1 / 47

Home Health Quality Improvement (HHQI) National Campaign Immunizations September 12, 2007

Home Health Quality Improvement (HHQI) National Campaign Immunizations September 12, 2007. New York State Local Area Network of Excellence (LANE). Objectives. Provide an overview of the CMS immunization goals in the 8 th Scope of Work for home health providers

ouida
Download Presentation

Home Health Quality Improvement (HHQI) National Campaign Immunizations September 12, 2007

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Home Health Quality Improvement (HHQI) National Campaign Immunizations September 12, 2007

  2. New York State Local Area Network of Excellence (LANE)

  3. Objectives • Provide an overview of the CMS immunization goals in the 8th Scope of Work for home health providers • Review New York State regulations targeting influenza & pneumococcal immunization • Discuss the relationship of improving immunizations while reducing acute care hospitalizations • Review the three principles of a comprehensive immunization program • Identify available tools and resources to support your agency’s immunization program

  4. Best Practice Intervention Package Available on the HHQI Web site http://www.homehealthquality.org

  5. Immunization Toolkit 2007-2008 Available in the Home Health Section of the MedQIC Web site at http://www.medqic.org

  6. CMS 8th Scope of Work Home Health Immunization Measurement (08/2005-08/2008) • Primary Performance Measure • Incorporate influenza and pneumococcal immunization assessment into the home health agency comprehensive patient assessment

  7. CMS 8th Scope of Work Home Health Immunization Measurement (08/2005-08/2008) • Results from baseline CMS Immunization Survey of the NYS Medicare certified home health agencies conducted 08/2005 • 98% of NYS home health agencies completed survey • 68% reported that their agency had incorporated assessment of BOTH immunizations into their comprehensive patient assessment • Re-measurement survey sent out 07/2007 • 70% (130) surveys have been received to date • 98% of the surveys received report assessment of BOTH immunizations

  8. CMS 8th Scope of Work Home Health Immunization Measurement (08/2005-08/2008) • Secondary Performance Measures • Offering these vaccinations (or aligning themselves to a vaccination source such as a physician practice or health department) as well as providing follow-up activities that include verifying patients have received vaccinations • Home health agencies that are not able to provide vaccinations shall demonstrate sufficient evidence of partnering to ensure patient receives vaccines

  9. CMS 9th Scope of Work Themes (08/2008-08/2011) • Patient Safety • Patient Pathways • Beneficiary Protection • Prevention

  10. New York State Department of Health Regulations “Assessment of patients must include an assessment of the patients’ immunization status completed at the start of care by the assessor and during follow-up assessments if pertinent.” “Clinical/patient care record reviews conducted during Department surveillance activities will include a review of the documentation of patient immunization status.”

  11. New York State Department of Health Regulations – Other Provider Settings • Hospitals • Amendments to Public Health Law effective 10/24/06 requires hospitals to offer vaccinations to patients 65 years of age or older who are admitted to the hospital. • Offer influenza vaccine annually between September 1st and April 1st • Offer pneumococcal vaccine to each admitted person 65 or older • Requires hospitals to adopt an immunization policy • Authorizes hospitals to implement a non-patient specific standing order policy for eligible patients in accordance with the immunization policy approved by the hospital.

  12. New York State Department of Health Regulations – Other Provider Settings • Effective April 1, 2000, NYS Public Health Law requires nursing homes, adult homes, enriched housing programs, & adult day health care programs to provide or arrange for influenza vaccination every year & pneumococcal vaccination for all residents and employees for whom the vaccine is recommended per the Advisory Committee on Immunization Practices (ACIP) guidelines. • Residents and employees may refuse vaccination due to medical contraindication, religious objection, or by choice after being fully informed of the health benefits and risks of such action. • Law requires facilities to document vaccination status of residents and employees, including refusal of vaccination and the reason for refusal.

  13. Clinical Importance • Pneumococcal disease & influenza together are the 7th leading cause of death in the U.S. among persons 65 years or older • Influenza • >200,000 hospitalizations/year in U.S. annually • >36,000 die/year in U.S. annually • 90% of deaths occur among those aged 65 or older Pneumonia • >1.4 million hospitalizations/year in U.S. annually • >65,000 die/year in U.S. annually

  14. Clinical Importance • Healthy People 2010 Campaign • Coalition of national organizations that created a statement of national health objectives designed to identify the most significant PREVENTABLE threats to health • National Goals • Patients – 90% rate for influenza and pneumococcal immunizations • Health Care Workers – 90% rate for influenza immunization

  15. Clinical ImportanceHealth Care Worker Immunization • Spread infection to patients • Contagious 1-2 days prior to onset of symptoms & for 3-5 days afterwards exposing vulnerable patients • Protect co-workers, own family and self • Professional Commitment - ethical obligation to protect patients and fellow caregivers

  16. Provides resources for home health agencies to utilize, create or improve upon a structured and effective immunization program

  17. Download Intervention Package & complete Agency Assessment to determine problem areas within your agency immunization program Review educational materials, resources & tools Review Action Items Develop an Action Plan utilizing the tools & resources to resolve your agency’s identified problems

  18. Sample Influenza & Pneumonia Immunization Protocol • Two versions available: • Agency Administering Vaccines • Agency Not Administering Vaccines • Available on HHQI Web site under the Associated Resources section • Can customize for your agency

  19. Immunization Program Structure 1. ASSESS 2. ACCESS 3. ADMINISTERed A

  20. ASSESSall of your patients for influenza and pneumonia immunizations Immunization Program Structure A Includes assessment of patient immunization status AND determination if the patient is eligible to receive the vaccines

  21. Advisory Committee on Immunization Practices (ACIP) Recommendations /Influenza • Recommendations regarding priority groups for vaccination are published each year prior to the start of influenza season • People who should get vaccinated each year are: People at high risk for complications from the flu, including: • Children aged 6 months until their 5th birthday • Pregnant women • People 50 years of age and older • People of any age with certain chronic medical conditions • People who live in nursing homes and other long term care facilitiesSource:http://www.cdc.gov/flu/about/qa/flushot.htm

  22. Advisory Committee on Immunization Practices (ACIP) Recommendations /Influenzacontinued • People who should get vaccinated each year are: • People who live with or care for those at high risk for complications from flu, including: • Household contacts of persons at high risk for complications from the flu (see previous slide) • Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated) • Healthcare workers Source: http://www.cdc.gov/flu/about/qa/flushot.htm

  23. Advisory Committee on Immunization Practices (ACIP) Recommendations / Pneumococcal • All patients age 65 or older at any time of the year should be screened to identify those patients who are candidates for vaccination, including patients who are candidates for a second dose • A second dose is recommended if the patient received vaccine>5 years previously and was aged <65 years at the time of vaccination http://www.cdc.gov/mmwr/pdf/rr/rr4608.pdf

  24. Advisory Committee on Immunization Practices (ACIP) Recommendations / Pneumococcal continued • Immunocompetent Persons • Persons aged >65 years • Persons aged 2-64 years with chronic vascular disease, COPD or Diabetes • Persons 2-64 years with alcoholism, chronic liver disease or cerebrospinal fluid leaks • Persons aged 2-64 years with functional or anatomic asplenia • Persons aged 2-64 years living in special environments or social settings • Immunocompromised Persons http://www.cdc.gov/mmwr/pdf/rr/rr4608.pdf

  25. Immunization Patient Plan • Provided as handout • Available on HHQI Web site under the Associated Resources section • Can customize for your agency

  26. Immunization Program Structure Ensure ACCESSfor influenza and Pneumonia Immunizations A http://www.dhfs.state.wi.us/rl_DSL/publications/02019at.pdf Page 61812

  27. New York State Education Department Office of the ProfessionsPractice Alerts and GuidelinesNon-Patient Specific Standing Orders and Protocol Guidelineshttp://www.op.nysed.gov/immunguide.htm

  28. Immunization Program Structure A ADMINISTERed- Follow-up • Documentation of administration of the vaccines • Date • Administered by • Documentation of reason for refusal, if applicable

  29. Physician Notification Form • Provided as handout • Available on HHQI Web site under the Associated Resources section • Can customize for your agency

  30. Physician Letter • Page 23 of Immunization Toolkit 2007-2008 • Available on MedQIC Web site under the Home Health section • Can customize for your agency

  31. Patient/Staff Immunization Tracking Record • Excel-based workbook • Created to track patient and/or staff status for influenza and pneumococcal immunizations • Excel tool is posted to HHQI Campaign Web site under the Associated Resources section • Webex demonstration and training program on use of the tool and data entry is also posted • Agencies can also choose to use paper-based version of the tool

  32. Patient/Staff Immunization Tracking Record

  33. Patient/Staff Immunization Tracking Record Summary Report

  34. Immunization Toolkit 2007-2008 Available in the Home Health Section of the MedQIC Web site at http://www.medqic.org

  35. Immunization Toolkit 2007/2008 • Influenza and Pneumonia • Current statistical information • Sample policies, forms, educational materials, posters • Standing orders, Adverse Event Reporting, • Resources • Billing Information • Vaccine access & storage • Avian and Pandemic influenza

  36. Immunization Toolkit Crosswalk to the Immunization Intervention Package Located on Page 10 of Immunization Intervention Package

  37. Next Steps • Review the Immunization Intervention Package Leadership and Care Provider Tracks available at http://www.homehealthquality.org • Print a copy of the Immunization Toolkit 2007/2008 as a resource, available at http://www.medqic.org • Select items appropriate for implementation at your agency • Inform RNs of opportunity to earn free CNEs (contact hours/CEUs) • Display Immunization Posters • Plan your immunization campaign • Immunize rather than hospitalize!

  38. Important Planning Considerations • Plan for future software enhancements to capture assessment, eligibility & follow-up action • Develop a system to track patient and staff immunizations & rates • If agency will not be administering vaccines, investigate potential partnerships & referral sources within the community to support administration of the vaccines • Develop a system to monitor & evaluate the effectiveness of your program • Percentage of immunized patients & staff • Number of ACH with influenza or pneumonia diagnosis

  39. Additional Resources • IPRO Immunization Teleconference Presentations • September 17, 2007 10:00 AM – 11:15 AM • September 20, 2007 2:00 PM – 3:15 PM • September 21, 2007 12:00 PM – 1:15 PM • Speaker: Sheila Palevsky, MD, MPH / Bureau of Immunization, New York City Department of Health & Mental Hygiene • Agenda: Flu Season 2007-2008 Updates • Standing Orders & Immunizations • Telephone Number: 866-793-1342 • Registration is not required & participation is free of charge

  40. Website Resources • HHQI Campaign Web site– www.homehealthquality.org • MedQICWeb site – www.medqic.org • IPROWeb site – www.ipro.org • Centers for Disease Control & Prevention – www.cdc.gov • New York State Education Department Office of the Professions - www.op.nysed.gov/immunguide.htm • Federal Register - www.dhfs.state.wi.us/rl_DSL/publications/02019at.pdf

  41. CONGRATULATIONS!!!St. Joseph’s Long Term Home Health Care ProgramYonkers, New York • Featured in Success Story Section of Immunization Intervention Package: “St. Joseph’s Long Term Home Health Care Program Topples ACH Rates”

  42. THANK YOU!!! Carol Ann Thomas, RN, MS,CPHQ, COS-C Manager Patient Safety & Quality Improvement St. Peter’s Hospital Home Health Care Served as a member of the Technical Expert Panel for the HH QIOSC for the Immunization Intervention Package

  43. Month Best Practice Topic March 2007 Hospitalization Risk Assessment April 2007 Patient Emergency Plan May 2007 Medication Management June 2007 Phone Monitoring and Front-Loading Visits July 2007 Teletriage August 2007 Telemonitoring September 2007 Immunization October 2007 Physician Relationships November 2007 Fall Prevention December 2007 Patient Self-Management January 2008 Disease Management February 2008 Traditional Care Coordination Schedule for Intervention Packages

  44. Sara ButterfieldProject Leader IPRO20 Corporate Woods BoulevardAlbany, New York 12211Phone: 518-426-3300 ext. 104Fax: 518-426-3418sbutterfield@nyqio.sdps.org IPRO Contact Information • Christine StegelPerformance Improvement CoordinatorIPRO20 Corporate Woods BoulevardAlbany, New York 12211Phone: 518-426-3300 ext. 113Fax: 518-426-3418cstegel@nyqio.sdps.org • Victoria AgramontePerformance Improvement CoordinatorIPRO20 Corporate Woods BoulevardAlbany, New York 12211Phone: 518-426-3300 ext. 115Fax: 518-426-3418vagramonte@nyqio.sdps.org

  45. Kelly DonohueCoordinator of CommunicationsContinuing Care Leadership Coalition555 West 57th - Suite1500 New York, New York 10019 Phone: 212-506-5424Fax: 212-258-5331donohue@cclcny.org State Association Contact Information • Alexis SilverDirector of Development and Special ProjectsHome Care Association of New York State, Inc.194 Washington Avenue, Suite 400Albany, NY 12210Phone: 518-810-0658Fax: 518-426-8788asilver@hcanys.org • Rose DuhanSenior AnalystHome and Community Based ServicesHealthcare Association of New York StateOne Empire DriveEastRensselaer, NY 12144Phone:  518-431-7620Fax: 518-431-7915rduhan@hanys.org • Margaret ClarkAssistant Director of Public Policy New York State Association of Healthcare Providers, Inc. 99 Troy Road, Suite 200East Greenbush, New York 12061Phone: 518-463-1118 ext. 811Fax: 518-463-1606clark@nyshcp.org

  46. For more information, contact Questions Comments This material was prepared by IPRO, the Medicare Quality Improvement Organization for New York State, under contract with the Centers for Medicare & Medicaid Services, an agency of the U.S. Department of Health and Human Services. The contents do not necessarily reflect CMS policy. Publication Number:8SOW-NY-TSK1B-07-07.

More Related