ADMISSION ASSISTIVE TOOL: SUMMARY OF THE PROJECT Karley Daniel Nursing 495 Ferris State University

PROJECT OVERVIEW *Quick reference guide for Great Lakes Caring-Home Health admission clinicians to have to refer to. *OASIS stands for Outcome and Assessment Information Set, Medicare’s required tool of assessment to ensure quality home care is being provided (Alster, Cushman, Ellenbecker, Samia 2007). *Medicare measures and monitors these answers for reimbursement purposes and measures outcomes for Home Health agencies. *Clinicians have to be able to answer these questions efficiently and appropriate for their patients, this tool will help guide them through this process. By setting up a more appropriate plan of care from the beginning, patients will have better outcomes. * “Evidence-based practice can serve a dual purpose for home healthcare (HHC): to improve patient care and to ensure appropriate reimbursement for home care agencies (Whittier 2008).”

PROJECT GOALS *GLC St. Johns Branch will show improvement in Medicare measured outcomes within 3 months of using the Admission Assistance Tool. *Quality Assurance Department will find improvements with GLC St. John’s Branch within 3 months of using Admission Assistance tool. All Registered Nurses and Physical Therapists whom do admissions will see improvements in their charting process within 3 weeks of using Admission Assistive Tool. *Nursing utilization within the GLC St. John’s Branch will be down within 3 months of using the Admission Assistance Tool. GLC St. John’s Branch will see improvement in ER visits within 3 months of using Admission Assistive Tool.

PROJECT OBJECTIVES 1. Put together Admission Assistive Tool packet for clinicians to use using the Oasis Home Health Guide and using the internet to become familiar with Medicare regulations and measured outcomes. 2. Having all team member contribute and look over the packet to add to and make suggestions. Branch director, Clinical Supervisor, and Education Department all participate in ideas and contributions with putting packet together. 3. Educate all admitting clinicians on the packet at team meeting. Allow for them to look over and use to provide feedback as how to improve tool.

CULTURE, QUALITY AND SAFETY By clinicians utilizing the Admission Assistance Tool, their OASIS will be answered with more accuracy allowing for improvements in quality care and outcomes for our patients. Evidenced Based Practices show that providing nurses with further education, resources, and awareness; home health agency outcomes improve (Whittier 2008). Better interventions will be put into place from the start of home health care. Patients will have less adverse events allowing for safer and more quality care.

PROCESS, PROGRESS, AND COMPLETION Chose a problem within my work environment that was needed to improve outcomes for our patients. Developed a Project Scope of Practice Plan Put together Admission Assistive Packet for Admitting Clinicians Put together a Work Package timeline to assist in keeping project on schedule. Recognized constraints and budgets for project Chose an interdisciplinary team to assist in project progression and plan Reviewed quality and assurance plans for project Educated admitting clinicians on tool and allowed for use and feedback Revised final copy of the Admission Assistive Packet and made copies for clinicians to have on hand.

OBSTACLES AND CHALLENGES Challenges *Keeping on Timeline; keeping myself and other interdisciplinary team to follow timely schedule. *Continuing to remind and encourage clinicians to use tool during admission process will be a continuing challenge *Did not receive as much feedback on tool from the admitting clinicians as wanted; possibly not utilizing as much as planned *Having all staff at team meeting; having to touch base with admitting clinicians whom missed meeting when tool was introduced and described to staff

ETHICAL AND PROFESSIONAL ISSUES * The Admission Assistive Tool promotes and follows many of the American Nurses Association- Code of Ethics* (American Nurses Association 2014). *The tool will assist the nurse to “Determines the appropriate delegation of task to consistent with the nurse’s obligation to provide optimum patient care.” -Provision 4 *The nurse will be fulfilling the “Responsibility to preserve safety and integrity, to maintain competency, and to continue personal and professional growth.” - Provision 5 *The nurse will be following the tool to promote interdisciplinary care for patients “Collaborates with other health professionals and the public in promoting community, national and international efforts to meet health needs.” -Provision 8

LESSONS LEARNED AS PROJECT MANAGER * It is rewarding to see my Admission Assistance Tool be completed. It is a good feeling to know that I could be assisting my co-workers in helping our patients. * When producing your original project scope plan, continue to follow your timeline. Staying on task with timeline makes your project move along smoother-with less stress. * Interdisciplinary teams make projects so much better than tackling them on your own. * Budgets, plans, progress reports, and work packages are all important aspects in producing a project. * Interdisciplinary projects are a very important part of continuing the nursing profession.

REFERENCES *Alster, K., Cushman, M., Ellenbecker, C., Samia, L. (2007). Chapter 13. Patient Safety and Quality in Home Health Care. Patient Safety and Quality: An Evidence- Based Handbook for Nurses *American Nurses Association Code of Ethics. *Heldman, K. (2011). Project management jump start (3rd ed.). Indianapolis, IN: Wiley Publishing, Inc *Yoder-Wise, P.S. (2011). Leading and managing in nursing (5th ed.). St Louis, MO: Mosby *Whittier, Sandra (2011). COMMENTARY: Home Healthcare Nursing and Evidence- Based Practice: A Call to Action. Volume 26 Number 5 Pages