implement the package at the
  home health agency

3
What is a Best Practice Intervention Package?

• Educational package that creates understanding of
  top best practices interventions to reduce
  avoidable acute care hospitalizations (ACH)
• User-friendly package designed to be flexible and
  functional

4
Who Should Use the Package?

• Designed for
• Leadership
• Administration
• QI Team
• Managers
• Care Providers
• Nursing
• Therapists
• Medical Social Workers
• Home Health Aides

5
How to Access the Package?

• Download from www.homehealthquality.org
• New package available the first business day of
  the month
• All resources are free

6
Leadership Track

• 2 Leadership Tracks
• Leadership Path (1)
• Agencies with NO experience with using a
  Hospitalization Risk Assessment
• Initiating the use of a Hospitalization Risk
  Assessment tool
• Leadership Highway (2)
• Agencies that HAVE experience with using a
  Hospitalization Risk Assessment
• Optimizing the use of a Hospitalization Risk
  Assessment tool

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Leadership Self Assessment
8
Leadership Self Assessment
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Risk Assessment Tool
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Risk Assessment Tool

• Identifies high risk patients
• Need threshold number modified at each agency
• Use your case mix analysis data, additional data
  reports clinical observations
• Can be paper based OR electronic

11
Leadership Action Items

• 2 Tracks
• Track 1 Leadership Path
• Track 2 Leadership Highway
• Check all action items that you may want to
  execute at your agency

12
Leadership Action Plan

• Review the Action Items that you checked on the
  Action Item sheet
• Prioritize the Action Items
• Select 4 6 items that you plan to implement in
  the month
• Additional items can always be implemented

13

• Packages are designed for education and
  understanding
• Remember, the next package will be posted April
  2nd
• Dont get overwhelmed Be selective with your
  action plan
• Even small changes can make an impact

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Connections

• Patient Family
• Physician
• Hospice Palliative
• Hospital Managed Care Organizations

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Patient Family Connection
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Care Providers Tracks

• Nurse
• Therapist (PT, OT, ST)
• Medical Social Worker
• Home Health Aide

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Care Providers

• Introduces best practice intervention topic to
  each care provider level
• Emphasizes interdisciplinary approach
• Provides education and awareness
• Offers a ready to use monthly educational
  product

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Care Provider Components

• Hospitalization Risk Assessment education
• Audio recordings for staff
• Downloadable from Web site
• Perfect for staff meetings or burn onto CDs for
  staff to listen (cars, computers, etc.)
• 10 to 15 minutes each
• 2 for Clinicians (SN, Therapists, MSW)
• 2 for Home Health Aides

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Care Provider Components-cont-

• Guide to Practical Application for each track
• Success Stories
• Investigating Resources Activities
• Post-test
• Perfect for staff education requirements
  competencies

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Tips for Use SN, Therapist MSW

• Incorporate package into monthly staff meetings
• Introduce package or sections of package at
  weekly team meetings
• Utilize as self-study packages
• Copy individual tracks distribute
• E-mail individual tracks (Ideal for
  contract staff)

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Tips for Use Home Health Aides

• Utilize as the required monthly educational
  program
• Monthly topic would correlate for all staff
• Interdisciplinary endeavor
• Ready to use package, including post test
• Multiple adult learning styles addressed

25
HHQI National Campaign Web Site

• www.homehealthquality.org
• Updated weekly with additional materials
• Additional Web pages to supplement the Best
  Practice Intervention Package
• Supporting Resources
• Physicians
• Survey for home health agencies to provide
  feedback---and potential to be featured on Web
  site

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Questions on Package or HHQI National Campaign
Contact your state LANE. Visit the HHQI Web
site, For Home Health Agencies
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Next Steps

• Promote the HHQI National Campaign
• Go to HHQI Web site download this
  Hospitalization Risk Assessment package
• Review the package and determine what tracks and
  sections your agency will utilize
• Leadership and Care Providers
• Complete the Leadership Track and develop an
  Action Plan for Hospitalization Risk Assessment
• Implement the tracks ASAP

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Next Steps

• Visit the HHQI Web site weekly
• Supplemental resources
• Additional web pages i.e. Physicians
• New updates weekly
• Watch for your monthly data reports at end of
  month

29

• Next Package
• Emergency Care Plan
• Available April 2, 2007

This material was prepared by Quality Insights of
Pennsylvania, the Medicare Quality Improvement
Organization Support Center for Home Health,
under contract with the Centers for Medicare
Medicaid Services (CMS), an agency of the U.S.
Department of Health and Human Services. The
contents presented do not necessarily reflect CMS
policy. Publication Number 8SOW-PA-HHQ07.356.