TriCentral PC Toolkit : Chapter 5: Quality Management Plan : Divisional and Regional Indicators and Indicator Worksheets

The following worksheet summarizes the quality indicators used by the Home Health Department at Kaiser-Permanente.

Domains of Quality	Home Health Quality Management Indicators	REG OR DIV	Frequency of Data Collection and Reporting	Reported Locally or Aggregated Centrally
Satisfaction	Home Health Patient Satisfaction Survey	REG	Quarterly	Central
	Patient Satisfaction	REG	Quarterly	Local
	Provider Satisfaction	REG	Annual	Local
	Staff Satisfaction	REG	Annual	Local
	Complaints Tracking	DIV	Quarterly	Central
Clinical Quality	Patient Clinical Record Review – Minimum content defined in Medical Record/Utilization Management Monitoring Tool	DIV	Review Process Quarterly	Local
	OASIS Adverse Event Monitoring	DIV	Quarterly	Local
	Pain Management	DIV	Monthly	Central
Infection Control	Rate of Infections	REG	Quarterly	Local
Risk Management	Unusual Occurrence Reporting Significant Adverse Drug Reactions Significant Medication Errors OASIS Adverse Event Monitoring	DIV	Quarterly	Local
Compliance	Frequency and Duration Orders	DIV	Monthly	Central
	Interdisciplinary Communication	DIV	Monthly	Central
	Medical Record/Utilization Management Monitoring Tool	DIV	Semi-Annually	Local
Contract Services	Service Agreement Providers Supplemental Staff Providers	DIV	Annual	Local
Contract Services	Complaints Monitoring	DIV	Quarterly	Central
OASIS Database Quality	OASIS Primary Diagnosis Appropriate	DIV	Semi-annual	Local
	OASIS ICD-9-Coding Accurate for Primary Diagnosis	DIV	Semi-annual	Local
	OASIS Data Entry Accuracy (when manually entering data)	DIV	Semi-annual	Local
	Documentation supports OASIS assessment	DIV	Monthly	Central
	OASIS RN completes initial assessment when another discipline ordered at referral	DIV	Semi-annual	Local
	Independent Audit of Primary Diagnosis and Coding Accuracy	DIV	Annual	Central
	Re-certification visit completed between day 56 and 60 for OASIS assessment	DIV	Semi-annual	Local
Utilization Management	Service Utilization Appropriate	DIV	Quarterly	Local

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For more information about the TriCentral Palliative Care Toolkit visit www.growthhouse.org/palliative/. All content is Copyright © 2002, 2003 by Richard D. Brumley, M.D. All rights reserved. No part of this toolkit may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without written permission from the publishers. This guide to developing home-based outpatient palliative care services was developed through a grant to the Kaiser Permanente TriCentral Service Area from The Project on Death In America. The Kaiser Permanente TriCentral Palliative Care Program is a Sustaining Member of the Inter-Institutional Collaborating Network On End-of-life Care (IICN) which links major organizations internationally.