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Education And Assessments: A Quarterly Review Of OASIS-C
Four months into the implementation of OASIS-C there are mixed reviews on how well the revised assessment system is taking hold in the home health care industry. OASIS-C is the first major overhaul of the home health assessment since 1997, according to Trish Tulloch, RN, BSN, MSN, HCS-D, a nationally-recognized expert in the home health care industry and author of Carosh Media and Marketing’s latest OASIS-C course. She says the assessment is a critical part of the home health care system.
“It links directly to accurate agency reimbursement and quality outcomes,” said Tulloch. “We are now in the first quarter of OASIS-C and we’re finding that field clinicians have a learning curve with the revised document and it’s substantial depending on their experience and education to date. Because of that learning curve, agencies need ongoing surveillance and reinforcement to enhance and monitor their accuracy and consistency with the new elements in the OASIS-C assessment document.”
According to Tulloch, the dreaded OASIS-C changes have been met with an open willingness to learn by clinicians; depending on their preparation for the changes.
“If they had accurate education to introduce OASIS-C last Fall, my experience has been that they are absolutely fine with it, especially if they understand why the changes have occurred. If they don’t know why it has occurred, then they aren’t as understanding. It’s an excellent tool for care planning, communication and coordination. OASIS-C embraces clinical best practices in the home care industry and agencies that have been doing those best practices for years will get credit in their quality outcomes and home care compare reports for the best practices they have been doing – that didn’t happen in the past.”
Tulloch says OASIS-C creates transparency not only for CMS, but also for patients and their families.
“The integration of the new OASIS-C items increases the precision and assessment of care as well as planning,” said Tulloch. “So we have more precise assessment and intervention information to give to the physician, which helps develop a patient’s plan of care. It also enhances the use of those clinical best practices so that clinicians are actually driven to provide better care. And because those new items are going to be posted as process quality outcomes in home care compare, there’s a transparency now. The consumer or Medicare beneficiary can go online and look at an agency’s report card and see if they are doing the new best practices. And for those of us who have parents and grandparents in home health care that transparency is an important feature and determining factor in which agency we choose for our loved ones.”
Overcoming Common Hurdles
Tulloch says an agency’s bottom line can and will be affected by the way clinicians perform OASIS assessments.
“As consumer systems outside of Medicare look at how agencies are performing their home health care with these new assessment tools, they will select and align with home health care agencies that are performing best practices,” said Tulloch. “It’s a liability for agencies that fail to perform them. It’s actually a huge risk management issue. So agencies that are not performing some of the new best practices because they are optional on the OASIS-C by Medicare are taking a risk. We encourage agencies that are not doing the best practices to plan ahead and be ready to integrate no later than the end of this calendar year.”
Knowing the Key to Success
Education is the key to success when it comes to OASIS-C. Experts like Tulloch say educational courses like the OASIS-C course she has written for Carosh Media and Marketing, a medical education company, are crucial to reaping the benefits of understanding the assessment and filling out the forms properly.
“The updated OASIS-C program is a four-part series that focuses on the new and revised items,” explained Tulloch. “It is really a from-the-field perspective because I’m in the field every week with clinicians. So it’s really refining clinical best practices to meet the spirit and intent of the revised OASIS-C regulations. It’s about practical, realistic examples and tools that have been field-tested. Important bits of information are shared in this four-part OASIS-C course series, which has been updated since last Fall to reflect the most up-to-date information on the assessment tool.”
Tulloch worked with demonstration agencies that tested OASIS-C and developed the course tools with their experiences in mind. The course was updated once again after the implementation of OASIS-C to reflect the weaknesses or gaps found by clinicians in the field.
“This is a time to revisit and refine practices to provide ongoing updates to best practices and staff monitoring,” she said. “This series is one way to do that in a practical, realistic way. It’s not Ivory Tower and it doesn’t come from consultants who don’t go in the field. We are in the field every week. That’s the difference between our programs and other programs.”
With Carosh Media and Marketing’s OASIS-C course, users should expect clarifications to any updates or changes to the OASIS-C guide. The course will direct users on how to apply the lessons learned to common and complex home care scenarios. Tulloch says it is a realistic tool that agencies can use for education and monitoring purposes.
“It is really important for agency leadership to keep their finger on the pulse of what’s going on with clinicians and to have surveillance processes in place so that they are monitoring the accuracy and consistency of the revised and new assessment items,” she stressed. “If they don’t have a way to do that with real-time data, they have a big problem. Not knowing this information puts an agency at risk, so I suggest that they identify their evaluation methods for the implementation of OASIS-C – and it should go beyond the anecdotal. It should be based on data, which will allow them to update their education efforts accordingly and continue to refine their practice. This will ensure that their documentation reflects accurate reimbursement and quality outcomes because there really is a lot at stake if they don’t.”
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