Agency Comments

HHQI Team Remarks

Although staff and I really buy into the value of HHQI, at times it seems like just another task to work into an already busy work life. How are other administrators and staff overcoming this difficulty?

It is difficult to squeeze one more thing into an endless list of tasks! Many agencies are approaching the HHQI best practices as an opportunity for administration and staff to focus on patient care. Even with all the important tasks, it is imperative that all of us remember the reason why we do what we do!

I am so happy that someone is publishing best practices in home care. I am looking forward to the disease management models.

It is evident that many are looking forward to the disease management BPIP-66% of August survey participants view this as the package in which they have the most interest.

First, thank you for the slower paced 'Summer Series' that allows us, as a small rural HH agency, the ability to continue to work on this initiative despite staffing issues with vacations. Secondly, this program has facilitated a greater staff understanding & buy-in of the QI process through both the best practices and forms, as well as the CE and contact hours. In my 15 years with QI in this agency, participation has never been this engaged. One request, could MSW CE's be offered in the future? As a rural agency, local offerings are infrequent and this would benefit our MSW's. Thank you for this program.

Glad to hear that this has helped staff understanding and buy-in. The discipline tracks have brought quality improvement to the clinicians. Currently at this time we are not providing continuing education for MSW, but will take that into consideration with future educational offerings.

I am very excited that our MSW and PT have come to me and said, "Finally, they include us in the education and outcomes of the agency!" They feel very happy to be a part of the initiative. I would like to be able to access CE's or certificates for our staff for past BPIP's starting with March because some of them are new or playing catch up and it is important for them to get credit for going back and doing all the modules from the beginning of the initiative. They have to do this for the current classes we are having for August to make sense to them.

All disciplines must be involved for home health agencies to be truly effective with improving clinical outcomes. Reaching all disciplines has been a major focus for the campaign. Not all packages have CNEs and certificates—this process has evolved with each package. Please see the table below which lists each package and what is offered. Or check out our new Contact Hours page on the site. Thanks!

The HHQI best practice intervention packages are mandatory in our agency for all nurses (RN, LPN) and therapists. We also share information with the HHA. It is frustrating for the LPN's that they do not receive CEU's for their participation. Can we obtain CEU's for the LPN's?

Many agencies have voiced the same concern. Therefore, LPNs /LVNs will be able to receive a certificate of participation beginning with the Immunization BPIP (September).

I believe your Web site is the best of its kind, hands down. The resources and educational opportunities are excellent and being used by multiple staff levels. Thank you for this significant offering that is so supportive of our agency mission and clinical objectives.

Thanks. We have received many positive comments about the Web site. The HHQI Web site is updated weekly with current information. Be sure and check out the information we include for hospitals, patients, physicians and managed care organizations. You may find some useful resources on these pages to use with other settings.

Our "Client Oriented" Company Goal for 2007-2008 is to "utilize strategies and tools provided by the HHQI National Campaign to reduce avoidable acute care hospitalization and improve bathing." These tracks and tools offer a total "improving agency performance" program - who benefits? Our clients and the community!

That’s right-the goal of the campaign is for home care patients to remain in their home settings, resulting in fewer avoidable hospitalizations. Hospitalizations can unnecessarily create financial and emotional burdens for patients and their families and can negatively impact the health care delivery system.

We have been using telemonitors for a couple of months. My problem is getting the nurses to recognize the patients that would benefit. I am now going to choose the patients myself using our admission criteria.

This is a common issue. Check out page 18 of the Telemonitoring BPIP. It has some ideas for maximizing use of telemonitors. Your idea to look at admission criteria and scrutinize all referrals is a good one; almost every patient can benefit from daily vital sign monitoring, especially in those vulnerable first 2-3 weeks post-hospitalizations.

Some staff are not sold on the validity of telehealth, due to cognitive issues with many patients. Feel that phone evaluation can be inaccurate since a patient may tell you what you want to hear over the phone.

It may be appropriate to ask more probing questions with patients. Staff needs to see the positives with phone monitoring, so buy-in may improve over time. Encourage staff that have favorable results with phone monitoring to share their stories with others. Another suggestion is to download Patient Vignette #1 or 2 and play at a staff meeting. You could also videotape your own vignette of a patient success story and share at a staff meeting. (Also consider playing the vignettes at your professional advisory committee and/or board meeting for leadership buy-in.)

Month

Best Practice Topic

RN Contact Hours available

LPN/LVN Certificate of Participation available

Therapy Certificate of Participation available

03/01/07

Hospitalization Risk Assessment

N/A

N/A

N/A

04/02/07

Patient Emergency Plan

1.25

N/A

N/A

05/01/07

Medication Management

2.0

N/A

N/A

06/01/07

Phone Monitoring and Frontloading Visits

1.5

N/A

1.2

07/02/07

Teletriage

1.7

N/A

1.0

08/01/07

Telemonitoring

1.0

N/A

1.0

9/4/07

Immunization *

1.3

1.3

1.3*