1. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com Hospice and Palliative Care Association of Iowa QAPI Snapshot Program Presented by Becky Anthony Roger Herr Joyce Brekke Introducing your state QAPI Compliance and Benchmarking Program Presented by Becky Anthony Roger Herr Joyce Brekke Introducing your state QAPI Compliance and Benchmarking Program

2. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com The QAPI CoP  Select a full complement of measures  Monitor patient care and agency performance regularly  Monitor and Manage your Adverse Events  Compare with your own and industry benchmarks  Manage care delivery and organizational improvement  Conduct PIPs when necessary  Select a full complement of measures  Monitor patient care and agency performance regularly  Monitor and Manage your Adverse Events  Compare with your own and industry benchmarks  Manage care delivery and organizational improvement  Conduct PIPs when necessary What Do You Need to Do?

3. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com QAPI CoP Measures  Phase I: Quality Domains and Measurement − Reflect Organizational Complexity − All Hospice Services − Palliative Care Outcomes − Patient Safety − Examples in Q&A  Adverse events (p32118)  Pain control within 48 hours of admission (p32119)  Family satisfaction(p32119)  Patient outcomes as well as Administrative data (p32120)  Patient safety (p32121) − 12 hours estimated (p32192) − Effective Dec 2, 2009  Phase I: Quality Domains and Measurement − Reflect Organizational Complexity − All Hospice Services − Palliative Care Outcomes − Patient Safety − Examples in Q&A  Adverse events (p32118)  Pain control within 48 hours of admission (p32119)  Family satisfaction(p32119)  Patient outcomes as well as Administrative data (p32120)  Patient safety (p32121) − 12 hours estimated (p32192) − Effective Dec 2, 2009 QAPI CoPs § 418.58 Federal Registry June 5, 2008

4. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com QAPI CoP Data  Phase II: Hospice Organization Will: − Enter data into patient clinical records during assessment and IDG meetings; − Aggregate data by collecting same pieces from  Clinical Records  Other sources: Human Resources, Pharmacy, Etc. − Analyze the data that is aggregated through:  Charts, Graphs, and various other methods to identify patterns, anomalies, areas of concern, etc...in targeting areas for improvement − Develop and Implement Performance Improvement Projects (PIPs)  Effective February 2, 2009  Phase II: Hospice Organization Will: − Enter data into patient clinical records during assessment and IDG meetings; − Aggregate data by collecting same pieces from  Clinical Records  Other sources: Human Resources, Pharmacy, Etc. − Analyze the data that is aggregated through:  Charts, Graphs, and various other methods to identify patterns, anomalies, areas of concern, etc...in targeting areas for improvement − Develop and Implement Performance Improvement Projects (PIPs)  Effective February 2, 2009 QAPI CoPs § Page 32193 Federal Registry June 5, 2008

5. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com QAPI CoP  Phase III: Hospice Organization Will: − Identify new domains and measures − Develop and revise policies − Educate employees and contractor  Phase III: Hospice Organization Will: − Identify new domains and measures − Develop and revise policies − Educate employees and contractor QAPI CoPs § Page 32193 Federal Registry June 5, 2008

6. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com QAPI: The Costs Involved  Phase I: 12 hours estimated annually  Phase II: 151 hours annually − 91 hours to enter data (4 min/assessment + 5 min IDG) − 48 hours to aggregate data − 12 hours to analyze data  Phase III: 78 hours annually − 1.5 hours week QAPI coordinator oversight  Based on average hospice of 303 patients*  Phase I: 12 hours estimated annually  Phase II: 151 hours annually − 91 hours to enter data (4 min/assessment + 5 min IDG) − 48 hours to aggregate data − 12 hours to analyze data  Phase III: 78 hours annually − 1.5 hours week QAPI coordinator oversight  Based on average hospice of 303 patients* * §418.58 Regulatory Impact p32192 Table 1. Assumptions and Estimates Used Throughout the Impact Analysis Section

7. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com QAPI Resources and Persons  Who: Key persons: − Governing Board − Executive Director − Key person for QAPI, AKA “Coordinator” − QAPI Interdisciplinary Group (IDG) − Other resources  What: − Governing board policies & procedures − Organizational policies & procedures − Selection of outcomes, measures and where/how they are included in documentation/systems − Staff job descriptions & competencies  Who: Key persons: − Governing Board − Executive Director − Key person for QAPI, AKA “Coordinator” − QAPI Interdisciplinary Group (IDG) − Other resources  What: − Governing board policies & procedures − Organizational policies & procedures − Selection of outcomes, measures and where/how they are included in documentation/systems − Staff job descriptions & competencies

8. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com The QAPI CoP  Measure all facets of performance – 360   Make measurable improvement in areas that matter  Demonstrate quality care  Document board-driven leadership  Demonstrate involvement throughout staff  Measure all facets of performance – 360   Make measurable improvement in areas that matter  Demonstrate quality care  Document board-driven leadership  Demonstrate involvement throughout staff What do we need to do?

9. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com QAPI – Some Basics Determine Measures Collect Data Analyze & Report Review & ID “ “ Gaps ” ” Select PI Projects More Data … … ID Drivers of Performance Develop PI Plan Implement PI Plan QA PI Determine Measures Collect Data Analyze & Report Review & ID “Gaps” Select PI Projects More Data… ID Drivers of Performance Develop PI Plan Implement PI Plan The QAPI Process

10. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com QAPI Snapshot  Comprehensive, strategically selected grouping of measures for QAPI Compliance − Clinical, Operational, Satisfaction  Web-based − Easy online data submission − Report access  Executive Dashboard and Tabular Reports − Annual report for strategic direction and target-setting − Quarterly reports for tracking and process management  Free OCS QAPI Help Desk for ongoing support  Comprehensive, strategically selected grouping of measures for QAPI Compliance − Clinical, Operational, Satisfaction  Web-based − Easy online data submission − Report access  Executive Dashboard and Tabular Reports − Annual report for strategic direction and target-setting − Quarterly reports for tracking and process management  Free OCS QAPI Help Desk for ongoing support What is QAPI Snapshot?

11. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com QAPI Snapshot Measures  Measures are defined based on four sources − NHPCO National Data Set (NDS) − NHPCO Family Evaluation of Hospice Care (FEHC) − NHPCO End Result Outcome Measures (EROM) − OCS Hospice Comprehensive Benchmark  Measures are defined based on four sources − NHPCO National Data Set (NDS) − NHPCO Family Evaluation of Hospice Care (FEHC) − NHPCO End Result Outcome Measures (EROM) − OCS Hospice Comprehensive Benchmark Measure Overview FEHC EROM OCS NDS QAPI Snapshot

12. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com Quarterly Report

13. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com Performance Measure Detail You National Median Peer Median Current Period Highlighted

14. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com Quality Partners Detail Component Rating Symbol Your Performance Your Percentile National Median (50 th %) National 25 th Percentile

15. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com OCS QAPI Snapshot Web Page  Secure Login − Enter through Client Login area of OCS website − Unique username and password (agency level) − Secure HTTP connection  Data Submission − A simple online form − Select the desired survey − Links to detailed definitions for each data element  Report Access − Select and download reports you wish to review − Reports available for each quarter you submit data  Snapshot Interpretation Guide & data definitions  Secure Login − Enter through Client Login area of OCS website − Unique username and password (agency level) − Secure HTTP connection  Data Submission − A simple online form − Select the desired survey − Links to detailed definitions for each data element  Report Access − Select and download reports you wish to review − Reports available for each quarter you submit data  Snapshot Interpretation Guide & data definitions

16. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com QAPI Snapshot Login From Client Login, select “Hospice”, then click on Login to QAPI Snapshot button

17. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com QAPI Snapshot Login Enter Agency ID & Password Click Login button on screen to access surveys and reports

18. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com QAPI Snapshot Survey Selection Click on survey link to begin entering data

19. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com QAPI Snapshot Data Entry Selected survey and date last modified Navigation links for jumping to sections to review or complete Agency name

20. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com QAPI Snapshot Data Entry Always save before moving away from page or leaving computer!

21. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com QAPI Snapshot  Uniform State Specific QAPI Measures  Full QAPI Compliance  Easy Submission and Report Access  Free Support  In line with NHPCO National Data Set  In line with Family Evaluation of Hospice Care Join the over 700 hospices using QAPI Snapshot!  Uniform State Specific QAPI Measures  Full QAPI Compliance  Easy Submission and Report Access  Free Support  In line with NHPCO National Data Set  In line with Family Evaluation of Hospice Care Join the over 700 hospices using QAPI Snapshot! Features and Benefits

22. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com Logistics of Participation  Upon registration, you receive an email from OCS, including: − Your agency’s unique username and password − Survey soft copies, measure descriptions, and data definitions − OCS key contact information  Determine internal data sources and reporting process  Submit quarterly data for as much of 2008 as possible  Communication − Reminder messages: Survey and reports − Client Services − Online access to: Data definitions and other resources  Upon registration, you receive an email from OCS, including: − Your agency’s unique username and password − Survey soft copies, measure descriptions, and data definitions − OCS key contact information  Determine internal data sources and reporting process  Submit quarterly data for as much of 2008 as possible  Communication − Reminder messages: Survey and reports − Client Services − Online access to: Data definitions and other resources A Simple, Well-supported Process

23. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com Pricing  Based per Provider Number − $600  Fee includes − 1 year participation with Hospice and Palliative Association of Iowa QAPI Snapshot Program − Customer Support & Report Interpretation − Ensure QAPI Compliance and Success !  Based per Provider Number − $600  Fee includes − 1 year participation with Hospice and Palliative Association of Iowa QAPI Snapshot Program − Customer Support & Report Interpretation − Ensure QAPI Compliance and Success !

24. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com QAPI Snapshot  A tool for meeting regulatory compliance  Utilizes current hospice specific measures  Integrates Peer Benchmarking frame of reference  Focuses on Performance Improvement − Monitor important measures − Performance Improvement Projects  A tool for meeting regulatory compliance  Utilizes current hospice specific measures  Integrates Peer Benchmarking frame of reference  Focuses on Performance Improvement − Monitor important measures − Performance Improvement Projects

25. ©2009 OCS, Inc. 206.325.3396 www.ocsys.com Please Call Joyce Brekke 888.325.3396 x185 Or Email hospice@ocsys.com For More Information