Anatomy of Organizational Process Change Through OutcomeBased Strategy

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Anatomy of Organizational Process Change Through
Outcome-Based Strategy
Mary Scordino, BA, RN, MBA/HCM Resurrection Home
Health Services Anthony Harris, MPH Strategic
Healthcare Programs April 16, 2007
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Program Objectives

• Evaluate available resources
• Determine the best utilization of these
  resources
• Enhance financial viability
• Improve patient outcomes

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Resurrection Health Care

• Active Home Health Patient Census 800
• Home Health Locations 2
• Acute Care Hospitals 9
• Long Term Care Facilities 7

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Historical Events

• Several months of below budget revenue
• Redundant departments and processes
• Reduction in force

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Assessing Structure and Function

• Functional tasks not standardized and
  consistent
• Poor communication
• Inaccurate OASIS completion jeopardizes revenue
• OASIS discrepancies between disciplines
• and individual clinicians
• Variances between service provision
• and revenue

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Financial Implications

• Case Weight Decrease 6.7
• Revenue Decrease gt300,000

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OASIS Errors Cost Money
Correcting this error yields 233 in additional
revenue.
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OASIS Errors Cost Money
Correcting this error yields 657 in additional
revenue.
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OASIS Errors Cost Money
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Variations by Clinician
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Variations by Manager
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Discrepancies between Disciplines and Individual
Clinicians
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Outcomes Remained Stable or Improved
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Outcomes Remained Stable or Improved
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Restructure

• Personnel involvement
• Process team structure and participation
• Resource availability
• Problem identification
• Identification of components
• Bone Basics
• Muscle Basics evolving to meet higher needs
• Skin Fully evolved and functional process

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Process Evaluation

• Start with outcomes
• Insert resources
• Identify areas for improvement
• Pilot for success
• Reeducate
• Implement
• On-going education
• Monitor and measure
• Reevaluate the outcome

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Re-education on OASIS

• Going back to the scenario with long time nurse
• employees vs. newer nurses
• Approach education based on OASIS coding
  habits
• Education starts with the managers

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Conclusion

• Data cannot be static
• You must be willing to challenge a hypothesis
• True data analysis requires creativity
• No process can be written in stone

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QA
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Contact Info
Mary Scordino [phone] mscordino_at_reshealthca
re.org
Anthony Harris [phone] aharris_at_SHPdata.com