Quality, not quantity of QI projects important
Pain, falls, billing processes make good studies
The types of quality improvement projects that will be required by early February 2009 by the Hospice Conditions of Participation (COPs) for Medicare will be challenging for some hospice organizations, but they will not be impossible if each hospice chooses the right projects, says Malene S. Davis, MSN, MBA, CHPN, president and CEO of Capital Hospice in Falls Church, VA, and president of the National Hospice and Palliative Care Organization (NHPCO).
Although the implementation date for other requirements of the COPs is Dec. 2, 2008, the quality assessment and performance improvement study requirements are not due for implementation until early February, she says. The COPs do not specify a certain number of performance improvement studies that need to be conducted on an annual basis, and this lack of specificity makes some people uncomfortable, she admits.
"[The Centers for Medicare & Medicaid Services] wants to see us select projects that are meaningful to the community we serve and to select projects that change the way we provide service to improve hospice care," Davis explains.
For some hospice agencies, the requirement might be met by one large performance improvement project that affects all patients, such as a pain study, Davis says. Another hospice might conduct several projects, each with a narrow focus, that affects care for specific patient groups, she says.
"As long as the projects use data to evaluate performance, identify ways to improve care, and produce an improvement in care when changes are implemented, the hospice will meet the requirements," Davis says.
The most logical performance improvement study for a hospice that has not conducted one recently is a pain control study, she suggests. "CMS doesn't want to see a hospice conduct a pain control study each year, but you have other studies that can look at falls or other adverse events that occur in hospice," Davis says.
"Don't assume that all of your studies have to be clinical," she says. Improving hospice care means improving the entire organization, including departments such as billing or admissions, Davis points out. "Over time, a hospice should use performance improvement studies to look at all areas of the hospice," she says.
The types of quality improvement projects that will be required by early February 2009 by the Hospice Conditions of Participation (COPs) for Medicare will be challenging for some hospice organizations, but they will not be impossible if each hospice chooses the right projects, says Malene S. Davis, MSN, MBA, CHPN, president and CEO of Capital Hospice in Falls Church, VA, and president of the National Hospice and Palliative Care Organization (NHPCO).You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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