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Hospice Quality Reporting Update: June 2014

This presentation provides an overview of recent updates to the Hospice Quality Reporting Program, highlighting the new Hospice Item Set (HIS) introduced in July 2014 and its components, including the Comfortable Dying Measure and other critical standards. It discusses the importance of staff involvement, timelines for admissions and discharges, and the evaluation of the patient and family experience through the Hospice Experience of Care Instrument. The session also delves into the necessary preparations, organizational communication strategies, and educational requirements for successful implementation and compliance.

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Hospice Quality Reporting Update: June 2014

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  1. Hospice Quality Reporting Update: June 2014 Presented by: Anne Shelley, MBA, BSN, RN Susan Wallace, MSW, LSW

  2. Objective • Discuss the updates to hospice quality reporting requirements.

  3. Hospice Quality Reporting Program • Structural Measure & Comfortable Dying Measure • Concluded April 2014 • Hospice Item Set • July 2014 • Hospice Experience of Care Instrument/CAHPS • Early 2015

  4. What is the HIS? • “Item Set” vs. “Standardized Assessment” • Based on seven NQF-endorsed measures • Treatment preferences (CPR, Hospitalization, Other life-sustaining treatments • Beliefs/values addressed • Pain screening and assessment (2) • Dyspnea screening and treatment (2) • Opioid and bowel regimen

  5. What is the HIS? • Admission & Discharge • Completed for ALL patients • Submitted on a rolling basis • Completed: 14 days from admission, 7 days from discharge • Submitted: 30 days from admission/discharge • Linked to 2% market basket reduction

  6. A NEW Alphabet Soup • QIES ASAP CASPER RTI QTSO HQRP NQF HIS HART MAP

  7. Preparation • Research • Staff Assignment • Medical Records Evaluation, Reconciliation with the HIS • Organizational Communication Plan • Staff Education • Implementation

  8. Research • http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/Hospice-Item-Set-HIS.html • HIS Manual • Training Slides (2/4 & 2/5) • Fact Sheet • https://www.qtso.com/hospice.html • Registration announcement • Technical Training Modules • Other announcements • https://www.qtso.com/hart.html

  9. Staff Assignment • Who needs to be involved in planning? • QAPI/Compliance • Executive Director • P&P Interdisciplinary Group • Care Managers • Administrative staff • Preliminary estimate of staff hours required • Paper: 40 minutes per patient • EMR: 15-20 minutes per patient

  10. Medical Records Evaluation, Reconciliation with the HIS • Contact EMR vendor • Are assessments aligned with HIS items and language? • Will reporting mechanisms be fully functional by July? • Will reporting mechanisms match CMS expectations? • Crosswalk the HIS to your records • Time Study

  11. Organizational Communication Plan • Leadership • Resource Allocation/Redistribution • Communication to Board • Initial Education Plan for Staff • Ongoing Education Plan for Staff • Orientation/Training • Annual Updates

  12. Staff Education

  13. Implementation

  14. What is the Hospice Experience of Care Instrument? • Evaluation of the patient/family’s experience of care • Caregiver as proxy • Post-death • Similar to CAHPS surveys • Similar to the Family Evaluation of Hospice Care (FEHC) • Developed by Rand Corporation • Three versions based on place of death • Home, Inpatient, Nursing Facility

  15. Hospice EOCS (CAHPS): Timeline • First quarter 2015: 1-month “trial run” for submission • April 1, 2015: Begin continuous usage

  16. Vendors • Hospices must contract with CMS-approved vendor • Vendor applications: late 2014 • Home Health CAHPS Vendors: • https://homehealthcahps.org/GeneralInformation/ApprovedSurveyVendors.aspx

  17. On the Horizon

  18. NQF Endorsement Process • Call for Measures • Call for Nominations • Measure Review • Comment • Voting • CSAC Decision • Board Ratification • Appeals

  19. Measures Application Partnership • Measure concepts: • pain • goal attainment • patient engagement • care coordination • depression • caregiver’s role • timely referral to hospice

  20. April 2014: Call for TEP Nominations • Project Objectives Include: • Investigate the potential for expanding existing quality measures or measure concepts to the Hospice QRP. • Generate measure ideas/concepts that address gaps in the current Hospice QRP identified by stakeholders such as the Measures Application Partnership (MAP).

  21. Questions?

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