On the Eve of OASIS-C
Tomorrow, we will be getting our first look at OASIS-C . If everything goes according to schedule, we will be using this dataset beginning January of next year. The preliminary set shows significant changes and we will likely be devoting a lot of time throughout the end of the year to learning the dataset.
Right, wrong or indifferent, the published dataset will become the standard for home health. Our time for suggesting changes has come and gone. The only thing left to do now is to learn the changes and incorporate them into our daily routines.
Before we dive headfirst into a new data set, I want to take one last opportunity to challenge you to make the current dataset as useful to your patients as possible. Getting paid is good. Superior outcomes are great. Easy, relaxed surveys are a joy. But using the data to improve patient care outranks all those reasons to get your data right!
In reviewing clinical records at a variety of agencies in the recent past, these are some of things that I see across the board that warrant extra attention:
Diagnosis Coding: The assignment of primary diagnoses and significant co-morbidities influences more than payment. Any clinician assuming care for the patient after the initial care plan will read the diagnoses coding and direct time and energy to those diagnoses. Incorrect coding, including the omission of any pertinent codes, can compromise patient care.
Vision: Whether or not you receive points in the clinical domain for vision, it is amazing to me how many patients have severely impaired vision that is not addressed in visit notes. One of my clients has an extensive low vision program. The supply all their patients with a black hand towel to lay down while taking meds. That way if a pill drops it is easy to see. How hard is that?
Pain: I read charts all the time that have pain noted throughout the episode. It seems nothing short of tragic to have a patient experiencing moderate pain on a daily basis with no phone calls to the MD or changes in care plan noted.
Wounds: As nurses, we have gotten very good at performing wound care exactly as ordered by the physician. However, the most expensive products in the world will not facilitate healing if the patient isn’t getting enough high quality protein, vitamin C and Zinc. We are missing an opportunity to make a big difference in our patients’ lives by overlooking nutritional needs of wound care patients.
Functional Limitations: We’ve gotten pretty good at assessing if the patient can safely ambulate, transfer, etc. And we are pretty good about ordering physical therapy and home health aide services for patients requiring help. But what about OT? How many patients could benefit from modifications in their living environment under the guidance of a qualified Occupational Therapist?
Before we move onto a new dataset, let’s make a point to make the current dataset as useful as possible to our patients. Because there are no changes in the payment system at this time, we can expect these questions to remain as part of the new dataset.
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