Process Measures in OASIS-C
One of the biggest changes in OASIS-C is the inclusion of Process Measures. According to the OASIS-C manual, process measures are the use of assessment tools and the care and delivery of specific clinical interventions. In other words, CMS wants to know how you are assessing patients and what you are doing about the stuff you find in your assessment.
CMS goes further to state that the inclusion of specific interventions and assessments are NOT mandatory. However, they are expected to affect your future outcomes. Read: Process measures ARE mandatory.
The list of process measures is below from chapter one of the new manual are:
- Date of referral and physician-ordered start of care (timeliness)
- Patient-specific parameters for physician notification (care coordination)
- Influenza and pneumococcal vaccines (population health and prevention)
- Formal pain assessment, pain interventions, and pain management steps (effectiveness of care)
- Pressure ulcer risk assessment, prevention measures, and use of moist healing principles effective care and prevention)
- Diabetic foot care plan, education and monitoring (disease specific: high risk, high volume, problem prone)
- Heart failure symptoms of volume overload and follow-up (disease specific: high risk, high volume, problem prone)
- depressive symptom screening and intervention/referral (influences self-management abilities)
- Falls risk assessment, planning and interventions (safety)
- Medication adverse events/reaction, reconciliation and follow up; drug education (high priority for safety – care coordination)
A compliance rate of 100 percent is not anticipated by CMS. CMS allows that clinicians may find that these interventions have no application for a particular patient. And the new OASIS manual states emphatically that CMS will not mandate the use of any one intervention in your care planning.
The process measures represent an entirely new aspect of assessment. In the past, we have specifically looked at the patient status on the day of assessment except where otherwise specified. In the new OASIS-C dataset, we will be assessing the patient as well as the agency and also a period of time since admit/roc or last comprehensive data collection.
Agencies who currently take case conferencing seriously will have little problems with the clinical record review. If your agency signs off on case conference with minimal discussion of patients, it is time to change your approach or be prepared for a very uncomfortable OASIS-C experience!
For questions or comments, please leave a comment below or email at firstname.lastname@example.org. More information on OASIS-C training will be posted soon. Mark November 12 and 19 on your calendars!