Quality

A series of blogs on the upcoming event THE INTENSIVES from educational content team members.

Building a Quality education Intensive takes a village and the NHPCO Quality team was up to the challenge.  

Topic development for this deep dive into quality education started with robust and lively discussion amongst the NHPCO Quality & Standards Committee under the leadership of Carol Spence, VP of Research & Quality. Spence presented this unique educational program as an opportunity to focus on the needs of the hospice quality community and the committee was instantly on board and excited about suggesting topics and speakers.  Quality topics from the NHPCO member education survey were also considered to determine the best mix of educational sessions for this 1.5 day learning program.

All through the planning process of the Quality Intensive was the guiding principle that each session builds on the previous session starting with  the how-to’s of successful quality assessment performance improvement (QAPI) and ending with  using implementation science to sustain improvement.  

Moving from the first to the last session is like walking the quality road and taking all that is learned to incorporate it into every day hospice practice at the end of the journey.  While the quality sessions emphasize compliance, the main aim of all sessions is improving quality practices that will in turn improve quality patient care. 

The best part about the Quality Intensive is that it is designed to reach a broad range of hospice professionals with varied quality experience and learning for all levels is guaranteed.  The combination of dynamic knowledgeable speakers and cutting edge topics is every hospice provider’s roadmap to the future of hospice quality.

Jennifer Kennedy, MA, BSN, RN, CHC
Senior Director, Regulatory & Quality
National Hospice and Palliative Care Organization 

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Register Now: Advance registration ends October 7.

Psychosocial and Spiritual Care

A series of blogs on the upcoming event THE INTENSIVES from educational content team members.

When first beginning to plan the Psychosocial and Spiritual Care Intensive, we took into account that the focus was on “next practices” versus best practices and that we wanted to have an Intensive that could help all disciplines become equipped with fresh ideas for the future, not only social workers, chaplains and counselors.  

We utilized NHPCO's educational needs assessment and our own experience and knowledge of the current hospice industry as to what most see as the biggest challenges and educational need areas.  We broke that down into 6-7 categories with many sub-categories under each.  We then started discussion on focusing on 6 of the most prioritized, developed the topics of 6 sessions and possible speakers.  Other meetings followed between our group and NHPCO to narrow down even further and solidify speakers.  

There are opportunities for all disciplines to expand their roles in psychosocial and spiritual care.  Not all disciplines know what to do beyond the medical perspective.  Roles and skills can grow in this realm with knowledge from eastern influence and research .  There are fewer resources across healthcare in general and hospice is not excluded from this.  Staff has to do more with less and delve into other areas with which they are not familiar.  Being able to teach families the skills they need to help the patient and family and themselves is pivotal in the future as resources continue to dwindle.  This also allows staff to make families the heroes as well. 
 
Acuity levels of families continue to increase and pose many challenges for the IDT.  New ideas and knowledge is needed to move forward to address such challenging cases.  There are many societal epidemics and issues that will continue growing and staff will need to be equipped in handling them. 
 
There are opportunities for growth, increased communication and increased care coordination, in knowing how to utilize the self and language in having difficult conversations, utilizing effective communication skills and cutting edge ways for the entire IDT to address spiritual care and healing.  Looking deeper within for cultural competence will be essential; we all have room for improvement.  Innovative self-care interventions will take us into the future to prevent burnout and compassion fatigue. 
 
The lack of resources, increased scrutiny and increased regulatory oversight will require all to be the best of the best going forward.  This will require expert guidance and creativity to meet goals without an environment rich in resources. 
 
Samantha Bechtel MSSA, LISW-S, ACHP-SW, GC-C
Chief Clinical Support Officer
Stein Hospice

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Register Now: Advance registration ends October 7.

Regulatory and Compliance

A series of blogs on the upcoming event THE INTENSIVES from educational content team members.

Last winter, when I was first given the opportunity to be a part of designing something different for our fall conference, I jumped at the chance.  Yes, we have been providing regulatory content on hospice regulations, on Medicare changes, for a very long time.  Maybe I was just bored with doing the “same old, same old” yet another year.  What if this could be different?  What if we could design something where we would hear from new and different experts, along with the experts we trust and use in other programs?  What if we could design something where we could learn from each other, in roundtable discussions, and by being together for a day and a half?
 

We formed a planning committee for the Regulatory and Compliance Intensive, with volunteers from the NHPCO Regulatory Committee, immersed in the issues that every day we are working on.  They were pumped, so excited to think “outside the box” and think about making this Intensive different from other years.  We talked about speakers we had heard in other settings.  We talked about topics (and speakers) that we didn’t know whether we could address, like government audits.  We talked about the age-old problem of attending a conference but having no idea what to do with the information when any of us got home…. helpful content, but no path to determine how to implement all the new ideas we had heard.  

We decided to “shoot for the moon” – why not ask those great speakers if they could join us in October at the Intensives?  Or why not ask a ZPIC and MIC auditor to join us so that we could hear “from the source” about what they are seeing as they review hospices in government audits?  And why not ask someone from CMS to help us think differently, and more expansively, about the place of hospice in the post-acute care world?
 
We won!  While the MIC auditor we asked did not get CMS approval to speak, the ZPIC auditor did!  And she is a former hospice director, so she understands hospice from the inside.  Dr. Paul McGann, from the CMS Center for Medicare and Medicaid Innovation said yes too… he said he would help all of us position hospice as we move into the post-acute care world.  Meg Pekarske, Roseanne Berry and Charlene Ross said yes, too, saying “we’ll come and help participants with their audit risks and in developing a comprehensive compliance plan.”  All of the speakers agreed to help each participant develop a game plan for “taking it all back home.”
 
Join us in October.  It is sure to be exciting, thought-provoking, and stimulating.  You can talk, in person, to speakers and to other participants from around the country.  You can participate in roundtable discussions on various timely topics, and most importantly, what you learn will be usable the day you get home!  It’s a different kind of conference – an Intensive.  Planned with you in mind.

Judi Lund Person, MPH, CHC
Vice President, Regulatory and Compliance
National Hospice and Palliative Care Organization

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Register Now: Advance registration ends October 7.

Pediatric Palliative Care

A series of blogs on the upcoming event THE INTENSIVES from educational content team members.
 
One of the challenges we’ve faced in the evolution of pediatric hospice and palliative care is the lack of an organizational “home,” despite a now decades-long history of practice in this “new” discipline. Fortunately, because of need and advocacy within the field, pediatric content at a variety of national conferences has grown steadily every year. Nevertheless, it’s difficult to find one event that satisfies multiple educational needs. That’s why I’m so jazzed about the upcoming “immersion experience” at the upcoming Pediatric Palliative Care Intensive this fall.
 

Our focus for this conference is on home – and community-based PPC, as this is clearly the next evolution in our maturity. (Funny – we started in homes and communities, and then concentrated on organizing ourselves in hospitals, and now the thrust is to re-engage in the community…. Ah, the cycles of life!) For our sessions, we chose topics that are the source of inquiries and questions each of us receives every day from others who are struggling with similar issues, from management of refractory symptoms with medications “only used in hospitals” to staffing ratios for a home-based PPC program.
 
The other day, we held a faculty planning call to ensure that we’re all focusing on “next practices” – a step beyond “best practices” – and outcomes through interactive content that goes beyond PPC 101. So impressive were the energy, enthusiasm, wisdom and drive to share and help others grow from our Intensive faculty members, that I got off the phone wishing the conference would start right away!
 
What will we be discussing? Every time I hear Julie Hauer speak or read what she’s written, I learn something and think about things in a new way. I’m really excited to learn more from her about serving children with severe neurologic impairment and their families in the home setting, since my team cares for more and more of these patients each year. We have also struggled with concurrent care here in Ohio – and with the hundreds of patients who really don’t meet the criteria to qualify, since they’re not hospice eligible. What are some strategies we can use to bridge the care gaps for them? How can we leverage the growing power of coalitions – local, state, regional and even national – to help us plan, deliver, fund and evaluate the care we’re providing? These and other issues will provide the fodder for group engagement and conversation as we focus on the future of our field, and care delivery in the home and community.
 
I’m also impressed with the structure of the Intensives – NHPCO has been thoughtful about allowing us to arrange the time to allow for networking and consultation with expert practitioners in various subjects, as well as for social gathering. And because there are parallel tracks (4 Intensives in each of the 2 groups), the conference allows for interaction with other attendees who may not be in the peds intensive but may share experience and perspectives. It’s easy to stay on for an additional day and a half of content organized around other pertinent topics as well. In short, the opportunity to have focused pediatric content delivered by experts in the field in such an efficient way (and in a beautiful location) is what we’ve been asking for. Come and join us in sunny Florida for a fabulous time. Hope to see you there!
 
Sarah Friebert, MD
Director, A Palette of Care
Haslinger Division of Pediatric Palliative Care, Akron Children's Hospital

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Register Now: Advance registration ends October 7.

Clinical Practice

A series of blogs on the upcoming event THE INTENSIVES from educational content team members. 

Having worked in hospice for over thirty one years, I have learned the importance of looking ahead. What will be our challenges as an industry?  What will our patient population look like?  And who will be the caregivers of those patients; what will they be like? 

The Future is NOW!  The patient that hospice cares for today is not the same patient we cared for in the past.  We do not have the same resources that we have had in the past. We must take into consideration the diverse populations that we are caring for.  Do we have the capacity to care for the ever growing mental health population?

Nurses need to recognize, now more than ever, the potential of drug diversion.  We can no longer hide our head in the sand and be “Nurse Nicey.”  Gone are the days that we can believe that the cat spilled the Morphine.  We need to be doing opioid risk assessments, looking at legal issues and doing drug screening.

We think that we are honoring our Veteran population, but do all disciplines recognize and understand the clinical and psychosocial needs of Veterans at EOL from ALL war eras?  And what about other diverse populations?  We need to know how to respect and meet end-of-life care needs of the diverse ethnic cultures that we care for including the homeless and non-traditional families. 

Being a baby boomer myself, I pity the staff that will need to care for my parents. I have a world of information, good, bad and ugly, at my fingertips.   The hospice involved with my family will need to be sure they have excellent communication skills to deal with my attitude of “I want what I want and when I want it.”

When I was working in the field, the most challenging patients I cared for were those of the mentally ill population whose needs are vast and varied.  The study of mental health remains a very new one.  Hospices need to understand the common medications, interactions with common hospice meds and what to expect when the patient can no longer take their meds.

The Intensives will help us with some of these conundrums. Specifically, the Clinical Practice Intensive will give us an opportunity to hear from experts on these topics as well as allowing us time to network with our colleagues.   

Tracey Wheatley , RN, CHPN
Director Home Hospice
Hospice & Community Care

See the other blogs that are part of this series.

Register Now: Advance registration ends October 7.

NHPCO's First Virtual Career Fair

Don't miss this unique opportunity to take an important step toward career advancement. In just two weeks, on September 21, from 11:00am to 4:00pm ET, NHPCO's will host its first Virtual Career Fair, exclusively for those looking to work in the hospice and palliative care field.

NHPCO’s Virtual Career Fair is a win-win for job seekers. It is a way for you to meet potential employers from wherever you are. And it’s easy to do from your computer or mobile device.

Registration for job seekers is FREE and will provide individuals the opportunity to connect with the following organizations:

The Watershed Group · Jordan Search Consultants · Amedisys Home Health Services · Carolinas Healthcare System · OSF Healthcare · Curo Health Services · BJC Home Care Services · Chapters Health System: LifePath Hospice and Good Shepherd Hospice · Pathways Home Health and Hospice · Suncoast Hospice · TrustBridge Health · US Medical Management · Seasons Hospice & Palliative Care · Celtic Healthcare · Baylor Scott & White Health . Hospice of the Chesapeake.

Learn more and register now to visit the employers’ booths and explore available job opportunities.

NHPCO Meets with CMS on NOE/NOTR Issues

On August 31, 2016, NHPCO staff and provider representatives from NHPCO’s NOE/NOTR Workgroup, met with individuals from CMS’ Provider Billing Group and Chronic Care Policy Group to share concerns about the NOE/NOTR process. 

Provider representatives from Hospice of Michigan and Seasons’ Hospice and Palliative Care shared first-hand, on the ground examples of the financial and administrative burdens they’ve faced with the NOE/NOTR and sequential billing processes. 

CMS staff were receptive to NHPCO's concerns, especially with regard to NOEs that should fall within the existing exception categories as well as inconsistencies with NOE filings across and within the various MACs. CMS also stated that they do not hear much from the field (either providers or MACs) that this issue is a significant problem, nor do they hear concerns about the loss of provider revenue.

CMS continues to work on a new system function to submit NOEs electronically, and to revamping the FISS system for hospice data.  They predicted that the electronic submission fix is at least one year away, but is in development at this time.  A more complete revamp is a longer term goal.

NHPCO members will hear more about this issue as it moves forward; members will find the latest regulatory and compliance news in the Regulatory & Compliance Center on NHPCO's website.