Therapist Meeting

Therapist Meeting
April 5, 2013

Positive and Encouraging Therapy Stories We want to hear your positive stories of progress and accomplishments in therapy! Please email your stories to heather@himmelhomehealth.com so we can share them!

Happy OT Month!!!! Thank you to all of our dedicated Occupational Therapists and Occupational Therapist Assistants! We appreciate everything you do to help kids live more successful, independent lives!

In Honor of OT Month, We Went on an OT Hiring Spree! Welcome New OTs: Mary Atkinson: Full-time OTR in Austin Gina Benavente: Part-time OTR in San Antonio Monica Obregon: Part-time OTR in San Antonio CrisPorras: Part-Time OTR in New Braunfels (starting in about a month)

Patient Satisfaction Survey Results Himmel received an overall score of 4.87 out of 5 on the satisfaction survey’s! WAY TO GO EVERYONE!!! You will be given a print out of your personal survey results. If you do not receive a print out, please email Melissa at martinez@himmelhomehealth.com and she will get you a copy.

Paperwork Survey 54 people completed the paperwork survey (THANK YOU!!!!!) Overall, people are satisfied with the paperwork system. However, there were some common concerns/ challenges that were voiced in the surveys. Based on survey results, here are some things we will be changing to attempt to address some of the challenges brought to my attention:

1) Upgrade to Full Word This was a common recommendation. We are trialing a full Word upgrade on 6 therapists’ tablets to see if this will actually improve some of the concerns with Word Starter. We should know whether we will upgrade everyone in about 2 weeks. More information to follow!

2) Spread Out Supervision of Assistants It is proving to be too large of a paperwork and travel burden for one supervisor to supervise large numbers of assistants (in all disciplines). Concerns: Driving large distances to cover all assistants’ service areas Increased paperwork due to large numbers of initial and re-evaluations SLP supervisors having to co-sign all documentation written by an assistant

Spread Supervision, Continued I fully understand this as a challenge. I’m going to limit supervisors to one assistant from here on out. Some will be grandfathered in and will keep supervision. Some will see a change in supervision. Those effected by this will be notified next week of any changes to supervision.

3) Make the Demographic Header the Same on All Documents Wow! This was a real “Duh” moment for me… why in the world didn’t I do this when I created the templates?!?! We have created a new demographic header that Ruth will complete at the referral level. Once a therapist receives this header from Ruth, it will be copied and pasted onto all documents for that patient (evals, notes, missed visits, etc).

Demographic Header, Continued This will apply to NEW referrals only. You DO NOT have to go back and change the header on current patients (unless you really want to). I will email out new templates that will accept this header next week. Please use these new templates for NEW patients once you receive them. This will also reduce errors in demographic information.

How to Cut and Paste the Header Once you receive the header that Ruth creates, you will highlight the entire header table. Right click on the highlighted table, and select Copy. Go to your desired template and highlight the blank header on that document. Right click on the highlighted blank template and select Paste. The completed header should appear. If you need technological help to know how to do this, please ask!!!!!!!

4) Peer Paperwork Training Sessions Several people put feedback on the survey that they have developed very efficient methods for the paperwork system and believe that they could help train their peers on their system. If you would like to conduct a training session to share your methods, please contact me (Heather). Once I have trainers, I will send out some information on training sessions, locations, and times. Thank you in advance for doing this! I think this is a fabulous idea!

5) Care Coordination is Challenging This has been a concern even prior to this paperwork system. For patients with multiple disciplines, please cc the other treating therapists when you send your evaluation and COIS forms to evals@h... If you do not know who the other therapists are, please contact Jeanine or Isela. Question- what barriers do you face in not knowing if a patient has another discipline or who the other treating therapists are? How can I help make that easier?

Care Coordination, Continued We are going to begin facilitating opportunities for you to hold monthly case conference meetings with the other HHH therapists that treat your patients. We will hold these case conferences after our regular monthly meetings. Due to the high volume of multi-disciplinary patients, it is not possible to conference about every patient each month, so we ask that you notify us, in advance, with the names of patients you would like to hold a conference about. Email your director (Jeanine or Isela) a list of multi-disciplinary patients that you want to discuss in case conferences. This email is due by noon of the Friday PRIOR to the therapist meeting.

Care Coordination, Continued The Directors will then email a list of all patients for whom a case conference has been requested. This list will be emailed out on the Monday prior to the therapist meeting. Please read through the emailed list and, if one of your patients is on the list,please plan to stay after the therapist meeting for case conferences. This is a work in progress and is open to suggestions and alteration as we go. This will begin in May.

Other Miscellaneous Comments Given Not happy having to follow up on illness reports- always forgetting them- AGREED!!!!! This was the only thing we were cited for on our last survey. It is, unfortunately, a regulatory rule, and we can’t get away from it. We have methods set up in the office to remind you to give us a follow up. The office doesn’t get mad if you forget to follow up. Just please complete a follow up once it’s requested.

Other Miscellaneous Comments Given Re-evals take longer because I have to re-type all the information. True, however this should reduce as we hit the 6 month mark of the paperwork system. Once the evaluation is completed on the current form, any re-evaluation can be completed on the same form, just with updated data. Please start saving the Word version of all evals so that if one person does the initial and a different does the RE, then we can get a Word version to the person doing the RE and they can update the information.

Other Miscellaneous Comments Given Make it so all signatures fall on the same page. Unfortunately, this all depends on the length of a person’s note (goals, how much data is put in). When the note is saved as a PDF, pages can’t be separated, so the signatures do ultimately stay together. If it truly bothers you that much, feel free to monkey with the margins and spacing to get it all onto one page.

Other Miscellaneous Comments Let us email in the Word version and have the office make any corrections, then they can save it as a PDF. I agree this would make it easier, but it is a HIPAA requirement that only the therapist that creates the documentation can make any corrections to it. Having you save and send the PDF ensures that only you, the documenting therapist, can make any alterations to your documentation.

Time Study Results The time study was conducted to assess the amount of time that it takes to complete all tasks related to your job and to assess if the time it takes to complete all aspects of the job are reasonable. Activities documented in the time study included preparing templates, completing therapy, travel, completing paperwork, preparing therapy materials, making phone calls, scheduling, emailing, etc. We determined that it takes approximately 1 hour 20 minutes of work per therapy visit. This amounts to 39 hours of work to complete 30 visits. This tells us that the current workload remains reasonable.

New Privacy Information You will be receiving a new privacy policy via email. Please read and sign and email it back to Kristen at (kristenhr@himmelhomehealth.com) Let’s review the new information:

Tablets (HHH issued computers) Your tablet MUST be password protected and it may not be the default password that is on the tablet when you receive it. Your password must have at least 6 characters (letters and/or numbers) and one special character. If your password does not meet this requirement, we will pause and allow you to change it now.

Tablets All PHI (protected health information) must be kept in one folder that is saved onto your desktop. You are free to have sub-folders within this main folder to keep yourself organized. If you need explanation about this, please talk to me, Corrine, Isela, or Jeanine and we will look at your tablet and help you. You must notify us IMMEDIATELY if your tablet is lost or stolen.

Tablets You must protect the tablet from loss and theft. This includes not leaving it unattended in your vehicle at any time, not leaving it at a table in a public place when you get up to use the restroom or refill a drink, etc. Keep your tablet with you or locked in your home at all times. Use of a thumb drive to store PHI is not allowed, unless the thumb drive is encrypted.

Tablets When accessing Himmel email on your tablet while using a public, open internet source (or any other time, for that matter), ensure that there is a padlock in the upper left hand corner of the website info. What does this look like?

What Does a Padlock Look Like?

Use of Personal Mobile Devices (cell phones, iPads, etc) You may set up your Himmel email onto personal mobile devices. However, when you set it up, you must ensure that the SSL encryption feature is turned on. For assistance, please see me. You may NOT forward your Himmel email to another email account to access it on your phone (or for any other purpose).

Use of Personal Mobile Devices If you use your phone or other mobile device for transmission of PHI, you must notify Himmel IMMEDIATELY upon the loss or theft of your device. Any mobile device that contains a Himmel email account or any other PHI must be deleted and wiped prior to discarding or recycling the mobile device.

Use of Personal Mobile Devices If you utilize your phone or other mobile device for Himmel email or other PHI, you MUST have a password protection on your phone or device. If you utilize your phone or other mobile device, please email Kristen by Friday, April 12, and tell her which devices you use and what you use them for (ie, I use my iPhone and have a Himmel email account set up on it.)

Emailing Protected Health Information Emailing from a Himmel email address to another Himmel email address is secured and encrypted, and emailing PHI between Himmel email addresses is allowed. Emailing from a Himmel email address to any other email address is NOT secure and encrypted, and therefore PHI may NOT be emailed.

Emailing PHI If you need to email any PHI (any email that contains any patient information- name, phone number, Medicaid number, etc) to an email address outside of the Himmel email system, you must notify your director and they will email the information using a secure email system. You also may NOT email any PHI from a non-Himmel email account, even if the email is going to a Himmel email. In other words, do not use your personal email address to send any PHI.

Emailing PHI All Himmel email accounts must be set up so that each email sent from that account contains the following confidentiality footer: Confidential: The information contained in this email is confidential and intended only for use by the person indicated above. If you are not the intended recipient, copying, use or distribution of this information is prohibited. If you have received this information in error, please notify Himmel Home Health immediately, or forward this email to the intended recipient immediately.

Re-evaluations We are starting to have challenges receiving Re-evaluations in a timely manner (3-4 weeks prior to the auth/POC expiration. What are the current barriers to completing these re-evaluations? How is it with the new RE lists?

Re-evaluations The auth department will start sending out reminders for re-evaluations 3 weeks prior to expiration- AS TIME ALLOWS. Don’t rely on this email, because if they get busy, they won’t be able to send this out. This email is just a courtesy and they promise, they are not hounding you.

Use of iPads, Phones, and Other Technology in Therapy We have had 3 recent complaints about the over-use of technology in therapy sessions. One family complained that while they understand the use of the iPad in therapy, they do not want their child to use it, because then all the child wants to do is play with the iPad when the therapist is not there. Another family complained that all the therapist does is use the iPad and does no other activities.

Use of Technology I agree that use of iPads and other technology can be a great part of therapy. However, I also agree that it should not be the only part of therapy. Please ask parents permission to use the iPad or other technology with their child prior to using it in therapy. It’s similar to giving them candy… not all parents want it for their children. Please explain to parents why you are using the technology and how it is helping to address goals.

Miscellaneous Info. Effective 5/1/13, you will no longer be able to access mjs on your tablets. If you are attempting to contact a family and they do not respond to voicemail or text messages, please drive by the home and see if they will answer the door. If you still can’t find them, you can also leave a door hanger asking that they call you. Please contact Ruth if you are having difficulty scheduling an IE or contact your Director (Jeanine or Isela) if you are having difficulty scheduling visits.

April Birthdays! Happy Birthday! Anna Krueger 04/16 Sheryl L. Jonsson 04/30 Sandra E Giddens 04/01 Jeanine P Lyons 04/24 Maria D Manzanarez 04/11 Kimberly R Cardenas 04/24 Cecilia Perez 04/27 Heather A. Engler 04/28 Trisha L Wade 04/21 Kelly M. Rholes 04/08

Therapist Meeting