1 / 19

Investigative Skills

Investigative Skills. Observing Interviewing Documenting. Definition.

cameo
Télécharger la présentation

Investigative Skills

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Investigative Skills Observing Interviewing Documenting

  2. Definition Investigative skills are key cognitive areas of decision making that guide or impact data gathering during any type of survey. These key cognitive areas are vital in guiding the direction of the investigatory work and directing the surveyor to investigate an issue further.

  3. Purpose Investigative skills: • Are used to obtain accurate information without creating a hostile or unpleasant atmosphere. • Allow the surveyor to decide what information is important and what is not. • Are critical to the surveyor’s role in writing and preparing to defend deficiencies.

  4. Investigative Elements • Observations • Interviews • Record or document reviews **Note that all three elements impact the investigative work and decision making during the survey process**

  5. Observations • Give surveyors first-hand knowledge • Help surveyors put together pieces of the puzzle and identify areas that may need further investigation • Are complex – see what is there and what is NOT there • Provide the most powerful evidence - Even more powerful when validated by interviews and record review

  6. Conducting Observations Within the context of the regulations, assess: • Whether the specific care and services provided are appropriate • The integration of care and services provided by individuals or departments to each patient/client/resident • The environment in which care and services are provided

  7. Interviews • Allow the surveyor to obtain background knowledge • Present an opportunity to build rapport • Are most beneficial when using open- and closed-ended questions • Are an opportunity to achieve clarity • May provide closure

  8. Interviewing Elements • Establish a purpose • Plan • Set atmosphere, tone, create rapport • Discover mutuality • Listen actively • Gain knowledge & experience • Consider time & timing • Evaluate & make decisions • Write a summary

  9. Document Review • Validates and clarifies observations or interviews • Assists in evaluation of assessments, Plans of Care, and patient outcomes • Reflects the provider or facility viewpoint

  10. Conducting a Document Review • Review standard items in records during every survey • Review specific items based on particular issues of concern by the team • Be aware of the significance of unrecorded information • Focus on documents that provide information on care and services being provided and investigated

  11. Systems View CMS Patients

  12. Investigative System

  13. Investigative System • Surgical Services • Governing Body • Medical Staff • QAPI

  14. Critical Thinking • What are the Red Flags • What other information do I need to gather? • Uncover root cause of problem. What specifically did the facility fail to do? • Was there a failure? Was the failure in the hospital system, individual performance or missed patient perspective/expectations? (What system failed?) • Surveyor decides what information is important and what is not • Document findings – paint picture with words.

  15. When is Enough, Enough? • The goal of our investigation is to provide irrefutable evidence regarding the provider’s compliance with regulations. • A new surveyor may: • Tendency to stop too soon • Lack training in event investigation • We don’t ask enough questions • “The root cause” myth • Root cause analysis is not about finding one root cause • Accidents and most issues have multiple causes

  16. Summary When applying investigative skills, surveyors: • Gather information to support findings • Identify representative beneficiary sample to investigate issues so scope of problem can be determined. • Determine an accurate set of problems and issues to investigate. • Determine and focus on what to look for and where to find it.

  17. Summary • Notice “red flags” (detect indicators of potential problems). • Uncover root cause of problem. What specifically did the facility fail to do? • Document findings – paint picture with words. • Determine extent or scope and severity of problems. • Interpret rules and regulations. • Determine what to cite at what tag or regulation.

  18. Putting It All Together • Use information contained in documents, combined with observations and interviews to determine compliance. • Be open to asking facility staff to help you find information you are unable to locate on your own. • Remember the expectation is that the provider will be in continual compliance • The goal of our investigation is to provide irrefutable evidence regarding the provider’s compliance with regulations.

  19. Investigative Skills Thank you so much for your kind attention!

More Related