1/28/ CMS ESRD Conditions for Coverage, 2008

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Dinah Carter
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1 The interdisciplinary team must provide the necessary monitoring and social work interventions. These include counseling services and referrals for other social services, to assist the patient in achieving and sustaining an appropriate psychosocial status as measured by a standardized mental and physical assessment tool chosen by the social worker, at regular intervals, or more frequently on an as-needed basis. -- MS ESRD onditions for overage, 2008 Another task we now have to do where do How do we do it? How do we explain it to our patients? How do we get our patients to buy in to this? What good will this do? Why? Another task we now have to do where do How do we do it? How do we explain it to our patients? How do we get our patients to buy in to this? What good will this do? Why? A linical Perspective Some models General tips Review main points 1

2 ase aide was administering all surveys via interview High participation rate Results appeared inconsistent between us earning more about each patient Patients responded clinically Suggestion items to increase scores appeared as coping skills ase aide was administering all surveys via interview High participation rate Results appeared inconsistent between us earning more about each patient Patients responded clinically Suggestion items to increase scores appeared as coping skills nsurance issues mmigration issues oping Anger / mpulse issues R E T E O N nsurance issues mmigration issues oping Anger / mpulse issues R E T E O N nsurance issues mmigration issues oping Anger / mpulse issues R E T E O N nsurance issues mmigration issues oping Anger / mpulse issues N A A N 2

3 R E T E O N nsurance issues mmigration issues oping Anger / mpulse issues A N am here to help you cope with any compromise necessary between your beliefs, expectations and standards, and those of the environment that we exist in. -- The Nephrology Social Worker s reed, 2003 am here to help you cope with any compromise necessary between your beliefs, expectations and standards, and those of the environment that we exist in. -- The Nephrology Social Worker s reed, 2003 am here to help you cope with any compromise necessary between your beliefs, expectations and standards, and those of the environment that we exist in. -- The Nephrology Social Worker s reed, 2003 Get a different view Make choices Follow your treatment plan Keep your sense of humor onnect with others Make good use of your treatment time Know your fluid goal Talk to someone Do what you can for yourself Be realistic Be more active Believe that you have a good life Help protect your heart by eating less salt and not gaining too much fluid weight ommunicate with your partner Do things you love -- Medical Education nstitute, nc. Some nterventions That mprove Scores (Research-Based) APD vs. APD1 More frequent HD2,3 V iron & ESAs4 Bone mineral balance5 1Bro S et al. Perit Dial nt Nov-Dec;19(6): Heidenheim AP et al. Am J Kidney Dis Jul;42(1 Suppl): Ting GO et al. Am J Kidney Dis Nov;42(5): Agarwal R et al. Am J Nephrol. 2006;26(5): unningham J et al. Kidney nt Oct;68(4): hang ST et al. Nephron lin Pract. 2004;97(3):c90-7 7Tsay S et al. J Adv Nurs Apr;50(1): ii Y et al. J lin Nurs Nov;16(11): Painter P et al. Am J Kidney Dis Sep;36(3):600-8 Reaching ideal weight6 Adaptation training7 Group counseling8 Exercise training9 -- Beth Witten, MSW, ASW, SSW: NKF Medicare Modernization Program Manager detailed to MS Survey & ertification Group under PA appointment, Witten and Associates, -- Dori Schatell, MS: Executive Director, Medical Education nstitute; Director, ife Options program 3

4 Results Reviewing / Referencing specific QO survey items 4

5 Reviewing / Referencing specific QO survey items PHQ-9 PHQ-9 ST PHQ-9 ST Mimic the way the questions are delivered during regular interaction with patients to get them used to that type of questioning Refer to content from the survey during regular interaction, including responses Provide results / goal setting as soon as possible 5

6 Another task we now have to do where do How do we do it? How do we explain it to our patients? How do we get our patients to buy in to this? What good will this do? Why? Another task we now have to do where do We re already providing (SFT). How do we do it? By connecting the QO survey to the SFT that we re already providing. SFT = brief, present-oriented, narrow focus, measureable outcomes How do we explain it to our patients? Explain that an association exists between a person s own perception of their QO and 2 things: risk of hospitalization and likelihood of survival. How do we get our patients to buy in to this? Explain your role in terms of coping skills and the result suggestions in terms of coping skills. Teach patients about QO in terms of process and its features including on-going. What good will this do? This focuses the content of your interventions. earn new things about each patient. Gateway to clinical work. Why? This quantifies your work and provides patients concrete scores that reflect their evolving perceptions. This creates measureable results that can be communicated to the patient and DT. Sometimes creative delivery is required, such as when piggy-backing PHQ-9 tool. Take advantage of patient s willingness to respond clinically in this particular context. Reviewing = ncludes counseling, motivational interviewing, active listening, empathic responding, open-ended questioning, and psychoeducation. Utilizing your base of knowledge to set and prioritize effective goals and to select appropriate interventions. How to utilize your tools and instruments to maximize outcomes. 6

7 motivational interviewing, solution focused therapy ESRD Program nterpretive Guidance Patient Health Questionnaire 7

Outline. I Love My Intern! How can we involve residents in patient satisfaction?

Outline. I Love My Intern! How can we involve residents in patient satisfaction? I Love My Intern! How can we involve residents in patient satisfaction? APDIM Fall Meeting October 2012 Outline Pre Assessment Introduction Small Groups Small Group Presentations G.U.I.D.E. TM Conclusions