Ready or not, here comes the Joint Commission's ORYX system
Ready or not, here comes the Joint Commission's ORYX system
Mostly, home care is not ready yet, but is it time to start?
Sure, the new outcomes measurement system from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is supposed to be implemented by the end of this year. But if you ask home care agencies if they have chosen the two items to be measured for the system, named ORYX, or if they have selected an approved vendor, most say no.
Homecare Quality Management contacted approximately 40 agencies around the country to take the pulse of the home care industry. Of the dozen people who spoke with us, only four agencies said they had chosen outcomes and vendors.
One of them is VNA Health Care of Staten Island, NY. Carol Sommese, RN, BSN, director of quality management for the agency, says it already has chosen Press, Ganey Associates to do patient satisfaction surveys. The second item the agency will study is likely to be wounds.
Sharp Home Health in San Diego also has chosen its outcomes and vendor, but little else, says Suzi Johnson, vice president of home care for the organization. "And part of the reason we are that far is that we are hospital-based, and they have been working on it longer than we have," she notes.
Kelly Ghidoni, RN, clinical director for quality at the Visiting Nurse Service of Maine in Saco is further ahead. "We've selected our system and will start collecting data in May," she says. "I think others are hanging back and waiting, though. We happen to be ahead of the game because we decided before ORYX was announced that benchmarking was the way to go. Luckily, we happened to choose a system which was approved."
Deborah Stamp, RN, BSN, CIC, vice president of clinical and quality management at Northwest Home Care in Gloucester, RI, says New England agencies may be a step ahead of others, in part because the VNA of New England has an organization that has been discussing ORYX and outcomes measurement for some time.
Northwest has chosen its outcomes and has been gathering data for more than a year. "We even sent someone on a course on our database system so that we can evaluate the data ourselves," she says. "We are proactive, but I understand why others aren't. Things are changing so fast, you end up being reactive whether you want to be or not."
One potential problem, Ghidoni says, is that many of her peers are acting under the assumption that OASIS will be approved for ORYX. But others mention the lack of a solid statement to that effect as a reason they are putting ORYX on hold for now.
"When we had our survey in November, they said that maybe there will be systems that meet both sets of requirements, but they weren't sure," says Judi Witter, RN, MHA, quality associate for community services at Carondelet Home Health Service in Tucson, AZ. "Until we know for sure, we aren't doing anything."
Although the Joint Commission has touted the fact that implementation of ORYX will cost less than $10,000 - that figure comes from a survey of home care organizations that use a performance measurement system - Witter says that for most home care agencies, $10,000 is a lot of money. "That money may cover the software and hardware, but it doesn't say anything about the full-time employee to run the system or training."
Although many of those to whom HQM spoke are dismayed by all the new requirements - some say they are already having a hard time just making it in an era of reduced reimbursement and increased regulation - most say they believe that the rationale behind ORYX is a good one.
"Potentially, this is a great thing," says Jeanette Gronda-Kootsilla, MSA, BSN, RN, clinical director for Henry Ford Home Health Care in Detroit. "We have seven branches, and potentially, there could be benchmarking between them and externally. We can better share our information. The tools which work for one of us would be more accessible to the others."
For those reasons, Gronda says she doesn't think anyone could call ORYX a bad thing. "But I think it will take time."
Her organization often sees its size as a problem - it moves slowly in the face of change. But Gronda-Kootsilla sees it in this case as a benefit. "ORYX shows that the Joint Commission and HCFA are on the same wavelength," she says. "OASIS is the questions and ORYX is the method. I think many agencies are in a quandary because there is software out there and no one knows if it will work for both OASIS and ORYX. In this case, it is good not to be spinning our wheels and spending on things we may have to adjust."
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.