Using Data to Improve HHCAPS and Home Health Compare

1. Using Data to Improve HHCAPS and Home Health Compare Diane Link, RN, BHA Executive Director Carroll Home Care MNCHA Annual Conference 2013

2. Agenda Understand how outcomes impact contracting and marketing practices Identify how technology can be used in outcome analysis Discover best practices to improve HHCAPS and Home Health Compare outcomes MNCHA Annual Conference 2013

3. HHCAPS and Home Health Compare results….Why does it matter to me? Management Aspect Identify your strengths and weaknesses Guides your QAPI Validate your staff performance reviews MNCHA Annual Conference 2013

4. HHCAPS and Home Health Compare results….Why does it matter to me? Marketing Aspect Know your competition Promote your performance Challenge your team MNCHA Annual Conference 2013

5. HHCAPS and Home Health Compare results….Why does it matter to me? Financial Aspect Prepare for Pay for Performance Contracting Advantage ACO Advantage MNCHA Annual Conference 2013

6. Impacting Results: Who, What, Where, How? MNCHA Annual Conference 2013

7. Tools to Identify the who and what Home Health Compare HHCAPS provider Organizational Dashboards Individual Scorecards MNCHA Annual Conference 2013

8. How to use Technology to Understand Outcomes Point of Care systems OASIS validation tools Benchmarking Services Dashboards Telehealth and other technology MNCHA Annual Conference 2013

9. What is best practice and how do I know if I am doing it right? A best practice is a method or technique that has consistently shown results superior to those achieved with other means, and that is used as a benchmark. Evidenced based practices would be methods or techniques that have current and researched results MNCHA Annual Conference 2013

10. Where do I find these “best practices” Research HHQI Pilot Programs Networking Outcome results White papers MNCHA Annual Conference 2013

11. So what is a good HHCAPS score anyway? MNCHA Annual Conference 2013

12. How often the home health team give care in professional way? National Average: 88% Highest states : 92% Kentucky and Louisiana 91% Alabama, South Carolina, West Virginia Lowest states: 80% Washington DC 83% Alaska 85% California, New York Carroll Home Care: 91% MNCHA Annual Conference 2013

13. How well did the home health team communicate with patients? National Average: 85% Highest States: 89% Kentucky, Louisiana, South Carolina, West Virginia Lowest States: 74% Washington DC 82% Puerto Rico, California Carroll Home Care: 89% MNCHA Annual Conference 2013

14. Did the home health team discuss meds, pain and home safety? National Average: 83% Highest States: 88% Louisiana, North Dakota 87% Alabama 86% Iowa, Oklahoma, South Dakota Lowest States: 72% Washington DC 75% Puerto Rico 78% Utah 79% Arizona Carroll Home Care: 85% MNCHA Annual Conference 2013

15. How do patients rate the overall care from the home health agency? National Average: 84% Highest States: 89% Louisiana 88% West Virginia, Kentucky Lowest States: 69% Washington DC 79% Alaska 78% California Carroll Home Care: 88% MNCHA Annual Conference 2013

16. Would patient recommend the agency? National Average: 79% Highest States: 91% Virgin Islands 85% West Virginia, Vermont, Maine, Louisiana, Kentucky Lowest States: 62% Washington DC 72% Arizona 73% California Carroll Home Care: 87% MNCHA Annual Conference 2013

17. Case Study on HHCAHPS MNCHA Annual Conference 2013

18. Carroll Home Care: Maryland Certified Home Health Agency covering Tri County Area Hospital based AvgDaily Census 200 70% Medicare population McKesson EMR user since 2006 Area of Focus Lowest scoring area on HHCAHPS is specific care issues. Range of responses on quarterly bases: MNCHA Annual Conference 2013

19. HHCAPS Best Practices on Medication Pain Safety Domain Medications: Medication reconciliation Instruct on benefits of single pharmacy utilization Leave written list in home – provide pill boxes Update list in home throughout episode/verbalize Train staff each visit to ask to see meds and verbalize Leave written materials on each med Use Notepad for patient to write questions for MD At discharge visit review meds again MNCHA Annual Conference 2013

20. HHCAPS Best Practices on Medication Pain Safety Domain Pain: Assess and discuss pain each visit Utilize visual pain expression charts and/or number ratings Offer nonpharmacy pain relief measures Discuss pain management goals with patient Utilize pre medication for painful procedures Follow up 24 hours after pain medication changes Call physicians from home to report pain issues MNCHA Annual Conference 2013

21. HHCAPS Best Practices on Medication Pain Safety Domain Home Safety: Verbalize and preform Home Safety Assessment Include patient/family members in Home Safety Assessment Leave written information on home safety and recommendations to improve safety. Review throughout episode and re-enforce on discharge MNCHA Annual Conference 2013

22. Home Health Compare Case Study:Reducing Acute Care Hospitalization MNCHA Annual Conference 2013

23. Home Health Compare Case Study:Reducing Acute Care Hospitalization Readmission to hospital: 2011 Score 27% 2013Score 16% MNCHA Annual Conference 2013

24. Rehospitalization Best Practices: Dashboards Root Cause Analysis on all Readmissions/ER visits On Call protocols with reviews Disease Specific Programs High Risk Identification for Rehospitalization Education at Monthly clinical meetings with case studies Telehealth (2011) MNCHA Annual Conference 2013

25. Who is leading the results? “Any individual who holds responsibility for any person, aspect, function, or task within an organization is in fact a leader. You may not be in charge, but if your direct or indirect efforts influence others, you are in fact leading” ~ Mike Myatt MNCHA Annual Conference 2013

26. Are you ready to celebrate your TEAM win? Questions? MNCHA Annual Conference 2013