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Posts tagged ‘Influenza’

That’s a 1040!

Have you ever, you know, just for fun, went perusing the outcomes of your competitors online? Maybe trying to see if they had an advantage over you? Did you notice anything strange about the OASIS questions regarding flu vaccine?

I always do. Like just now, I went to and put in my zip code and pulled an agency beginning with A, B and C. This is what I found:

How often the home health team determined whether patients received a flu shot for the current flu season?

So, the blue bars are for agencies A, B and C. The first yellow bar is the Louisiana average and the second bar is the National Average.

What on earth is wrong with Agency C, you ask? Would it inconvenience them so very much to inquire about a flu shot?

Chances are they did. Remember, these were the first three that I pulled up. The problem lies in the OASIS question that determines this data.


The word, ‘Episode’ may not have been the best choice to describe the period of time under consideration in this question. It is a vastly overused word and maybe someone at the Head OASIS Office should have considered the likelihood of people confusing the ‘episode of care’ with an ‘episode’.

Don’t let this happen to you. Prove to the world that you care about your patients by learning the difference between an episode and an episode of care.

Episode – A 60 day period of time sometimes called a cert period. It can be cut short by death, partial episode payments and a couple of other things.

Episode of Care – an unknown period of time which begins at admission and continues until discharge unless the patient goes into the hospital. If the patient goes into the hospital, the episode of care ends at transfer and a new episode of care begins upon resumption of care.

In the example below which serves as proof that I have no graphics designer on staff, you see two plain old generic episodes separated by a pale blue line on Day 60 if the admit episode. The episodes of care are in the blue boxes. In this case, the first episode of care goes from admit until day ten of the second episode when the patient is transferred to the hospital (70 days). A second episode of care begins on resumption and ends on discharge (45 days). This means that the episode of care could be 180 days if the patient is on service for 3 episodes and has no intervening hospitalization. Alternatively, if a patient is admitted to the hospital twice in the first 6 six weeks after admission, you will have three episodes of care in one generic episode.

episode jpeg

Is that clear as mud?

Patients who were admitted to services after March 30 and discharged before October 1, should have NA checked. If your answer is, ‘No’, it will not figure into the outcomes if the patient received the flu shot from your agency in another episode or received the vaccine from another healthcare provider (Walgreen’s, their MD, etc.) which will be reflected in M1045.

Don’t shoot the messenger. I serve as the translator and obviously nobody asked me before naming the ‘episode of care’ because I would have come up with a different word to describe that period of time that took over a hundred words and a poorly constructed graphic to fully describe.

Remember, nobody likes the flu. Don’t be known as the agency who can’t be bothered to ask about flu shots. This isn’t nearly as hard as it seems but much more confusing than it has to be. Just saying. If you have any questions, please feel free to call the OASIS help desk.




Tis the Season…..

Almost nobody is stupid enough to run a computer or a network without virus protection. Those that are, often find that their machines are worse than useless in a few weeks if they are lucky. If they are not lucky, people all over the world are shopping with their credit cards, transferring funds from their bank account and sending annoying spam to all of their friends.

So it makes sense that an enormous amount of time, energy and expense is devoted to protecting our computers against viruses. And yet…… aside from a statistically insignificant number of suicidal IT techs, a computer virus has never killed anyone.

The Flu, on the other hand kills thousands of people each year. If we spent a fraction of the time trying to prevent flu in our community by providing virus protection which is free to most of our patients, we would save lives. That’s a good thing, I think. Healthcare Reform has raised some payment issues. But, as always, I digress.

There are a lot of arguments against getting the flu shot. One quick search on the internet will alert you to the fact that the flu vaccine is ineffective and kills people. Therefore, all of these unlicensed medical pontificators have advised the rest of the internet against taking the flu vaccine. One man in Canada died of anaphylaxis after a routine flu injection. Another blogger accused the healthcare industry of lying about the possibility of anaphylaxis and covered it up by calling it a ‘severe allergic reaction’. The Internet School of Medicine is apparently not hosted by an Ivy League facility.

First of all, about 35,000 people die each year from the flu. Other than the dude in Canada, I do not see any reliable statistics about deaths from the flu vaccine. One and a half people out of a million will have a serious allergic reaction (also known as anaphylaxis for the ISM crew), and some people feel crummy for a day or two as their immune system kicks into action. This is not the same thing as the flu.

There are some agencies who will decide not to give the flu shot. Depending on your state and the pharmacy laws, that is understandable. However, if your agency decides not to administer flu vaccine, that doesn’t mean it isn’t just as important to educate your patient and their family members on the importance of being vaccinated.

Remember that all patients currently admitted, assuming they are on service until the end of episode will have at least part of their episode in the current 2011-2012 flu season.

This is easy folks. Let’s save a few lives this year. Start by getting your own flu shot. Your patients will appreciate it. So will your family.

Please feel free to email with any brilliant ideas for effectively promoting flu vaccines among staff and patients. As nurses working together we can make a serious dent in the damage the flu does to our collective patients this year.

Flu Season is Here!

Are you interested in saving a few lives? If your aspirations are less lofty, what about improving your outcomes?

You can accomplish either or both of these objectives by gearing up for flu season if you haven’t already. Since it is officially flu season, the OASIS dataset questions about the flu will no longer be answered as N/A on admission assessments.

Last year, everyone got excited about H1N1 flu. There was good reason to do so but the threat to our patients was less than that of the regular flu. It seems that elderly people had some resistance related to a 1950’s flu epidemic. This year, the flu shot combines protection against the ‘regular’ flu as well as H1N1 eliminating the need for two injections. How easy is that?

Each year between 30,000 and 40,000 deaths occur as the result of the seasonal flu. The overwhelming majority of these deaths occur in the elderly. Our Medicare patients can receive the flu vaccine at no out of pocket cost. If you have patients who have to pay for flu vaccines, be aware that the cost of a flu shot is less than one trip to the drug store to buy Nyquil, Advil, chicken soup, Gatorade, saltines, etc.

So get busy! If your agency does not administer the flu vaccine, encourage your patients to find someone who does. Get a list of providers. It may be as simple as a trip to the local Walgreens. And don’t stop with patients. Encourage family members who reside with your elderly patients to be vaccinated as well.

Me? I think it is cool to be able to offer immunity. It kind of makes me feel like a federal agent.

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