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Data collected for Indiana QAPI project
Outcomes, operations, and practices monitored
The Indiana Association for Hospice and Home Care (IAHHC) in Indianapolis initiated a benchmarking project in 2007 to help hospice members meet the Quality Assessment and Performance Improvement (QAPI) requirements of the new hospice Conditions of Participation. Working with an outside vendor, the association and member hospices identified the following data to collect and measure against other hospices:
comfort within 48 hours of admit;
percent avoided unwanted hospitalizations;
falls with injury per 1,000 patient days;
percent caregivers willing to recommend;
percent caregivers rating weekend and evening response excellent.
Patient volume and mix:
average daily census;
average length of service;
median length of service;
cancer percent of total admissions;
percent of patients admitted by location: home, inpatient facility, hospice unit, hospital nursing facility, and assisted living facility;
live discharges as a percent of total discharges.
percent of total revenue from fundraising;
average daily census per FTE by discipline: nursing, social services, home health aide, chaplain, physician, nonclinical, and total;
weekly visits per FTE by discipline: nursing, social services, home health aide, chaplain, physician, and nonclinical.
percent of physicians certified by American Board of Hospice and Palliative Medicine (ABHPM);
percent of nursing certified by Hospice and Palliative Nurses Association (HPNA);
routine patient record review percent;
compliance meeting guidance from Office of Inspector General;
date of last review against standards;
bereavement to community;
ethics committee access.
An advantage to using these data is that they reflect those already collected on a national level by the National Hospice and Palliative Care Organization (NHPCO), so there are national data against which the Indiana group can be compared, says Todd Stallings, executive director of the IAHHC. "There is no need to reinvent the wheel," he says.
Need More Information?
For more information about quality improvement and assessment, contact:
Lynda Laff, BSN, Principal, Laff Associates, 117 Club Course Drive, Hilton Head Island, SC 29928. Telephone: (843) 671-4170. Fax: (843) 671-4306. E-mail: firstname.lastname@example.org.
Susan E. Saxon, RN, Administrator and Principal, Tidewater Hospice, Bluffton, SC 29910. Telephone: (843) 757-9388. E-mail: SusanSaxon@TidewaterHospice.com.
Todd Stallings, Executive Director, Indiana Association for Home & Hospice Care, 6320-G Rucker Road, Indianapolis, IN 46220. Telephone: (317) 844-6630. Fax: (317) 575-8751. E-mail: email@example.com.
For tools, sample studies, and other performance improvement ideas, go to:
Indiana Association for Home and Hospice Care. Web: www.iahhc.org. On the right side of the home page, click on the "We Will Prevent Pressure Ulcers" logo, then select "Forms and Handouts" to see a list of assessment tools and questionnaires.
Institute for Healthcare Improvement. Web: www.ihi.org. On the left navigational bar, select "topics," then choose "Last Phase of Life" for literature, tools, and guidelines related to palliative care.
National Hospice and Palliative Care Organization. Web: www.nhpco.org. On left navigational bar, select "Quality Partners Home" to access tools and resources for quality improvement.