Using OASIS Data to Target Patient Satisfaction Quality Improvement Initiatives in Home Health Care

The researchers sought to determine differences in patient satisfaction based on patient characteristics, events during the course of care, and the ultimate clinical and functional outcomes of home health care treatment. The researchers obtained permission from the Home Nursing Agency (HNA), a Visiting Nurse Association headquartered in Altoona, Pennsylvania, to link Outcome Concept Systems (OCS) and Press Ganey. OCS is a health care information company that manages Outcome and Assessment Information Set (OASIS) data and reporting to the Centers for Medicare and Medicaid Services (CMS) for 1,500 clients.

Because CMS is considering pay-for-performance (P4P) systems that factor in patient satisfaction as well as high performance in clinical outcomes, Press Ganey, a healthcare satisfaction measurement research firm, sought to use the OASIS data to determine which patient characteristics were related with higher patient satisfaction and willingness to recommend the caregiver's services to others. This led to the following three specific research areas and the effect of each on patient satisfaction:

• Patient characteristics, such as primary diagnosis, discharge within two-weeks from hospitalization, presence of pressure ulcer, stasis ulcer, or surgical wound, living situation, presence or absence of smoking or obesity
   
• Events during care, such as number of visits, need for emergent care, re-hospitalization for any reason
   
• Clinical or functional outcomes, such as degree of improvement in self-care abilities, reduction of pain, and oral medication management

The researchers summarized OASIS factors into flags indicating presence or absence of a characteristic, event, or outcome. Between September 2005 and May 2006, HNA patients completed a satisfaction survey. The researchers suggest that the results of the survey present opportunities for organizations to target quality improvement efforts.