In addition to the OASIS-C training resources we listed last week, an important OASIS-C research project was conducted this fall by Fazzi Associates and sponsored by Delta Health Technologies. The “Delta National OASIS-C Best Practice Project” tapped the expertise of more than 80 experienced home care clinicians to identify best practices for gathering data with the new question set.
Results will be published in January. Fazzi will be able to distributed the project’s findings at no cost thanks to Delta’s sponsorship. We will publish information about how to obtain your free copy as soon as we have it.
Groundwork laid in October
Though the bulk of the work developing best practice recommendations occurred in Chicago on November 10 and 11, Fazzi Associates laid the groundwork during the October NAHC Annual Meeting in Los Angeles. In an innovative approach for involving clinicians throughout the country, Fazzi launched an online “Input Forum” on October 11. It was set up to give clinicians who were not on the final panels the opportunity to identify those questions and issues they would like to see addressed by the national experts in Chicago.”
All home care clinicians were asked to list their three biggest concerns and name the three new data items that worry them the most. Those results were compiled and delivered to Chicago to help stimulate panel discussions and ground them in real-world concerns expressed by their peers.
We spoke with Dr. Robert Fazzi, president of Fazzi Associates, and Delta Health Technologies president Keith Crownover to get each of their perspectives on how valuable the expert best practices will be, as well as some insights into the methodology used to develop them.
Dr. Robert Fazzi
“The recommendations that came out of these meetings are incredible,” Fazzi began. “Nearly 100 people came to Chicago and spent two days together in targeted work groups. They took their assignments seriously and spent hours examining the most minute details about how each question should be answered.
“The goal of the project was to develop best practices, best strategies, techniques and tips for generating more accurate OASIS-C answers,” Fazzi continued. “We provided the experts with national input and peer recommendations on issues that needed to be addressed, which we had been gathering for a month. Over 1,000 recommendations came in. That input phase was followed by two intense days of review and discussion in Chicago, where the invited experts were divided into ten focus groups, each with its own specific OASIS section. They collectively developed recommendations, suggestions, strategies, and tips for every OASIS question.
“They worked in groups on the first day from 2:00 to nearly midnight and from 7:00 am to 2:00 the next afternoon. Workgroups included senior clinicians from nearly every big agency, plus NAHC’s Mary St. Pierre and Deb Dietz from Abt Associates.”
The recommendations from this group are now being reviewed for regulatory and clinical accuracy. When this step has been completed, they will be subjected to further review by Fazzi Associates’ outside reviewer, Liz Madigan from Case Western University.
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Panelist Honored to Participate One of the participants described her experience to Keith Crownover after returning from Chicago. “I was able to be a co-facilitator at a table of eight other home health clinicians,” wrote Tecla Webber of St. Francis Home Health in Tulsa. “We developed tips and strategies on how to correctly answer the 18 questions related to activities of daily living and the fall risk assessment. “I was so impressed with the all the attendees who worked from two in the afternoon to ten at night to get all the OASIS-C questions covered. By the end of the event all the OASIS-C questions had tips and recommendations on how to meet the intent of the question. “I was very honored to be associated with a company that not only provides an excellent product, but also is willing to be an industry partner. The final product of the Delta Forum will assist all of home care to develop an assessment of the patient that is both accurate and answered consistently throughout the home health community.” |
The project was initiated because the new format gives OASIS assessments even more impact on agency revenue than they have now. “There are over 80 changes and an array of new process measures,” Fazzi explained. ”Results of clinician assessments will have a dramatic impact on an agency’s financial and quality outcomes. Despite its importance, there has been little time for clinical leaders to come together to define best practices, strategies, techniques and the like for conducting quality assessments using the new instrument.”
Keith Crownover
“The Delta OASIS-C National Best Practices Project” began with invitations sent to recognized experts in every state, most from the nation’s largest home care organizations. Local state associations nominated invitees and others were chosen directly based on their reputations. “I was impressed for a number of reasons,” Crownover told HCTR. “Our sponsorship included room and board but these people had to get themselves to Chicago at their own expense and there were only two or three no-shows! In a few cases, individuals who were not invited asked their state association to intervene for them with Fazzi’s selection team, they wanted to participate that badly.”
The Delta president said he was also impressed with how seriously participants took their tasks. “Everyone went away talking about the infamous Table Eight,” Crownover related. “The groups started working at 2:00 that afternoon. We thought we would have to push them to keep working after dinner but most went until 10:00 and we finally had to force Table Eight to stop and get some sleep at 11:00.”
Fazzi’s staff facilitated the effort, which included analyzing each table’s written results and having them ready for in-depth, general critique and discussion by 7:00 on the morning of Day Two. Crownover said that he attended, visiting tables and sitting in on various discussion, simply because he wanted Delta to be more involved than just writing a check. “I couldn’t believe how much I learned in two days,” he said. I was most impressed with personal notes I received afterward with feedback from some of the panelists, describing their experience in Chicago.” (see “Panelist honored to participate”)
“What makes the National Forum so unique,” concluded Crownover, “is that an industry-wide challenge has been responded to by industry-wide experts. We brought together clinical experts recognized in their state as being true experts and passionate advocates for ensuring the accurate completion of each assessment. And with so many new questions and new challenges with the new OASIS-C instrument, this could not be done at a more timely moment.”
