National rollout of CMS web site in October
The effect of Home Health Compare, the Centers for Medicare & Medicaid Services (CMS) web site that publicizes results of 11 home health quality indicators, has been minimal for agencies located in the eight pilot test states. Home Health Compare’s pilot test began in May 2003 and includes outcomes data such as improvement in ambulation, improvement in bathing, acute-care hospitalization, and improvement in toileting. The national rollout of the program to include all 50 states is set for mid- to late October, according to a CMS spokeswoman. (Editors note: The exact date had not yet been announced at press time.) All 11 indicators that were used in the pilot test will be continued, she adds.
Early response and education
"We’ve had a few families tell us that they contacted us after viewing the CMS web site, but it has not been significant," says Joanne Smith, RN, director of Florida Hospital Memorial Home Health in Ormond Beach, FL. "We did not promote the web site to our patients or referral sources, but local newspapers did run articles," she says.
A statewide newspaper in West Virginia also ran an article on the web site and listed comparisons of the bathing improvement indicator among agencies but neither the article or the web site has resulted in families or referral sources choosing or staying away from Braxton County Memorial Hospital TLC Home Health Care, says Lisa Ware, RN, nurse manager of the agency. "Even if people in our area checked the web site, we are in a rural area, and we are the only home health agency serving the area," she adds. "We still rely upon word of mouth and our usual referral sources," she says.
Although North Kansas City (MO) Hospital Home Health Services has not received any comments, telephone calls, or other feedback regarding the web site, Rebecca Murrell, RN, BSN, supervisor of the agency says that everyone was prepared. "We started educating our staff a year before the web site went on-line," she says. "Because we started before the final 11 indicators were chosen, we shared outcome information for all 41 indicators with staff members," Murrell explains.
The focus of the educational effort was to increase accuracy of the initial patient assessments so that outcomes would not appear to be negative, Murrell says. "We divided the staff into small groups of four to five people and had each group evaluate each question," she continues. The definitions, guidelines, and suggestions on what should be included in answers were suggested by the small groups and shared with the entire staff, she explains. "We wanted to make sure that everyone was assessing the patient accurately and that everyone was consistent in how they documented and reported each item," she explains.
Denise McConnell, RN, clinical manager for Roper-St. Francis Home Health in Charleston, SC, contends that very few patients or families understand the quality information and they don’t know how to apply it to their situation. "I also wish that indicators that measured stabilization were included as well as improvement indicators," she adds. "For many home health patients, stabilization is the ultimate goal and is just as important as improvement might be for other patients," says McConnell.
Staff need to have the answers
Even if patients and their families, or even some of your referral sources don’t understand the data, be sure your staff members are all aware of the web site, suggests Murrell.
"Your staff members should be able to answer any questions a patient might have, or at least know about the web site and offer to get the answers for the patient. This reassures the patient that you are comfortable with your quality information being made public and you are proud of your agency’s record," she says.
For more information on Home Health Compare, contact:
• Joanne Smith, RN, Director, Florida Hospital Memorial Home Health, 785 W. Granada Blvd., Ormond Beach, FL 32174. Telephone: (386) 673-3121.
• Lisa Ware, RN, Nurse Manager, Braxton County Memorial Hospital TLC Home Health Care, 100 Hoylman Drive, Gassaway, WV 26624. Telephone: (304) 364-1063.
• Rebecca Murrell, RN, BSN, Supervisor, North Kansas City Hospital Home Health Services, 2900 Clay Edwards Drive, North Kansas City, MO 64116. Telephone: (816) 691-1358.
• Denise McConnell, RN, Clinical Manager, Roper-St. Francis Home Health, 1483 Tobias Gadson Blvd, Suite 208A, Charleston, SC 29407. Telephone: (843) 402-7000.