Home health care industry braces for OASIS
Agency offers tips on coping with assessment tool
If you’re running a home health care agency, you probably have heard the news. As of July 19, after years of debate and field-testing, use of the Health Care Financing Administration’s (HFCA) Outcome and Assessment Information Set (OASIS) standardized data set became mandatory for all home health care agencies (HHAs) participating in the Medicare and Medicaid programs.
You may not know the whole story, though. If you’ve been worried about the organizational resources that administering OASIS will consume as you incorporate it into your HHA, you can relax a bit. And if you’re skeptical about the usefulness of collecting the sociodemographic, environmental support system, and health/functional status information covered in the 89-question data set, you may well change your mind as you get more familiar with the system.
This good news is based on the experience of Sharon Johnson, director of clinical practices and outcomes for Jefferson Home Care, a unit of Bryn Mawr, PA-based Jefferson Health System. Jefferson Home Care was one of 50 national home care organizations nationwide to participate in the five-year OASIS trial program, and the only one to institute OASIS standards on a systemwide basis during this period.
While acknowledging that there is a "learning curve" associated with the data set, Johnson says OASIS is the most exciting development affecting the quality of patient care that she’s seen during her career as a nurse. "When you first look at the 24-page assessment questionnaire, it seems overwhelming — which I think accounts for much of the near-hysteria that is going on [among many in the HHA industry] right now," she says. "But, if an agency is already doing a good job, it’s just a matter of getting familiar with the questions."
Johnson has several tips for HHAs that are incorporating OASIS into their daily businesses:
• Beware of duplication. "It’s important to reduce duplication and/or redundancy between what you are already doing and OASIS," she says. "Since OASIS needs to be integrated into your existing assessment, you don’t want to waste time covering the same territory twice."
• Don’t rely 100% on OASIS. "OASIS is not a comprehensive tool, from either a clinical or regulatory point of view," says Johnson. "As wide-ranging as it is, it doesn’t stand alone as an assessment data set — you will need to augment it."
• Don’t be overwhelmed. "Don’t believe the rumors flying around about how much of a burden OASIS adds," she says. "Studies have not proven that. And, in our case, assessment times have either stayed the same or been reduced slightly, while the consistency of data has improved."
• Relax! OASIS will not (by itself) cause productivity to suffer. "I’ve heard people say it takes 40 hours to educate a clinician about OASIS, but that is just not the case," says Johnson. "We’ve found that a two-hour initial education session, with some follow-up troubleshooting, works well." At the same time, because HHA clinicians have already been gathering much of the OASIS information through their existing in-house assessments, "integration with your existing systems will be smoother than you might expect."
Benefits of OASIS
Designed to foster improved home health care outcomes, OASIS is a tool with real benefits for both HHAs and their patients, according to Johnson.
"What makes OASIS so exciting is that, for the first time, HHAs will be building real data that will help them make decisions about quality improvement." Most important, she adds, "These data are statistically significant and risk-adjusted," making that information particularly useful as a basis for outcome-based quality improvement.
OASIS will also help reduce the inconsistency inherent in open-ended assessments of patients that are conducted by different clinicians. "OASIS is a good assessment that neutralizes variability in staff assessment skills," says Johnson. "The OASIS data set requires clinicians to use forced-field answers, which reduces the disparity between how Nurse A and Nurse B might view the same patient." Clinicians can find OASIS frustrating in this respect, she notes.
To alleviate this frustration — and get the best possible patient assessments — "We tell them that if there is something more they want to say, they need to write it up in accompanying notes," she says.
[For more information, contact:
• Sharon Johnson, Director of Clinical Practices and Outcomes, Jefferson Home Care, 130 S. Bryn Mawr Ave., Bryn Mawr, PA 19010. Telephone: (610) 526-3837.
• Health Care Financing Administration, 7500 Security Blvd., Baltimore, MD 21244. Telephone: (410) 786-3000. Web site: www.hcfa.gov.]
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content. TESTING
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content