www.ohiokepro.com
Vol. 2 No. 4
Winter 2004-2005
Final Remeasurement Data Provide Roadmap to
2005 Quality Initiatives
2005 Quality Initiatives
By John Dooley, MBA, Health Data Analyst
T
he final remeasurement data were recently received for
Ohio's original 151 identified par ticipant home health
agencies (IDPs) and the 165 plans of action (POAs) that
they submitted to Ohio KePRO. Analysis of the data provid-
ed information that will greatly benefit Ohio KePRO's Home
Health Team in preparing for the 2005 Quality Initiatives and assisting
home health agencies throughout Ohio.
Ohio's original 151 identified par ticipant home health
agencies (IDPs) and the 165 plans of action (POAs) that
they submitted to Ohio KePRO. Analysis of the data provid-
ed information that will greatly benefit Ohio KePRO's Home
Health Team in preparing for the 2005 Quality Initiatives and assisting
home health agencies throughout Ohio.
Of the 146 agencies eligible for remeasurement, 58 made statistically
significant improvement in Outcome-Based Quality Improvement
(OBQI) quality measures, resulting in an overall success rate of 40
percent. POAs from large agencies (with episode size greater than
500) were more successful (61 percent) than were smaller agencies.
About one-third of small- and medium-sized agencies showed statistically
significant improvements. Hospital-based agencies were considerably
significant improvement in Outcome-Based Quality Improvement
(OBQI) quality measures, resulting in an overall success rate of 40
percent. POAs from large agencies (with episode size greater than
500) were more successful (61 percent) than were smaller agencies.
About one-third of small- and medium-sized agencies showed statistically
significant improvements. Hospital-based agencies were considerably
Interesting patterns emerge
In looking at changes in relative improvement for the same seven
aforementioned measures over the last year, some interesting
patterns emerge. Several of the measures have strong positive
correlations with each other, which means as one measure improves
(or declines) the other measure will also tend to move in the same
direction. Correlations may var y between 1 (a perfect negative cor-
relation) and +1 (a perfect positive correlation), with zero indicating
that there is no correlation between the two measures. A perfect
cor relation indicates that as one measure increases (or decreases)
the other measure increases (or decreases) by the same propor tion.
The following cor relations are listed below in descending order of
strength. All are statistically significant at the .01 level, which
means there is only 1 percent probability that the difference is due
to chance, and 99+ percent probability that the difference is real.
In looking at changes in relative improvement for the same seven
aforementioned measures over the last year, some interesting
patterns emerge. Several of the measures have strong positive
correlations with each other, which means as one measure improves
(or declines) the other measure will also tend to move in the same
direction. Correlations may var y between 1 (a perfect negative cor-
relation) and +1 (a perfect positive correlation), with zero indicating
that there is no correlation between the two measures. A perfect
cor relation indicates that as one measure increases (or decreases)
the other measure increases (or decreases) by the same propor tion.
The following cor relations are listed below in descending order of
strength. All are statistically significant at the .01 level, which
means there is only 1 percent probability that the difference is due
to chance, and 99+ percent probability that the difference is real.
IDPs showed considerable relative
improvement in many OBQI measures.
improvement in many OBQI measures.
Correlation
.434
Measures
Transferring & Bathing
more successful (50 percent) than those that were freestanding or
affiliated with a chain or government entity. Likewise, those with
JCAHO or similar accreditation, as well as those par ticipating in
Community of Practice (COP) teleconferences, were successful at a
statistically significant higher rate than those without accreditation or
COP par ticipation.
affiliated with a chain or government entity. Likewise, those with
JCAHO or similar accreditation, as well as those par ticipating in
Community of Practice (COP) teleconferences, were successful at a
statistically significant higher rate than those without accreditation or
COP par ticipation.
.420
.333
.307
.275
Mgt. of Oral Meds & Status of Surgical Wounds
Acute Care Hospitalization & Any Emergent Care
Transferring & Pain Interfering with Activity
Transferring & Status of Surgical Wounds
Ohio has performed well
IDPs showed considerable relative improvement in many OBQI
measures over the course of the 12-month period ending with the
last month of the remeasurement period (July 2004). The relative
improvement for those agencies submitting POAs for often-selected
OBQI measures was as follows: Transferring, 19 percent;
Management of Oral Medications, 18 percent; Bathing , 11 percent;
Any Emergent Care, 11 percent; Pain Interfering with Activity, 10
percent; Acute Care Hospitalization, 8 percent; and Status of
Surgical Wounds, 1 percent (Figure 1). Transferring and Management
of Oral Medications were the most successful POAs, with 60 to 70
percent of them showing statistically significant improvements.
IDPs showed considerable relative improvement in many OBQI
measures over the course of the 12-month period ending with the
last month of the remeasurement period (July 2004). The relative
improvement for those agencies submitting POAs for often-selected
OBQI measures was as follows: Transferring, 19 percent;
Management of Oral Medications, 18 percent; Bathing , 11 percent;
Any Emergent Care, 11 percent; Pain Interfering with Activity, 10
percent; Acute Care Hospitalization, 8 percent; and Status of
Surgical Wounds, 1 percent (Figure 1). Transferring and Management
of Oral Medications were the most successful POAs, with 60 to 70
percent of them showing statistically significant improvements.
Given the above data, as a patient improved in transferring, for
example, there was a tendency for him/her to improve in bathing as
well. When choosing an outcome measure to focus on, note that
improvement in another measure with which it strongly correlates is
also likely to occur. The strong correlation indicates the two measures
have a tendency to go hand in hand.
example, there was a tendency for him/her to improve in bathing as
well. When choosing an outcome measure to focus on, note that
improvement in another measure with which it strongly correlates is
also likely to occur. The strong correlation indicates the two measures
have a tendency to go hand in hand.
As previously noted, the success rate and relative improvement of
transferring was ver y impressive. Also, please note that transferring
significantly correlates with three other measures: bathing, pain, and C
surgical wounds. Therefore, when selecting transferring as a measure
on which to focus effor ts, there is likely to be gains in bathing, pain,
and surgical wounds as well.
transferring was ver y impressive. Also, please note that transferring
significantly correlates with three other measures: bathing, pain, and C
surgical wounds. Therefore, when selecting transferring as a measure
on which to focus effor ts, there is likely to be gains in bathing, pain,
and surgical wounds as well.
ontinued
Final Remeasurement Data... (cont.)
Cor relations should not be confused with statistical significance.
For example, the relationship (correlation) between transferring and
bathing (.434) is not quite halfway between no correlation (0) and a
perfect positive correlation (1). However, the statistical significance
indicates only that the probability of this relationship being due to
chance is ver y small (less than 1%).
bathing (.434) is not quite halfway between no correlation (0) and a
perfect positive correlation (1). However, the statistical significance
indicates only that the probability of this relationship being due to
chance is ver y small (less than 1%).
State vs. National: Home Health Compare
A comparison with the national average of publicly repor ted OBQI
measures reveals that Ohio has performed well on some measures
for the 12-month repor ting period ending May 2004. On average,
the state has performed at or better than the national average on
Transferring, Toileting, Confusion Frequency, and Ambulation/
Locomotion. However, Management of Oral Medications, Upper Body
Dressing, Acute Care Hospitalization, Stabilization in Bathing, Pain
Interfering with Activity, Any Emergent Care, and Improvement in
Bathing continue to present challenges and oppor tunities (F igure 2).
A comparison with the national average of publicly repor ted OBQI
measures reveals that Ohio has performed well on some measures
for the 12-month repor ting period ending May 2004. On average,
the state has performed at or better than the national average on
Transferring, Toileting, Confusion Frequency, and Ambulation/
Locomotion. However, Management of Oral Medications, Upper Body
Dressing, Acute Care Hospitalization, Stabilization in Bathing, Pain
Interfering with Activity, Any Emergent Care, and Improvement in
Bathing continue to present challenges and oppor tunities (F igure 2).
A note of thanks
Ohio KePRO's Home Health Team extends its deep appreciation to home
health agencies (HHAs) throughout Ohio. Over the past two years, HHAs
have worked hard to improve the health of the state's Medicare
beneficiaries. The Home Health Team looks forward to working with
HHAs on the 2005 quality initiatives. If you need assistance or infor-
mation, please do not hesitate to contact us at 1-800-385-5080, or
via e-mail at homehealth@ohqio.sdps.org . And, be sure to visit our
Web site at www.ohiokepro.com.
Ohio KePRO's Home Health Team extends its deep appreciation to home
health agencies (HHAs) throughout Ohio. Over the past two years, HHAs
have worked hard to improve the health of the state's Medicare
beneficiaries. The Home Health Team looks forward to working with
HHAs on the 2005 quality initiatives. If you need assistance or infor-
mation, please do not hesitate to contact us at 1-800-385-5080, or
via e-mail at homehealth@ohqio.sdps.org . And, be sure to visit our
Web site at www.ohiokepro.com.
Figure 2. Ohio vs. National Comparison
11 Publicly Repor ted Measures
Home Health Compare: June 2003 May 2004
11 Publicly Repor ted Measures
Home Health Compare: June 2003 May 2004
OBQI Measure
Ohio
National
Variance
The results of the CMS Provider
Satisfaction Survey...were very positive
Satisfaction Survey...were very positive
Transferring
Toileting
52%
63%
51%
62%
1%
1%
Provider satisfaction
The results of the CMS Provider Satisfaction Sur vey for the period:
January 26April 30, 2004 were very positive (Figure 3). The composite
satisfaction scores for identified and nonidentified par ticipant
agencies were 95 percent and 87 percent, respectively, resulting in
an overall weighted satisfaction score of 93 percent. A near perfect
score of 99 percent was earned from the IDP group in the area of
professionalism, cour tesy, and respectfulness. Ohio KePRO's Home
Health Team was also gratified to receive high satisfaction ratings in
technical suppor t methods (which include site visits, training work-
shops, telephone calls, conference calls, e-mails, and broadcast
e-mails) from both identified participants (94 percent) and nonidentified
par ticipants (96 percent).
The results of the CMS Provider Satisfaction Sur vey for the period:
January 26April 30, 2004 were very positive (Figure 3). The composite
satisfaction scores for identified and nonidentified par ticipant
agencies were 95 percent and 87 percent, respectively, resulting in
an overall weighted satisfaction score of 93 percent. A near perfect
score of 99 percent was earned from the IDP group in the area of
professionalism, cour tesy, and respectfulness. Ohio KePRO's Home
Health Team was also gratified to receive high satisfaction ratings in
technical suppor t methods (which include site visits, training work-
shops, telephone calls, conference calls, e-mails, and broadcast
e-mails) from both identified participants (94 percent) and nonidentified
par ticipants (96 percent).
Confusion
Ambulation
Mgt. of Oral Meds
Upper Body Dressing
StabilizationBathing
Pain Interfering with Activity
Bathing
Acute Care Hosp.
Any Emergent Care
43%
36%
37%
64%
90%
56%
56%
30%
24%
42%
36%
38%
65%
92%
59%
60%
28%
21%
1%
0%
-1%
-1%
-2%
- 3%
-4%
-2%
-3%
Figure 1. Top 7 OBQI Measures
1 Year Relative Improvement: July 2003 July 2004
1 Year Relative Improvement: July 2003 July 2004
20%
18%
19%
18%
16%
Relative Improvement
14%
12%
10%
8%
6%
8%
11%
10%
11%
4%
2%
1%
0%
Acute Care
Hosp 26
Hosp 26
Emergent
Care 26
Care 26
Pain Interferring
with Activity 21
with Activity 21
Bathing 15
Mgt of Oral
Meds 11
Meds 11
Status of Surg
Wounds 11
Wounds 11
Transferring 10
OBQI Measures
Figure 3. Ohio Home Health Agencies
Provider Satisfaction Sur vey Results Identified Par ticipants
Data Collection Period: Januar y 26 April 30, 2004
Provider Satisfaction Sur vey Results Identified Par ticipants
Data Collection Period: Januar y 26 April 30, 2004
100%
99%
99%
98%
% of Satisfied Responses
96%
94%
92%
95%
96%
94%
95%
92 %
95%
90%
88%
Sur vey
Response Rate
Response Rate
Satisfaction
Composite
Scores
Composite
Scores
Information
Dissemination
Methods Sub-
Composite
Score
Dissemination
Methods Sub-
Composite
Score
Technical
Suppor t
Methods Sub-
Composite
Scores
Suppor t
Methods Sub-
Composite
Scores
Access Sub-
Composite
Scores
Composite
Scores
Timeliness Sub- Professionalism Overall
Composite & Courtesy Sub- Relationship
Scores Composite Sub-Composite
Scores Scores
Composite & Courtesy Sub- Relationship
Scores Composite Sub-Composite
Scores Scores
Rates/Satisfaction Scores
hio KePRO Reaches Out to Home Health Agencies
Through Free Training and Services
Through Free Training and Services
T
hroughout the past year Ohio KePRO's Home Health Team
worked with many Home Health Agencies (HHAs) throughout
Ohio. It has offered a variety of free training, educational
seminars, and individual agency consultations to help
increase agency awareness of tools that can help them
fine-tune the quality of their patient care.
worked with many Home Health Agencies (HHAs) throughout
Ohio. It has offered a variety of free training, educational
seminars, and individual agency consultations to help
increase agency awareness of tools that can help them
fine-tune the quality of their patient care.
If your agency is interested in finding out more about the ser vices
and resources listed here or how the Ohio KePRO Home Health
Team can work with you, please call us at 1-800-385-5080, or con-
tact us via e-mail at homehealth@ohqio.sdps.org, or visit Ohio
KePRO's Web site at www.ohiokepro.com.
and resources listed here or how the Ohio KePRO Home Health
Team can work with you, please call us at 1-800-385-5080, or con-
tact us via e-mail at homehealth@ohqio.sdps.org, or visit Ohio
KePRO's Web site at www.ohiokepro.com.
Here are a few of the ways the Home Health Team was able to
reach out to Ohio's HHAs:
reach out to Ohio's HHAs:
Outcome-Based Quality Improvement Training (OBQI) with CEUs.
Individual Agency OBQI Staff Education and Training with CEUs.
Plan of Action Development Training.
OBQI Repor t Access and Data Analysis.
Individual Agency Consultation and Technical Assistance
Including Task, Data, and Process Analysis.
Regional Seminars Regarding Topics of Interest for Improving
Outcome Measures.
Teleconferences Addressing Improving Outcome Measures.
Communities of Practice.
Weekly Home Health Tip of the Week Featuring Tools for
Improving Patient Outcomes.
Education Updates.
Individual Agency OBQI Staff Education and Training with CEUs.
Plan of Action Development Training.
OBQI Repor t Access and Data Analysis.
Individual Agency Consultation and Technical Assistance
Including Task, Data, and Process Analysis.
Regional Seminars Regarding Topics of Interest for Improving
Outcome Measures.
Teleconferences Addressing Improving Outcome Measures.
Communities of Practice.
Weekly Home Health Tip of the Week Featuring Tools for
Improving Patient Outcomes.
Education Updates.
MATERIAL FEEDBACK SURVEY
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delivered to Medicare beneficiaries. We offer innovative products and
ser vices, and educational resource materials to encourage and
suppor t continuous quality improvement.
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suppor t continuous quality improvement.
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it using the self-contained mailer. We appreciate your feedback.
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Ohio KePRO
Rock Run Center, Suite 100
5700 Lombardo Center Drive
Seven Hills, Ohio 44131
Tel: 216.447.9604
Fax: 216.447.7925
www.ohiokepro.com
ATTN: Marketing & Communications Dept.
Rock Run Center, Suite 100
5700 Lombardo Center Drive
Seven Hills, Ohio 44131
Tel: 216.447.9604
Fax: 216.447.7925
www.ohiokepro.com
ATTN: Marketing & Communications Dept.
ATTN: MARKETING COMMUNICATIONS
Ohio KePRO Home Health Team
Alice Stollenwerk Petrulis, MD, FACP
Betty Pilous, RN, MHSA, CPHQ
Linda Day, RN, BSN, MBA
Cindy O'Connell, RN, BSN
Eileen Wallenhorst, RN, BSPA
John Dooley, MBA
Donna Maynard
Rosalie McGinnis, RN, MS
Ramona Pennell, RN, BA
Marla Rawson, BA
Chris Titus, MCSE, CNA, MCP
Betty Pilous, RN, MHSA, CPHQ
Linda Day, RN, BSN, MBA
Cindy O'Connell, RN, BSN
Eileen Wallenhorst, RN, BSPA
John Dooley, MBA
Donna Maynard
Rosalie McGinnis, RN, MS
Ramona Pennell, RN, BA
Marla Rawson, BA
Chris Titus, MCSE, CNA, MCP
Publication No. 4011-OH-006-12/2004.
This material was prepared by Ohio KePRO,
the Medicare Quality Improvement
Organization for Ohio, under contract with
the Center s for Medicare & Medicaid
Ser vices (CMS), an agency of the U.S.
Depar tment of Health and Human Ser vices.
The contents presented do not necessarily
reflect CMS policy.
This material was prepared by Ohio KePRO,
the Medicare Quality Improvement
Organization for Ohio, under contract with
the Center s for Medicare & Medicaid
Ser vices (CMS), an agency of the U.S.
Depar tment of Health and Human Ser vices.
The contents presented do not necessarily
reflect CMS policy.
ALENDAR OF EVENTS
Save the date!
Januar y 19, 2005
OBQI Training
Embassy Suites Hotel
3775 Park East Drive
Beachwood, OH 44122
OBQI Training
Embassy Suites Hotel
3775 Park East Drive
Beachwood, OH 44122
For fur ther information,
please contact the
Home Health Team at
1-800-385-5080,
or visit Ohio KePRO's
Web site at
www.ohiokepro.com
please contact the
Home Health Team at
1-800-385-5080,
or visit Ohio KePRO's
Web site at
www.ohiokepro.com
Januar y
National Glaucoma Awareness Month
National Thyroid Awareness Month
National Cataract Awareness Month
Februar y
American Hear t Month
National Hyper tension Awareness Month
Women's Hear t Health Day 1st
National Wear Red Day for Women 4th
National Cardiac Rehabilitation Week 13th 19th
National Women's Hear t Day 18th
March
National Colorectal Cancer Awareness Month
National Save Your Vision Month
Patient Safety Awareness Week 6th 12th
Brain Awareness Week 14th 20th
American Diabetes Aler t day 22nd
Executive Editor: Suzana C. Iveljic, MBA Editor: Robert A. Feigenbaum, MS
THE WINTER 2004-2005 ISSUE OF QUALITY OUTCOMES HAS ARRIVED!
THE NEWSLETTER OF THE HOME HEALTH OUTCOME-BASED QUALITY IMPROVEMENT INITIATIVE
THE NEWSLETTER OF THE HOME HEALTH OUTCOME-BASED QUALITY IMPROVEMENT INITIATIVE
Ohio KePRO Provider QIC Line--Your Quality Improvement Connection: 1-800-385-5080 · Medicare Help Line: 1-800-MEDICARE (1-800-633-4227)
Home Health Team e-mail: homehealth@ohqio.sdps.org
Home Health Team e-mail: homehealth@ohqio.sdps.org