Initially, when OBQI was introduced to our agency almost 2 years ago by our quality improvement (QI) officer, I must admit, I was skeptical. Yes, I knew our industry needed some well-defined benchmarks that we all could use. These benchmarks needed to be standardized and somehow risk adjusted to take into account variations in agency size, type of client population serviced, the client's age, and other variables.
Now, having worked through the entire process of OBQI and actually having seen its end result-reliable "Positive Client Outcomes,"-I'm a true believer! Yes, OBQI does work!
When asked about what one piece of advice I would recommend to other agencies as they begin their execution of the OBQI process, the answer comes easily:to involve all your staff in the process. Agencies vary in size and available resources, so become creative as you structure and work through the process. A key factor of OBQI success in your agency is your staff buy-in; they will be the "action" in your Plan of Action! Keep them involved and informed.
Using and incorporating into our QI program the many OBQM/OBQI tools now available has added the missing piece. That piece is "benchmarking" with our peers on a national level. The benchmarking component of QI is pivotal in setting standards and measuring performance based on established reference points.
As our agency began working with the process and available tools, we analyzed the information contained in the Adverse Events and the Case Mix reports. The Case Mix report provided an overall snapshot of our agency in a point in time. This report became helpful to our organization as we began to study and analyze the types of clients we were servicing. For example:
* Some of the information we obtained from the case mix was not new but was helpful in validating our assumptions and applying marketing strategies.
* The diagnosis mixture became helpful in identifying specific pathways that we would begin to make clearer and in more depth.
* Our case mix report revealed over one-half of our clients had wounds. This became beneficial as we planned for upcoming inservice topics for our clinical staff.
* Length of stay became a focus for comparison with the national standard and would help to ensure we were on target with the rest of the industry.
* The Adverse Event Report assisted us in identifying where potential problems may lie and addressing those areas before they become real problems.
As 2002 unfolds, we now have available 41 outcome measures and another set of case mix reports to round out the final phase of OBQI. As you begin to work with the latest set of tools and begin your initial efforts in the OBQI process, I feel strongly you will see the benefits of what OBQI can and hopefully will become.
OBQI is the first step to our industry working together to begin to identify the "best of the best." This sharing of information among our organization on those practices or interventions that work the best in achieving goals set for our clients in the most efficient and cost-effective manner can only enhance our client's care and strengthen our industry as a whole. With these reports we can now demonstrate that the care we provide in the home is effective and achieves positive client outcomes.