2. An integrated system that facilitates the management of information in key areas Affords consistency across the state Expedites communication and processes Increases overall service effectiveness HCSIS = Home and Community Services Information System

3. HCSIS: A Component of DMRIS Is a web based individual information system to be used by both DMR and providers of services Is geared to capture important events and health care information for individuals served by DMR

4. MODULES COVERED IN HCSIS Death Reporting Event Management National Core Indicator Survey Provider Sign-Up User Administration Health Care Record

5. Event/ Incident Management Incident reporting Restraint reporting Medication occurrences Optional Reporting

6. Incident Management: Component of Quality Management System Shift from incident reporting to incident management Procedures similar to current system Serves important functions:  Identifies adverse events  Notifies key people  Prompts action and response to protect and to minimize risk  Analyzes trends and patterns leading to service improvements

7. Incident Management Process Closure Review Agreement DMR and Agency Provider I-Report

8. Development of Incident Management Process Goal to integrate various existing processes Input from stakeholders including DMR and DMR- Provider Partnership Committee Most processes, including restraint reporting and medication occurrences remain the same Incident Reporting System enhanced into Incident Management System

9. Incident reporting Today's training is on the newly written form for reporting incidents-- generally completed by the direct support staff. Is not a training on the technical use of HCSIS.

10. Incident Management Business Process Training and Support DMR Training Staff conducting actual training DMR Content Leaders are available resources for answering questions and providing additional information about the incident management system Reason for roll-out of Incident Management System as paper process first

11. Incident Report Form

12. Site-Based Incident Report Form

13. Incident Type Categories Primary Categories Death (sudden or unanticipated) Suicide Attempt Unplanned Hospital Visit Near Drowning Assault Missing Person Medical Treatment Resulting From Injury Property Damage Suspected Mistreatment Unplanned Transportation Restraint Theft Fire Other Criminal Activity Transportation Accident Emergency Relocation Other: a n incident that does not easily fit into one of the incident types

14. Secondary Incidents Type Category Helps the reporter by specifying the adverse event that has occurred, for example : Unplanned Hospital Visit  Medical Hospitalization  Psychiatric Hospitalization  E.R. Visit With Treatment Provided But No Admission  E.R. Visit With No Treatment, No Admission

15. Secondary Incidents Type Category Death  Accidental  Suicide  Unusual Circumstances Suicide Attempt  First Known Attempt  Repeat Attempt Assault  Sexual Assault – Victim  Sexual Assault – Alleged Perpetrator  Physical Assault – Alleged Perpetrator  Physical Assault – Victim

16. Cause of Injury Inflicted by self, by staff, by peer, by other Environmental Restraint-Related

17. Type of Injury Abrasion/Cut Fracture Poison

18. Affected Body Part Ankle Eye Shoulder

19. Initial Treatment Provider Self/Family LPN, RN, NP MD’s Office EMT

20. Location of Incident DMR Residence Individual’s Family Home Day Service Community Activity

21. Incident Location Detail Bedroom Yard Vehicle

22. Relation to Individual Reporting Provider Staff Individual/Consumer Relative

23. Hospital Occurrence Death Admission to ICU/CCU Surgical Procedure Psychiatric Admission

24. Discharge Instructions Increase in medication (compared to medications before admission) Instructions on when to contact the health care practitioner Wound care Transferred to rehabilitation or nursing facility

25. Current Status Change in daily living capabilities – lower than before hospitalization New Health status-temporary condition that will get better New Health status – permanent condition, not changing New health status – terminal condition

26. Follow-Up Appointments Primary Care Physician (PCP) Specialist Outpatient/ Admitting psychiatrist

27. HCSIS Deployment March, 2006, pilot of electronic HCSIS scheduled for roll-out in the Northeast Region July, 2006, full implementation of electronic HCSIS scheduled.

28. DMR Web Page Under Publications you will find all the handouts and HCSIS Alerts www.Mass.gov/ DMR