Home Health & Hospice

Policy Pointers for OASIS-C and Heart Failure Patients

Homecare Insider, February 1, 2010

OASIS-C includes two data elements addressing the status of patients with a diagnosis of heart failure:

  • M1500, symptoms in heart failure patients asks if the patient exhibited symptoms
  • M1510 heart failure follow-up, targets the actions an agency takes, from no action to actively obtaining orders for changes in the care plan.

The need to measure homecare processes related to cardiac status in known heart failure patients stems from the prevalence of heart failure and the importance of early response to symptoms in controlling both the heart failure and the associated costs of care.

Cardiac assessments are often the primary nursing skill for homecare patients diagnosed with heart failure.  Since clinicians are routinely familiar with visits for this purpose, there is always the risk that it will be difficult to highlight individual instances of symptoms.  Additionally, because caring for cardiac patients is so common, many agencies rely on clinician expertise regarding assessment and follow up rather than establishing protocols.  As this process measure begins to produce data, it seems likely that OASIS-C will foster evaluation and adjustment of processes.

As your agency fine-tunes care delivery in response to the cardiac process measures, consider these policy pointers.

  • Review agency demographics and diagnosis statistics.  How prevalent is heart failure within the agency’s census?
  • Establish policies for cardiac assessment, including whether such assessment is stressed during orientation.  What are clinician expectations for follow-up and physician notification?  Consider establishing specific protocols.
  • Establish focus audits for cardiac cases.  If the agency uses outcome evaluation software, it may be possible to customize reports for this function.
  • Determine how clinicians will access data to answer M1510.  Check with your software provider regarding plans to include this in the software, or consider the use of a manual tracking system.
  • As the agency develops its education plan for the coming year, evaluate the need for a refresher on heart failure, nursing interventions, and current treatment protocols.

The newly updated, OASIS-C in Action, provides an introduction to the process measures and best practices.  Learn more about this educational video at — http://www.beaconhealth.org/cgi-bin/ccp51/cp-app.cgi?pg=prod&ref=VOCIADVD.