Home Health Quality Improvement Campaign Glossary
   
Acute Care Hospitalization (ACH) Rate
National, state, and agency publicly reported quality measure as it appears on Home Health Compare at www.medicare.gov; expressed as the percentage of patients admitted to the hospital during an active home health episode of care.

Avoidable Acute Care Hospitalization (ACH)
Potential hospitalization of a home health patient that may have been prevented through home health agency proactive interventions.

Best Practice Interventions
In Outcome Based Quality Improvement (a home health quality improvement process), the term “best practices” is used to denote specific clinical actions expected of home health staff in order to impact the identified problem (OBQI Implementation Manual, 2002). These interventions can be based on scientific evidence, health literature, and/or performance improvement findings.

Best Practice Intervention Packages (BPIP)
A series of monthly educational packages provided throughout the Home Health Quality Improvement (HHQI) Campaign. The packages, each featuring an identified best practice, have been designed for all agency clinical disciplines, administration and management to be utilized to reduce avoidable acute care hospitalizations.

Campaign Champion
The role of the champion, as visible leaders of the campaign, is to work at both local and national levels to recruit agencies to participate and to promote the campaign goal and interventions. Includes: state and national home care associations, QIOs, and other health care leaders.

Campaign Supporter
Individuals and organizations that register on the campaign Web site at www.homehealthquality.org to visibly support the campaign within their organization and/or at the local community level; supporters receive the monthly campaign informational e-Bulletin.

Examples of campaign supporters: individual clinicians, home health aides, consultants, home health corporate leaders, vendors, hospital discharge planners, case managers, physicians, medical office staff, etc.

Emergency Care Planning
The established agency process that includes all activities, tools and policies/procedures used to assist clinicians with educating patients on what actions to take if a medical problem or change in condition occurs.

Episode of Care
Period of time during which home health services are provided to a patient after initiated by physician orders.

Fast Track Intervention Package
Abridged best practice intervention package for agencies who find they have limited time and resources in any given month and want an overview of the tool and key points only.

Frontloading Visits
Home health practice of increasing the visit frequency or services at the beginning of care when patients are more vulnerable to hospitalization.

Hospitalization Risk Assessment
An assessment that is completed at targeted intervals during the home health episode of care to determine the risk of patient hospitalization.
  
LANE (Local Area Network for Excellence)
Local Area Networks for Excellence are responsible for disseminating key campaign initiatives and information.  Each U.S. state and territory has a LANE consisting of identified state home care associations and/or the Quality Improvement Organization.  LANEs drive and coordinate the HHQI Campaign at their local (state) levels.

Medication Management
A best practice intervention strategy of utilizing specific tools and interventions to assess and monitor the patient/caregivers’ ability and willingness to accurately and safely maintain the physician ordered medication regimen.
 
MedQIC
The Medicare Quality Improvement Community Web site at www.medqic.org, which provides quality improvement resources for physician offices, hospitals, home health agencies, nursing homes, underserved populations and pharmacies.

OASIS 
(Outcome and Assessment Information Set) A set of data elements for use in home health agencies that represents core items of a comprehensive assessment for an adult home care patient and forms the basis for measuring patient outcomes across an episode of care.

Patient Emergency Plan
A home health patient emergency plan is a written patient-centered plan that defines what the patient is to do in case of an emergency or change in health status.

The plan includes a range of signs and symptoms to report to the home care nurse versus when it is more appropriate to call 911.

Phone Monitoring
Scheduled remote care delivery or monitoring in which patient encounters via the telephone occur between a health care provider and a patient and/or caregiver (Home Telehealth Reference 2005).

Plan of Care (PoC)
Physician signed orders for home care that cover up to a 60 day period for home health care (a.k.a. Medicare form 485).

Resumption of Care
For a patient active in home care, the resumption of care visit is the first visit the patient receives after hospital discharge or discharge from any skilled facility.

Start of Care
The date that a home health patient receives the first home care visit; often referred to as the admission visit.

Telemonitoring
Includes the collection of clinical data and the transmission of such data between a patient at a distant location and a health care provider through electronic information processing technologies (Home Telehealth Reference 2005).
 
Teletriage
As it relates to home health, teletriage is the unscheduled, appropriate disposition of health-related problems by a skilled clinician via telephone or telemonitoring technology when initiated by the patient/caregiver (Home Telehealth Reference 2005).