QIO HHQI Weekly Update :: May 24, 2004

TIP OF THE WEEK

Use the CASPER Outcome Tally Reports for Quality Improvement *

 

Quick Links

• Download the tally report template and instructions from the CMS Web site. (Requires WinZip, Excel 97 or higher, and Adobe Acrobat)
• Read more from the CMS OASIS/OBQI Web site.
• Download Appendix A in the Home Health Care Agency System Users Guide from the QIES technical support website.

 

Using Tally Reports to Explore What Helped Achieve Improvement

The tally report available through CASPER provides information that your agency may want to use in determining which patients achieved or did not achieve a selected outcome. Tally reports identify individual patients. Looking at actual identified patients may prove more meaningful for staff than data figures. As an example, if you were working on improvement in transferring as the selected outcome measure, the tally report identifies those patients that improved by achieving the outcome and those that did not improve by not achieving the outcome. Taking it a step further, if the patient’s rehabilitation potential is “good” and the patient did not improve, the record might be helpful in exploring the reasons for the lack of improvement. Were the best practices from the Plan of Action (POA) apparent in the care interventions? Were there circumstances that the POA did not address? Are there areas that should be modified in the POA that will improve the outcome in the future? Is there something that needs to be included in the best practices?

 

The tally report may be more helpful as it can be filtered for a shorter time period than 12 months. It uses the “observed” or current rate, not the risk adjusted rate. The home health agency may use the patient tally reports for outcome-based quality improvement purposes. It enables the agency to focus on patients with specific attributes and outcomes and avoid reviewing lengthy printed reports. The ability to connect a patient with the numbers from the data may help staff explore the care processes or best practices from the POA in a more meaningful manner. The identified patient that achieved or did not achieve the outcome provides an opportunity to explore what care process was in effect and if additional interventions might prove beneficial for improvement in the future. Each patient case identified from the tally report provides the practical aspect of retrospectively analyzing the type of services and care process provided for that patient from the clinical record. The comparison of the care process provided to cases that achieved the outcome (and those that did not) could answer questions about the effectiveness of the best practices chosen for the POA. Following this exploration into the care process, areas of modification or additional interventions to the POA may be implemented.

 

 

Outcome Tally Report

Includes data that show whether or not a case achieved

a particular outcome in the OBQI reports. Data are

updated monthly after the 2nd weekend of the month.

 

x = achieved the outcome

y = achieved the utilization outcome

 

0 = did not achieve the outcome

n = did not achieve the utilization outcome

 

- = case was not eligible for this outcome

 

 

Steps for Using the Tally Report Workbook

• Download the tally report workbook tool and instructions
• Download the tally reports from Casper
• Open the workbook, import the tally reports, and start using them!

 

Download the Tally Report Workbook at http://www.cms.hhs.gov/oasis/obqi.asp

• Halfway down the page is a section entitled, “Revised Patient Tally Report Workbook with Data Filtering Tools.” Click on the link to the “revised workbook and instructions.” This is a ZIP file that contains the workbook and instructions. You will need the WinZip program installed on the computer. Save this zip file on your computer, and then extract the contents by opening the file. You will need Excel 97 or higher to use the workbook, and Adobe Acrobat to print and view the instructions. 
• After you click on the link, a box will pop up telling you that you are downloading the file and asking if you would like to save it to your computer. Click “Save.” A box will pop up asking you to select a location to save the file. Go to that location, and remember where it is, because you will have to go back to that location to open the zip file.
• Another box will pop up to show you the status of your download. This can take a few seconds to several minutes, depending on the speed of your computer. When finished, the box will say “Download Complete.” Click on “Open Folder” to go to the location where you saved your file. Or, use Windows Explorer to go to that location.
• Double-click on the tallyreportworkbook.zip file. If you have WinZip installed on your computer, it will open. In WinZip, click on the “Extract” button. A Box will pop up. Choose the location where you want to save the extracted files. Click “Extract.” (This can be the same location where you saved the Zip file.) The instructions and workbook are now ready to use; go to that location to open them.

 

Downloading/Using the Tally Reports

• Request the Outcome Tally Report in the CASPER/OASIS system. Directions for this are available at: Appendix A in the Home Health Care Agency System Users Guide on the QIES technical support office Web site at www.qtso.com.
• Instead of printing the .pdf file (which can be large) you will be downloading the tally reports in Excel format.
• To use the Tally Report Workbook Template, the Outcome Tally Report must be downloaded from CASPER in the Excel format.
• To download the Tally Report data from CASPER, first request your report. They will be stored in the “Folders” area. Open the report you wish to download (as if you are going to print it). Notice the default to “Save As” is an Adobe PDF.
• Change the format to Save the Report to Excel by clicking the drop down box and choosing “Excel.”
• Click on the “Save As” button. After you click “Save As,” the data will come up on your screen in an Excel table. This may take a while to come up – especially if you have many episodes in your reports.
• After the Excel table comes up on your screen, save this table on your computer. To do this, click the File tab and choose “Save As.” A “Save As” box will appear. Choose the location where you want to save the file. It is important to name the file appropriately i.e., “Outcome Tally Report.”
• To pull a report from this data pertinent to one outcome, first create a drop-down list. This is done by going to “Data”, then choose “Filter”, and then choose “Autofilter”. Each column should now have a small drop-down arrow by the column name.
• To widen the columns, press CTRL + A (or click the square immediately above row 1 and to the left of column A), and the entire worksheet should now be highlighted. Go to “Format,” then choose “Column,” and then choose “AutoFit Selection.”
• Choose cases that achieved an outcome by first finding the column with the abbreviated outcome name of interest. Click the down arrow next to it and select the “x.” Highlight the columns to be printed (selecting) and then print the “selection.” You may also highlight those columns at top (A, B, etc.) and right click to choose “hide;” thereby hiding from view several columns of data you may not wish to print at this time.
• Clear the filter (get all your data back) by going back to the same drop-down arrow, and select “All.” You will then be back to the entire list of outcomes.
• Choose cases that did not achieve an outcome by going back to the drop-list under the outcome and choosing “0.” Highlight the columns to be printed (selecting) and then print the “selection.” You may also highlight those columns at top (A, B, etc.) and right click to choose “hide;” thereby hiding from view several columns of data you may not wish to print at this time.
• Data are updated monthly after the second weekend of the month

* Content for this week’s tip is provided by Delmarva Foundation for Medical Care and Kansas Foundation for Medical Care.

IN THE NEWS

Specialized care from hospital to home improves the health of elderly with heart failure

May 12, 2004 - - NIH - - A new study shows that when elderly heart-failure patients receive specialized nursing care throughout their hospital stay and at home following hospital discharge, the patients have a better quality of life and have fewer hospital readmissions. Instead of costing more money for this specialized care, the study showed that the care resulted in a nearly 38% savings in Medicare costs. The study, funded by the National Institute of Nursing Research, one of the National Institutes of Health, appears in the May, 2004 issue of the Journal of American Geriatrics Society. Read more >>

 

Winona Artists Raise Funds For Home Health Care, Hospice

April 30, 2004 - - Winona, IN - - The Village at Winona recently hosted the first annual CharARTy Gallery Walk. Proceeds from the evening were presented to Kosciusko Home Care and Hospice Inc. More than $2,000 was raised by the showcase of artwork from five galleries in The Village. Guests were treated to live music and hors d’oeuvres as they toured the galleries.

 

This year’s nonprofit receipt of the CharARTy proceeds was to Kosciusko Home Care and Hospice Inc., an organization that provides end-of-life care when curative treatment is no longer possible. Hospice recognizes that terminallly ill individuals and their families face physical, emotional, spiritual and social challenges. Under the direction of a physician, the hospice team works together to make this phase of life as comfortable and meaningful as possible.