6
The Home Care Association of Florida
www.homecarefla.org
FEATURE
T
he search for a tried and
true way to ensure OASIS
(Outcome and Assessment
Information Set) accuracy
can often seem endless. Since its
inception, agencies have struggled
with discrepancies between the
improvements captured by outcomes
and their intuitive sense of the degree
to which their patients actually have
improved under their care. Outcome
reports just do not match clinician
reports of patient progress. With
ever-increasing emphasis placed on
outcomes and risk adjustment, not to
mention impact on an agency’s bottom
line, OASIS accuracy is paramount.
By accurately completing this data set at
the beginning of care and at predefined
time points during the course of care,
the patient’s outcomes may be measured.
Outcomes assist with identifying
and integrating continuous quality
improvement across all agency services.
Agencies are encouraged to compare
years, national references, and utilize
benchmarking. CMS also publishes
these outcomes for the public, so the
results are not just valuable to providers
internally but on a larger scale. Accuracy
with these assessments is critical as
this is the foundation of outcome
measurement. Medicare is looking
for patient outcome improvements,
and reimbursement for the patient
care episode is directly related to the
assessing clinician’s responses.
One area of the OASIS that regularly
undergoes scrutiny yet continues to
present itself as a problem area to
providers is the functional domain.
Functional independence is a very
important facet of the health and
well-being of a patient. Although an
agency’s administrators, directors, and
quality assurance directors want to
achieve the best possible outcomes, the
patients are even more invested in the
outcomes achieved. Patients typically
experience a significant decline in the
ability to perform basic ADL needs
after a hospitalization. By accurately
identifying functional deficits, the best
possible plan can be put into place to
allow the patient to return to the highest
functional level possible.
There may be multiple reasons that an
agency has inaccurate data collection
and subsequent inaccurate outcomes.
Clinicians who are new to home
health may experience difficulty with
understanding the intent of OASIS
items, while nurses may not be adept at
performing functional assessments. They
may rely too heavily on interviewing and
do not observe the patient performing
these activities to obtain more accurate
responses. Furthermore, therapists may
fail to perform an adequate functional
assessment in all areas, such as not
observing the patient’s ability to ambulate
on different surface types, both inside
the home and to transportation, which is
captured at discharge. Nurses may admit
patients who are later discharged by a
therapist. The difference in the way each
discipline performs the functional
assessment
may
cause
multiple
By Kammie Beversdorf, RN, HCS-O, HCS-D
OASIS Spotlight:
Outcome Reports vs. Clinician Reports
THE QUE S T TO AVO I D COMMON FUNCT I ONA L S COR I NG E RROR S
