With any new patients over the age of 18, home healthcare clinicians are required to complete a lengthy assessment designed to enable systematic comparative measurements for outcomes, called the Outcome and Assessment Information Set (OASIS). In part one of this two-part blog series, we explored the importance of looking for clues to assist with answering OASIS questions and reminded the audience that the OASIS is an assessment, not a questionnaire.
It is imperative to understand OASIS guidance in order to accurately score patients and develop an appropriate plan of care. Clinicians should look for clues that the patient can perform each activity safely and at least 50% of the time. Just because a patient is doing something does not mean that they should be doing it. Always rate a patient at the level of activity that the patient can safely perform.
Instead of drilling a patient for each question on the OASIS, try the “show me” walk, a method developed by home health experts at Axxess. In this installment of the 15-minute OASIS two-part series, you will learn what clues to look for and how to use the OASIS Walk to easily obtain OASIS information while performing the comprehensive assessment.
Upon Arrival: Show Me to the Bathroom
Asking the patient to show the location of their bathroom for the clinician to wash their hands at the beginning of the visit gives an opportunity for the clinician to determine many OASIS questions through observation rather than questionnaire.
On this walk, clinicians can identify:
· Gait patterns and the patient’s ability to ambulate and transfer independently
· Level of pain as the patient rises from and lowers to the chair
· Shortness of breath when resting and upon ambulation
· Potential safety hazards, like throw rugs, clutter, extension cords and the absence of smoke detectors
· Possible incontinence issues if soiled clothing is observed in the bathroom
· The patient’s ability to bathe independently based on the functionality of the bath and shower
During the time the clinician is washing their hands, they should engage the patient in further conversation driven by the clues already discovered.
It is often a good time to bring up incontinence by stating the question in a way that maintains the patient’s dignity. For example, the clinician might say “Many of my patients who take water pills like you do experience issues with not being able to make it to the bathroom in time. Does that ever happen to you?”
After Washing Hands: Show Me to the Kitchen
On the walk back, the clinician should ask to see the kitchen to gather additional OASIS clues, including the patient’s:
· Ability to prepare food independently
· Ability to perform household chores
· Compliance with diet
· Cognition when asked to perform a diet recall of the last 24 hours
Asking the patient what they ate for their last meal and who prepared it will confirm clues and provide insights into who the patient lives with and other organizations involved in care, such as Meals on Wheels.
Finishing the Assessment: Final Observations
When the walk is finished and the patient sits down for the formal assessment, the clinician can further investigate the patient’s ability to groom their upper and lower body by having the patient remove their sweater for a blood pressure check or reach their arms above their head.
By having the patient remove their shoes to assess their feet, the clinician can determine the patient’s ability to dress the lower body.
By asking the patient to read the label on a medication bottle, the clinician can assess health literacy, as well as determine visual acuity.
When clinicians are familiar with the OASIS questions and understand that it is an assessment and not a questionnaire, patients will benefit from the reduced burden of data collection with clinicians spending less screen time and more bedside time.
Axxess Home Health is a cloud-based home health software with built-in OASIS documentation and scrubbing tools that guide clinicians through accurate, efficient OASIS completion that meets regulatory standards and improves patient outcomes.
