Home Health Tip of the Week

QIO HHQI Weekly Update :: August 6, 2007

TIP OF THE WEEK

Effective strategies for phone monitoring

The use of phone monitoring as an intervention to reduce avoidable hospitalizations can be a strong component in your patient care and monitoring of care. As defined in the Home Telehealth Reference, phone monitoring is the scheduled remote care delivery or monitoring in which scheduled patient encounters via the telephone occur between a health care provider and a patient and/or caregiver.

Consider the strategies below when implementing a phone monitoring intervention program.

Identify Key Patient Population(s). To begin using phone monitoring, it is important to identify patients that will benefit from this intervention. A hospitalization risk assessment and clinical judgment will assist home health staff in identifying patients and caregivers that are appropriate for this service. Consider patients who fit the following categories:
- Patients at high risk of hospitalization, according to a hospitalization risk assessment
- Patients with one or more chronic diseases
- Patients who are hospitalized frequently
- Patients who are known to call the agency frequently
Patient Considerations. Patient abilities such as being able to hear and talk clearly are essential factors. Other skills include the patient’s or caregiver’s ability to manage self-monitoring tasks such as tracking weight, temperature, blood glucose and blood pressure.
Educate Patients and Caregivers. Education is key to the effectiveness of this intervention. Patients and caregivers need to know how phone monitoring will help them manage their disease. They should also be introduced to the person who will be phoning them and they should know when to expect the call.
Educate Staff. Home health agency staff also benefit from education. Staff members need to know how they should coordinate phone calls with other healthcare professionals and how the encounter should be documented. Documentation of the encounter should be in the agency’s approved format and should ideally include the assessment findings, instructions, and any follow-up that may be needed. Home health agency staff members also need ideal days/times to schedule the phone encounters and coordinate them with their visits and other discipline visits.
Staff Communication. Communication among all staff involved with the patient is also essential. Staff should be communicating the patient’s status, potential issues, visit schedules, and tasks that require the patient/caregiver to follow up or complete between visits. Good communication allows the agency to reinforce important information with every encounter, regardless of who is visiting or calling the patient.

RESOURCE SPOTLIGHT

Best Practice Intervention Package: Phone Monitoring & Frontloading Visits
This intervention package, developed for the Home Health Quality Initiative National Campaign, includes reference guides, checklists, posters, and audio recordings designed to help agencies improve phone monitoring and frontloading visit practices. When implemented properly, these two interventions assist home health agencies in reducing avoidable hospitalizations.

LEGISLATIVE UPDATE

Federal Register: OASIS Data Collection Changes Open for Comment
July 27, 2007 -- Federal Register -- As a result of a study by Abt Associates and University of Colorado Health Science Center, the Centers for Medicare & Medicaid Services (CMS) has proposed changes to the OASIS, which are posted to the Federal Register for comment. Changes include the elimination of seven items and the revision/simplification of 44 OASIS items, and the addition of 30 items.