Client Services Train the Trainer Workbook...

OACCAC Education October 2013

Client Services Train the Trainer

Workbook OBP/OBR

Client Services Train the Trainer Workbook OBP/OBR

[ii]

Revision Table

Date Version Author Comments

October 1,

2013

1 Clare Corrado

OBP/OBR Crossword and

Word Search were

created by Stacey

Grammick


[iii]

Table of Contents

1. Introduction ................................................................. 1

1.1 Learning Objectives for this workbook ...................................... 1

1.2 The Workbook ....................................................................... 1

2. CHRIS – OBP/OBR ......................................................... 2

2.1 CHRIS: Home Care Referral - Intake/Eligibility ......................... 2

3. Add a OBP Service ......................................................... 4

3.1 Exercise 1-Add OBS ............................................................... 4

3.2 Exercise 2- Add Offer ............................................................. 5

3.3 Section 3 Quiz ....................................................................... 7

4. Navigating to the Pathway Details „Action‟ Page ................. 7

4.1 Demo 1 - Navigating to the Pathway Details „Action‟ Page .......... 7

4.2 Demo 2 - Pathway Details „Action‟ Page .................................... 8

4.3 Section 4 Quiz ..................................................................... 10

5. OBP Details Page - CCAC Activities ................................. 10

5.1 Exercise 3 – Change the OBP Start Date ................................. 10

5.2 Exercise 4 – Change the Interval Review Date......................... 11

5.3 Exercise 5 – Submit CCAC Report -Additional Information ........ 13

5.4 Section 5 Quiz ..................................................................... 14

6. OBP Details Page - Responding to SPO events ................. 14

6.1 Demo 3 – SPO Interval Outcome – Request to Change to the

„Correct‟ Pathway ......................................................................... 16

6.2 Exercise 6 – Submit SPO Interval Outcome ............................. 16

6.3 Exercise 7 – Submit SPO Additional Information ...................... 20

6.4 Exercise 8 – Submit 2nd SPO Interval Outcome (Incomplete) .... 21

6.5 Activity Notifications/Requests .............................................. 24


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6.5.1 Exercise 9– SPO & Patient Activity Notifications/Requests .................. 24

6.5.2 Exercise 10 – Re-Submit Interval Report and a CCAC Activity

Notifications/Requests ................................................................... 26

6.5.2.1 Exercise 11 – Review CCAC Activity Notifications/Requests ................ 27

6.5.2.1 Exercise 12 – Complete Activity Report for CCAC Activity

Notifications/Requests ...................................................................................... 28

6.6 Exercise 13 – Submit final SPO Outcome & Discontinue SPO

Report ........................................................................................ 29

6.7 Section 6 Quiz ..................................................................... 32

7. Adding a 2nd OBP .......................................................... 32

7.1 Adding a second Pathway ..................................................... 32

7.1.1 Demo 4 – CCAC Add New Pathway Request ..................................... 32

7.1.2 Demo 5 – SPO Add New Pathway Request ....................................... 33

8. Discontinue Pathways & Discharge Wizard ....................... 34

8.1 Demo 6 - Discontinue Pathways – Discharge Wizard ................ 34

9. Discontinue – Supervening Event .................................... 35

9.1 Demo 7 - Discontinue – Supervening Event ............................ 35

9.2 OBP/OBR Cross Word ........................................................... 36

9.3 OBP/OBR Word Search ......................................................... 37

10. Quiz Answers ............................................................... 38

10.1 Section 3 Quiz ..................................................................... 38

10.2 Section 4 Quiz ..................................................................... 38

10.3 Section 5 Quiz ..................................................................... 39

10.4 Section 6 Quiz ..................................................................... 39

10.5 OBP/OBR Cross Word Answers .............................................. 40

10.6 OBP/OBR Word Search Answers ............................................ 41


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OACCAC Education October 2013 Page 1 of 42

1. INTRODUCTION

This workbook contains learning activities and review questions needed to support

your learning. Active learning (which refers to techniques where learners do more

than simply listen to a lecture or instruction) is a very important part of achieving

the learning objectives. You will have the opportunity to hear, see, discover,

explore, and apply the information that you are learning.

Your instructor will provide you with information through lecture, demonstration,

discussion, quizzing and guided practice.

1.1 Learning Objectives for this workbook

After this training session, the participants will be able to:

Understand how to add an OBS and OBP

Understand how OBR Eligibility is determined

Learn how to navigate to the Pathway Details Page

Learn about CCAC only Activities

Understand when you need to review various report types:

o Interval Outcomes (complete/incomplete)

o Variances and Risk Factors

o Activity Notifications and Requests

o Additional Information

o Discontinue SPO/Pathway

Understand where and when Tasks are generated

1.2 The Workbook

This workbook is composed of a series of scenario-based exercises designed to

provide you with the opportunity to systematically practice and apply the CHRSI OBP

OBR functionality as you learn it in the classroom.

Some sections provide Instructor demonstration only.

How will you use the workbook?

Your Instructor will guide you through the activities in the workbook using the client

you have added.

It is important that you follow the exercises as designed to ensure that you

experience CHRIS OBP/OBR as intended.

In each exercise, you will be provided with specific information to enter in a field

when that information impacts on exercises to follow. You will not be provided with

information to be entered in every field that must be completed on a page. In this

case, you can draw from your CCAC experience and enter information that you feel is

appropriate.

(Be sure not to enter any personal information)



2. CHRIS – OBP/OBR

You may need to add a client and complete the Add Intake Page and Add

Eligibility page for a Home Care Referral.

2.1 CHRIS: Home Care Referral - Intake/Eligibility

Scenario:

You are a hospital Care Coordinator; you have completed your assessment and

determined that the client is eligible for the Home Care Referral.

1. Example of a Home Care - Add Intake Page for your client uses the following table

as a reference.

Intake Page - Field Name Information to be entered

Referral Type Home Care

Referral Date to CCAC Today‟s Date

Assessed Out of Region No

Referral Source Hospital

Referral Contact Name and Phone At your discretion

Presenting Problem Post op surgical care

Client Resides out of Region No

Consent Date Today‟s Date

Consent to Proceed with Assessment Verbal

Intake Team Select a Team

Intake Case Manager Select a name

Assessment Urgency Leave Blank

Primary Care Group Blank

Preferred Language for Service Blank

Specialty Program Blank



Intake Page - Field Name Information to be entered

Client Population/Sub-

Population/Local Population

*Please leave blank

Treatment Location Blank

Assessing Team Selection Same as Intake Team/Case Manager

2. Select „Save and Add Eligibility‟ for Home Care. Use the following table to

complete the Add Eligibility page.

Eligibility Page – Field Name Information to be entered

*Assessing Team Select a team

*Assessing Case Manager Your name

*Assess Start and End Dates Today‟s date

*Assessment Tool RAI Contact Assessment

*Eligibility Outcome Eligible – Admit to Home Care

*Eligibility Determined Date Today‟s date

*Admit Date Today‟s date

*Payment Liability Other

Primary Care Group Blank

Preferred Language for Service Blank

Speciality Group Blank

Client Population/Sub-

Population/Local Population

*Please leave blank

*SRC 91 - Acute

*Team To a community team-your choice

*Caseload A caseload within the above team-your

choice



Eligibility Page – Field Name Information to be entered

*Treatment Goal Healing of wound

Primary Diagnosis Add a new diagnosis i.e. Surgical wound

3. Select “Save”

3. ADD A OBP SERVICE

The Authorization and Offer processes for OBP remain essentially the same as for other

Services with a few additional fields.

3.1 Exercise 1-Add OBS

1. Observe the Instructor adding a OBS (Outcome Based Service)

2. Add an OBS Service by completing the Add Service Page. Enter information of your

choice in fields not identified below. However it is important that you enter the following

information as specified here:

Add Service Page - Field Name Information to be entered

Service Type Outcome-Based Wound

Service Delivery Type Outcome-Based Wound –sdt

Local Distinction Select if required for this client in your

CCAC

Treatment Location You must select a Treatment Location.

Geographic Area Select if required for this client in your

CCAC

Focus of Intervention Add if required

Service Plan Goals Add if required

Scenario:

You are a hospital CC and your patient has had surgery and requires wound care at

home. You have completed your assessment and determined that he/she would meet

the criteria for a Surgical wound Pathway and would meet the OBR criteria. The

hospital has informed you that the client will be discharged tomorrow



Add Service Page - Field Name Information to be entered

Treatment Orders At your discretion

Provider Instructions At your discretion

Service Response Time At your discretion

Service Priority Rating At your discretion

Verbal Confirmation At your discretion

Initial Authorization Date Today‟s date

Date Service Required by At your discretion

Required First Visit Date At your discretion

CC Reassessment Date At your discretion

Service End Date At your discretion

Authorizing CC Your name

3. DO NOT Add Frequency

4. Once you have completed the Add Service Page, select “Save and Add Offer”

What happened when you selected „Save and Add Offer”

What CHRIS level are you in?

Complete the information required for OBP-OBR and navigate back to the

service level to complete the service offer.

3.2 Exercise 2- Add Offer

1. Observe the Instructor completing the Add Offer page and adding the OBP

2. Add an OBP by completing the Add Offer Page. Enter information of your

choice in fields not identified below. However it is important that you enter the

following information as specified here:

Add Offer Page - Field Name Information to be entered

Outcome-Based Pathway Surgical Wound (v1.0)

Pathway Start Date Tomorrow‟s Date



Add Offer Page - Field Name Information to be entered

Provider Notification Notes At your discretion

Offering Team Select the team

Offer Contact Name Your Name

Service Response Time At your discretion

Service Priority Rating At your discretion

Verbal Confirmation At your discretion

Required Provider Selection Select if required

Offer Date Today‟s date

Date Service Required by At your discretion

Required First Visit Date At your discretion

CC Reassessment Date At your discretion

Outcome-Based Pathway Max. Interval

Date

CHRIS calculates this date based on the

OBP selected and the OBP start date

Provider End Date Enter the same date as above for the OBP

Max. Interval Date

Offer Authorizing CC Your name

3. Once you have completed the Add Offer page, select “Save and Send”

4. CHRIS determines if the patient has met all the 4 eligibility criteria for OBR

5. CHRIS displays the option for you as a Care Coordinator to determine if the

OBP will be OBR or FSS

To be eligible for OBR, ALL four of the following criteria must be met:

1. OBR pathway

2. 19 years of age or older

3. Short Stay Client Population assigned

4. No other active Services

If any one of the OBR eligibility criteria are not met then CHRIS automatically

set the OBP as FFS



6. Select AGREE and this pathway is OBP-OBR

7. Go to the Notification tab at the Service Offer level to see if the offer was

successfully sent and in the Response tab, accept the offer for the provider.

3.3 Section 3 Quiz

1. True or False

There are three types of OBS (Outcome-Based Services): Orthopaedic, Palliative

and Wound

2. To be eligible for OBR, the following criteria must be met:

a. OBR pathway

b. 19 years of age or older

c. Short Stay Client Population assigned

d. No other active Services

e. All of the above

3. True or False

CHRIS determines if the client meets the OBR eligibility criteria, then YOU

determine if the OBP will be OBR or FFS.

4. NAVIGATING TO THE PATHWAY DETAILS „ACTION‟ PAGE

4.1 Demo 1 - Navigating to the Pathway Details „Action‟ Page

1. Observe the Instructor navigating in CHRIS

You can complete the following and/or add notes to figures provided:

HINT – look for the pathway name hyperlink

Tab/Page Describe the Area that has Hyperlink to go to the

Pathway Details „Action‟ Page

Referral Overview Page

Provider Level



Navigating to the Pathway Details „Action‟ Page

Referral Level – Overview Page

Provider Level/Outcome-Based Pathway Level

4.2 Demo 2 - Pathway Details „Action‟ Page

The Pathway Details page provides a detailed view of the pathway and displays the

details, history, reimbursement status, Interval and outcome status, and submitted

pathway reports for the pathway that have been submitted by the CCAC and/or SPO.



This Pathway Details Page:

Provides the ability for SPOs and CCACs to submit and view additional OBP

information such as Exceptions (variances and risk factors); Activity

Notifications/Requests; Supervening Events

Provides the ability for Client Services staff to submit CCAC only outcomes and

for SPOs to view those outcomes

Provides the ability for CCACs and SPOs to generate an outcome report that

displays OBP information for a client

Communicates information about patient‟s care in a timely manner, through the

CHRIS and HPG

Provides notification and tracking for follow-up during Pathway course of

treatment

1. Observe the Instructor navigating in CHRIS

In each section on the Pathway Details page, there are a number of actions

that you can complete and/or review.

The table below describes the sections and associated links and/or activities on

the Pathway Details page.

Section Links and/or Activities

1. Details a. Generate a Pathway Summary Report

b. Link to detail information about the

Pathway<Name>

c. Access the edit hyperlink to edit the Pathway

Start Date

2. History a. Review all events that have occurred during the

course of the OBP

3. Interval Outcomes a. View the list of Outcomes with their due dates

b. Access the Review <Date> hyperlink to change

the Interval Review Date

4. Interval Reports a. Review a pathway report

b. Generate a pathway report

c. Submit a CCAC Pathway Report

d. Submit a SPO Pathway Report

From the Pathway Details page, the SPO and CCAC Team can complete a number of

activities but ONLY the CCAC Team can complete the following activities:

A. Access the edit hyperlink to edit the Pathway Start Date

B. Access the Review <Date> hyperlink to change the Interval Review

Date

C. Submit a SPO Pathway Report (based on your business process)



4.3 Section 4 Quiz

1. True or False

The Pathway Details page is called the „action‟ page as all communication and

action is generated from this page in both CHRIS and HPG

2. Only the CCAC Team can:

a. Change the OBP Start Date

b. Change the Interval Review Due Date

c. Submit a Pathway report for the SPO

d. All of the above

5. OBP DETAILS PAGE - CCAC ACTIVITIES

Only the CCAC Team can change the Pathway Start Date and the interval Review

Date of an interval outcome.

CCACs are able to submit pathway reports that include additional OBP information

such as Exceptions (variances and risk factors); Activity Notifications/Requests.

When the CCAC Team completes an „Additional Information‟ Report, these notes are

entered in the Client Level Notes Tab

5.1 Exercise 3 – Change the OBP Start Date

You can only edit the Pathway Start Date when the pathway is authorized and no

outcomes, requests, notifications, activities, responses or additional information have

been submitted for the pathway

When a new Start Date is set, CHRIS deletes all Intervals related to the Pathway

assignment and recreates new Intervals based upon the new Start Date in CHRIS and HPG/CHP.

To Change the Start Date

Check the current Review Dates for the outcomes, before changing the start Date

1. Observe the Instructor changing the OBP Start Date

2. In the Details section of the Pathway Details page, select the Edit hyperlink

CHRIS displays the pop-up page to edit an OBP Start Date.

Scenario:

The hospital has contacted you, to advise you that the patient is being discharged

today.



3. Complete the fields

Field Label Description

*Start Date Change the start date to today‟s date

Additional Info Add any additional comments

*Authorizing CC Your name

4. Select SAVE

5. CHRIS asks you to confirm OBR eligibility, select „Agree‟

6. How has the Pathways Details Page changed?

Expand each section to see if there are any changes

Pathway Details

Sections

Questions? Select Yes/No

Details Has the Start Date

changed?

Yes/No

History Has a new event been

added?

Yes/No

Reimbursement Status Has a core payment

been made?

Yes/No

Interval Outcomes Have the Interval Due

and Review Dates

changed?

Yes/No

Interval Reports Is this area still Blank? Yes/No

5.2 Exercise 4 – Change the Interval Review Date

From the Interval Outcome section, you can change the Interval Review Date.

The New Review Date cannot be:

earlier than Interval Due Date

later than the Provider End Date

less than the Care Pathway Assignment Start Date

later than the Care Pathway Assignment End Date

later than the Care Pathway Assignment‟s Maximum Interval End Date

Scenario:

The SPO has asked the CCAC Team to extend the date of the 1st interval, to

accommodate changes to the Pathway Start Date.



To change the interval review date

Review the current Review dates for the outcome interval

1. Observe the Instructor changing the Interval Review Date

2. In the Details section of the Pathway Details page, click on the Interval

Outcome section

CHRIS expands the section to display all the Outcomes required for this

pathway

3. Select the first outcome and click on the review <Date> hyperlink

CHRIS displays the pop-up page to edit an OBP start date.


Field Description

Current Review Date The current interval review date (not editable)

*New Review Date Change the Review Date to the following day


5. Select SAVE

6. Expand each section of the Pathway Details „Action‟ Page to see if there are any

changes

Pathway Details

Sections



added?

Yes/No


been made?

Yes/No

Interval Outcomes Has the Review Date

changed?

Yes/No

Interval Reports Is this area still Blank? Yes/No



5.3 Exercise 5 – Submit CCAC Report -Additional Information

In the CCAC Submit Pathway Report page, the Check box „Additional Information‟

provides an opportunity for CCAC (and SPO) to provide additional notes about the

OBP course of treatment that cannot be captured elsewhere in the interval report

When a CCAC submits a CCAC report, the content of the „Additional Information‟ is

saved in the Pathway details page Interval Reports section and in the Client Level

Notes tab. Remember this is your client note.

To complete an Additional Information Report

1. Observe the Instructor adding the „Additional Information‟ report

2. In the Interval Report section of the Pathway Details page, select the „Submit

CCAC Report button

CHRIS expands the section to display the Submit Pathway Report page

3. Check the „Additional Information check box

CHRIS expands this section


Field Description

Additional Information At your discretion i.e. “Receive a call today from the hospital that the patient is being discharged today”

*Reported By Your name

*Reported Date Today‟s date

5. Select the SUBMIT button

6. Expand each section of the Pathway Details page to see if there are any

changes

Pathway Details

Sections


History Has a new event been added? Yes/No

Reimbursement Status Has a core payment been

made?

Yes/No

Scenario:

You complete an Additional Information report to document the reason for changing

the pathway start date and changing the outcome interval review date.



Pathway Details

Sections


Interval Outcomes Has an Outcome Interval

report been submitted?

Yes/No

Interval Reports Has a report been submitted?

If yes, review the columns:

Where does the hyperlink

take you?

What does the PDF display?

Who Submitted the Report?

What is the Status of the

Report?

What type of report was

submitted?

Yes/No

7. Go to the Client level Notes Tab:

a. Is the information displayed there?

b. What is the subject line for the pathway note?

5.4 Section 5 Quiz

1. True or False

You can only edit the start date when the pathway is authorized and when no

pathway reports have been submitted for the pathway

2. The New Review Date cannot be:

a. earlier than Interval Due Date

b. later than the Provider End Date

c. less than the Care Pathway Assignment Start Date

d. later than the Care Pathway Assignment End Date

e. later than the Care Pathway Assignment‟s Maximum Interval End Date

All of the above

3. True or False

When a SPO submits a Pathway report, any information added within the

„Additional Information‟ report is also saved in the Client Level Notes Tab.

6. OBP DETAILS PAGE - RESPONDING TO SPO EVENTS

Previously only outcome reporting was available on all pathways, now the OBP

Pathway Report form in both CHRIS and HPG are laid out in a similar fashion.



A single pathway report may contain a combination of different types of OBP

reporting data such as outcomes, exceptions, activity notifications/requests,

additional information, discontinue provider, discontinue pathway or add new

pathway requests.

You can expand and collapse each section of the pathway report independently by

selecting the section check-box, and you can enter data for one or many of the

outcomes, risk factors, activities or requests available in the report.

There are two types of reports that may be submitted depending on the responsible

actor – an SPO report and a CCAC report.

You can submit CCAC pathway reports and SPO pathway reports on behalf of the

service provider.

NOTE: Your CCAC may have business processes in place regarding CCAC

team submitting SPO reports.

For the training purposes only, you are asked to submit reports on

behalf of the SPO in order for you to understand your role and

responsibilities with pathways.

The following exercises and demos describe:

Which SPO Pathway activities have „Review Not Required‟ and „Pending Review

When SGT are generated (SGTs are regenerated nightly until the task is

reviewed)

As you are completing Section 6, complete the following table:

Pathway Reports

Review type

Place a check mark in the appropriate column

CCAC

Activity

Response

Required

Yes/No Review Not Required

Pending Review

Incorrect Pathway

Outcomes (Status = Complete)

Outcomes (Status = Incomplete)

Variances and Risk Factors

Activity Notifications/Requests (CCAC)

Activity Notifications/Requests (SPO/Patient)

Additional Information submitted by CCAC

Additional Information submitted by SPO

Discontinue



6.1 Demo 3 – SPO Interval Outcome – Request to Change to the

„Correct‟ Pathway

When the pathway is incorrect i.e. Diabetic Leg Ulcer vs. Venous Leg Ulcer:

In the Discontinue Report, the SPO selects;

o Discontinue Reason = “Pathway incorrect‟

o Requested Action= “Discontinue Pathway and add new Pathway”

a request is sent to the Care Coordinator to Agree or Disagree with the SPO‟s

request

When you transition to the correct pathway, this new pathway will have same Start

Date as previous pathway.

To Review Change to the Correct Pathway:

1. Observe the instructor demonstrating CCAC role when the SPO determines that

the pathway is incorrect

2. What is the status of the original and correct Pathway?

3. Is there a task generated for this activity?

4. Where does the CCAC respond to this request?

5. After authorizing the request to discontinue the original pathway and

authorizing the new correct pathway, what is the status of the original and

correct Pathway?

6.2 Exercise 6 – Submit SPO Interval Outcome

Each Pathway outcome is identified as belonging to a single “Responsible Partner”.

The Partner is the CCAC or SPO who is responsible for achieving the Interval

Outcomes and submitting the Interval Reports by the Interval Due Date

Interval Outcomes:

define Interval Goals

contain a collection of Service Outcome Types for each Pathway Event

defines the Outcomes that are reportable in a Pathway Report and must be met

to complete the related Interval

are assigned a Display Order that applies within the Interval to provide a

customizable reading order on Interval Reports

have a status of „Complete‟ or „Incomplete‟

Scenario:

The SPO has confirmed that the pathway is correct and completed and submitted the

outcomes for the 1st interval



To Submit an SPO Interval Outcome

1. Observe the Instructor Submitting a SPO interval outcome report


SPO Report” button


3. Check the box for the first SPO interval report



Outcomes Value Performed By Performed Date

Holistic patient &

wound assessment

completed

Yes Your name first name with Provider as your last name

Today‟s Date

Correct Outcome-

based pathway

confirmed

Yes Your name first

name with

Provider as your

last name

Today‟s Date

Wound therapy

Initiated


Today‟s Date

Patient Discharge

Planning Initiated

for Patient

Independence and

Prevention


Today‟s Date

Wound

Measurement

Value (LxWxD)

Your discretion

Your name first name with Provider as your last name

Today‟s Date

Note: You can enter a 0.5 value and if a wound is protruding like a blister or

protruding wound it can be captured as a negative „Depth‟. Negative

depth being -2



changes

Pathway Details

Sections

Questions? Answer the questions


added? Yes/No



Pathway Details

Sections


Reimbursement Status Has a core payment been made?

Yes/no

Interval Outcomes Has an Outcome Interval report been submitted?

Yes/No


Yes/No

What is the Status for the report?

Review Not Required/

Pending Review


submitted (check under the Content column)?

* If your CCAC has set ‘Completed’ Outcome Reports NOT to be reviewed by

CCACs, continue with this section

To Review Pathway Reports:

1. In the Pathway Details Page Interval Section, under the submitted Date column

select the hyperlink

CHRIS displays Review Pathway Report Page

Is there a „Review‟ Check Box available?

2. Select Cancel to return to the Pathway Details Page

Continue to Section

* If your CCAC has set ‘Completed’ Outcome reports to be reviewed by CCACs,

complete this section


3. Go to the Client Level Action button and select the „View Task‟ and select GO

a. Chris displays the task asking you to review the report

b. Select the Outcome Based Activity Summary hyperlink under the Task

Description column to return to the Pathway Details Page




5. Add a check mark in the Review box

Once you check the Review box, CHRIS displays the SAVE button



6. Select the Save button (you would also complete any other action required

based on your CCAC business processes)

7. You are returned to Pathway Details page and the report is marked as

“Reviewed Completed <Date Reviewed>”


a. Is the task still displayed?

Continue to Section



6.3 Exercise 7 – Submit SPO Additional Information

Additional information (unlimited free text) can be submitted in an interval report by

either partner SPO or CCAC.

Summary notes contain additional information about the OBP course of treatment

that cannot be captured elsewhere in the interval report

Based on your CCAC business process for frequency reporting, this area can be used

to update frequencies for the OBP-FSS pathways

To complete an Additional Information Report

1. Observe the Instructor adding the „Additional Information‟ report


SPO Report button


3. Check the „Additional Information check box



Field Description

Additional Information At your discretion i.e. “Client staying with daughter for a few days”

*Reported By Your name first name with Provider as your last

name

*Reported Date Today‟s date



changes

Pathway Details

Sections

Questions? Fill in the answers


Yes/No

Scenario:

The next Outcome Interval report is not due for another 2 weeks and the SPO is

submitting an „Additional Information‟ report to inform the CCAC that patient is going

to stay with her daughter for a few days and the daughter will contact the SPO if

there is any concern about the wound.



Pathway Details

Sections



Yes/No


Yes/No



Pending Review


submitted (check under the Content column)?

To Review an Additional Information Report:





2. In the Pathway Details Page - Interval Section, under the submitted Date

column select the hyperlink










6.4 Exercise 8 – Submit 2nd SPO Interval Outcome (Incomplete)

Surgical Wound Outcome-Based Pathway second interval outcome is due 21 to 28

days based on the pathway Start Date and there must be a 20 to 30% reduction in

the wound size.



To submit the 2nd incomplete interval report:


SPO Report button


2. Check the box:

for the 2nd SPO interval report and enter the same measurements as

the 1st report

for “Additional Information” report and enter information at your

discretion


4. What happens when you select the Submit button

When an incomplete outcome report is submit, a message is displayed:

“The submitted report contains unmet outcome(s). Please submit one or

more Variances and Risk Factors in the report.”

5. Check the box for the Variances and Risk Factors

CHRIS expands this section and displays three (3) types of Variances and risk

Factors (Clinical, System, Patient/Caregiver)

6. Add a check mark next to the “Pain” and “Nutrition” items under the Clinical

section

CHRIS expands the items


Scenario:

The SPO submitted the outcomes for the 2nd interval (Incomplete outcome: In this

exercise, to submit an incomplete report, you are going to submit the wound same

measurements reported in the first outcome report)

Variances and Risk Factors are also known as Exceptions. These

variances are barriers or risk factors that are affecting or may affect patient

outcomes during the OBP course of treatment.

These variances/risk factors are customized according to the three

Outcome-Based Service (OBS) types (Wound, Ortho, and Palliative)

Variances and Risk Factors:

Are submitted in an interval report by a SPO or CCAC (each partner

is notified when a variance report is submitted)

May be submitted independent of outcomes

Must be submitted when outcomes are reported as unmet



Outcomes Reported by Reported Date Additional

Information

Pain Your name first name with Provider as your last name

Today‟s Date “pain in surgical site”

Nutrition Your name first name with Provider as your last name

Today‟s Date “Poor eating habits”


9. Review the Pathway Details page

10. In the Pathway Details Page - Interval Outcome Section: Check the 2nd report

and note if there are any additional information about the wound displayed.


changes

Pathway Details

Sections



been made? Yes/No

Interval Outcomes Has an Outcome Interval

report been submitted? Yes/No

Interval Reports Has a report been

submitted? Yes/No



Pending Review

What type of report was submitted (check under

the Content column)?

To Review Outcome and Variances and Risk Factors Reports:


















6.5 Activity Notifications/Requests

Activity Notifications/Requests are submitted in an interval report by the SPO or

CCAC on behalf of the SPO.

When the SPO or Client is arranging the activity, the CCAC is notified and a review is

not required.

When the SPO directs the CCAC to complete an activity, you will need to complete a

review and activity response.

Activity Definition CCAC Task

Activity

Notification

Activity notifications are

intended to notify the CCAC that

the SPO and/or Client is

arranging an activity such as an

inter-professional referral

Reviews are not required

Activity

Notifications

/Requests

Activity requests are intended to

direct the performance of an

activity by the CCAC

1. Review the Information

2. Complete the Activity

Response i.e. arrange a

community referral

6.5.1 Exercise 9– SPO & Patient Activity Notifications/Requests

To Submit an SPO/Patient Activity Notifications/Requests Report

1. Observe the Instructor Submitting a SPO Activity Notifications/Requests report

Scenario:

With the slow progress with wound healing, the SPO is submitting an Activity

Notifications/Request to notify the CCAC that the SPO is arranging to have the

patient see the Special Physician and the patient is arranging to see a nutritionist




SPO Report button


3. Check the box for the Activity Notifications/Requests


4. Under the Select responsible partner, Inter-Professional Services section

„Special Physician‟, select the SPO radio button

5. Under the Select responsible partner, Inter-Professional Services section „Nut‟,

select the Client radio button


Outcomes Referred By Referral Date Additional

Information

For both:

„Special Physician‟ and

„Nut‟


Today‟s Date At your discretion



changes

Pathway Details

Sections


History Has a new event been added?

Yes/No


Yes/No


Yes/No


submitted? Yes/No



Pending Review

What type of report was submitted (check under the Content column)?



To Review SPO/Patient Activity Notifications/Requests Report



CHRIS displays Review Pathway Report Page:

Is there a Review check box?

What is the status of the report?

6.5.2 Exercise 10 – Re-Submit Interval Report and a CCAC Activity

Notifications/Requests

To resubmit the 2nd Interval and a CCAC Activity Notifications/Requests

Report

1. Observe the Instructor resubmit the 2nd interval report and a CCAC Activity

Notifications/Requests report


SPO Report button


3. Check the box for the 2nd interval report and Activity Notifications/Requests

4. Complete the fields:

2nd Interval Report:


Wound

Measurement

Value (LxWxD)

Numbers to

correspond to

50% healing


Today‟s Date

Activity Notifications/Requests

Under the Select responsible partner, Community section „Adult Day Program‟,

select the CCAC radio button


Information

Adult Day

Program

Your name first name with Provider as your last

Today‟s Date “pain in surgical site”

Scenario:

The SPO is re-submitting the 2nd interval (wound healed 50%) and a CCAC Activity

Notifications/Request to arrange for the patient to attend an Adult Day Program




Information

name



changes

Pathway Details

Sections



added? Yes/No


been made? Yes/No

Interval Outcomes Has an Outcome

Interval report been submitted?

Yes/No


Yes/No



Pending Review


submitted (check under

the Content column)?

7. To review and complete CCAC activities continue to the next two sections

6.5.2.1 Exercise 11 – Review CCAC Activity Notifications/Requests

To Review CCAC Activity Notifications/Requests Report:


a. Chris displays the task with 2 descriptions:

Activity Request has been received and requires a response -

reported date: 2013-09-18 Activity Type requested: 'Adult Day

Program' Owner: CCAC

Report has been received and requires review - 2013-09-18

Report contents: 'Activity Notifications/Requests'








3. Select Review check box







a. Is there a task displayed?

b. Return to the Pathway Details Page

6.5.2.1 Exercise 12 – Complete Activity Report for CCAC Activity

Notifications/Requests

To Complete an CCAC Activity Report

1. In the Pathway Details Page Interval Section, select the Submit CCAC Report

button and CHRIS displays Review Pathway Report page

2. Select Activity Response check box

CHRIS expands the “Activity Response” item


Outcomes Action Reported

By

Reported

Date

Additional

Information

Activity

Response

Community

Services: Adult

Day Program

From the Action drop down select, „Completed’

Your Name Today‟s Date Add any appropriate information



changes

Pathway Details

Sections



added?

Yes/No


been made?

Yes/No



Pathway Details

Sections


Interval Outcomes Has an Outcome

Interval report been

submitted?

Yes/No


submitted?

Yes/No

What is the Status for

the report?


Pending Review


a. Is there a task displayed?

b. Return to the Pathway Details Page

6.6 Exercise 13 – Submit final SPO Outcome & Discontinue SPO

Report

When the SPO has submitted all the outcomes and reports then the SPO should

send a „Discontinue SPO” request to indicate that the SPO is no longer be

responsible for the patient care.

To Submit an SPO Interval Outcome and Discontinue Report

1. Observe the Instructor Submitting a SPO interval outcome report


SPO Report” button


3. Check the box for the:

Discontinue Report

Final SPO interval report

CHRIS expands these sections

4. Complete the fields for the reports:

A. Final SPO Report


Scenario:

The SPO is submitting final interval outcome report and as the wound is healed

submitting “SPO Discontinue” report (there is no further role for the SPO).




Wound

Measurement

Value: 0 x 0 x 0 Your name first name with Provider as your last name

Today‟s Date

B. Discontinue Report

Field Information to be entered

Reason Treatment complete – goals met

Requested by Your name first name with Provider as your last name

Requested Date Today‟s Date

Additional Info Your discretion

Requested Action Discontinue SPO



changes

Pathway Details

Sections


Detail Section What is the „Partner Status?‟

SPO-Active/ SPO-

Discontinued Requested


Yes/No


Yes/No

Interval Outcomes Are all the intervals

completed? Yes/No

What is the Status for

the report? Review Not Required/

Pending Review












Once you check the Review box, CHRIS expands the page to include

Discontinue SPO fields

(You can change the radial button to „Disagree‟ and view the changes then

return the radial button to „Agree‟)

10. Complete the fields with the radial button at „Agree‟


New Provider Status Date Today‟s Date

Authorizing CC Your name






changes

Pathway Details

Sections


Detail Section What is the „Partner Status?‟



Interval Outcomes Are all the intervals reviewed/completed?





6.7 Section 6 Quiz

1. True or False

SGTs are regenerated nightly until the task is reviewed

2. True or False

Variances and Risk Factors are barriers or risk factors that are affecting or may

affect patient outcomes during the OBP course of treatment.

3. When the SPO submits an Activity Notifications/Request reporting that

the SPO and/or the patient is arranging an activity such as an inter-

profession referral:

a. A task is generated to remind you to review the report

b. This is only a notification that the SPO and/or Patient are arranging an

activity

c. A task is not generated as you do not need to review the report

d. B and C

4. Core payments are sent from CHRIS to the SPO when PLOs were met,

which interval outcomes were PLOs:

a. Each interval outcome

b. First interval outcome

c. Second Interval outcome

d. Last final Interval outcome

e. A and B

7. ADDING A 2ND OBP

7.1 Adding a second Pathway

„Add New Pathway‟ request can to be used to add a second pathway to existing

service only

When a second pathway is added and authorized by the CCAC to an existing OBP-

OBR, the second pathway:

is OBP-FFS

has NO FFS visit payments released during the period the second pathway

overlaps with the OBR (until Day X)

Has FFS payment released on the start date of the warranty period

A second pathway may be requested by the CCAC or SPO

7.1.1 Demo 4 – CCAC Add New Pathway Request

1. Observe the Instructor



2. From the Provider Level/Details Tab/Outcome-Based Pathways, select the „add

pathway button‟



*Pathway Select a pathway

*Start Date Today‟s date

Additional Info Your discretion


4. Select Save

5. Review the following:

a. From the Provider Level/Outcome-Based Pathways hyperlink, review the

Pathway status of each pathway

b. For each pathway, navigate to the Pathway Details page and review the

Details section

7.1.2 Demo 5 – SPO Add New Pathway Request


To Review SPO Add New Pathway Request:





3. Which Pathway Details Page is displayed?



Scenario:

You receive a fax from the patient‟s physician stating that there is a second wound.

Scenario:

The SPO has added a new pathway as there is a second wound that requires

treatment





Once you check the Review box, CHRIS expands the page to include Add New

Pathway fields



6. Complete the fields with the radial button at „Agree‟


Start Date Today‟s Date

Additional info Your discretion






9. Review the following:

a. From the Provider Level/Outcome-Based Pathways hyperlink, review the

Pathway status of each pathway

b. For each pathway, navigate to the Pathway Details page and review the

Details section

8. DISCONTINUE PATHWAYS & DISCHARGE WIZARD

8.1 Demo 6 - Discontinue Pathways – Discharge Wizard


2. The first page of the Discharge Wizard displays:

a. Outcome-Based Pathways Outstanding Activity Requests

If there are any outstanding activity requests displayed, the Report

Date hyperlink navigates you to the Activity response page

b. Outcome-Based Pathway Interval Reports requiring Review

If there are any reports requiring review, the Submitted Date hyperlink

navigates the Review Pathway Report Page

c. Outcome-Based Pathways grid:



If there are any active pathways, the Pathway<name> hyperlink

navigates you to the Discontinue Report page

9. DISCONTINUE – SUPERVENING EVENT

Supervening events are events which:

identifies conditions that determine that Patient is no longer eligible for the

pathway

occurs independently of (i.e. are not caused by) the pathway itself that affect

the quality of treatment

9.1 Demo 7 - Discontinue – Supervening Event


The SPO discontinues the pathway as the client is moving to live with her

daughter in another city. The SPO has submitted a Discontinue Report





Once you check the Review box, CHRIS expands the page to include

Discontinue SPO fields



4. Complete the fields with the radial button at „Agree‟ and „Save‟

5. Review the Pathway Details Page:

Details section: Reimbursement type, disposition, etc.

Event section: What new events have been added?

Reimbursement: What has change?

Interval Outcome: What has changed?

Interval Report: Are there any pending reports?



9.2 OBP/OBR Cross Word

DOWN ACROSS

2. _____ with patients and the health care

team is key to improving everyone‟s care

experience

3. _____ focus on achieving defined results

within a defined time period

4. _____ is an example of the type of category

of pathways available

5. What occurs for the providers when PLOs

are completed and goals met?

1. What is consistently measured?

6. What is shared with the health care

team?

7. What pathways are based on

9. What the health care team focuses on

10. What is required initially by the Care

Coordinator to determine which pathway

is most suitable?



8. What is collaborative initiative between

CCACs and SPOs?

9.3 OBP/OBR Word Search

ACCOUNTABILITY

ASSESSMENT

CARE

COLLABORATION

CONSISTENCY

CONTRACTS

EREFERRAL

EVIDENCE

INNOVATION

JOURNEY

PATHWAYS

PILOTS

PUBLIC

QUALITY

REMIMBURSEMENT

SATISFACTION



EVOLUTION

FLEXIBILITY

HIPS

SUCCESS

TEAM

WOUND

10. QUIZ ANSWERS

10.1 Section 3 Quiz

1. True or False

There are three types of OBS (Outcome-Based Services): Orthopaedic, Palliative

and Wound

True

2. To be eligible for OBR, the following criteria must be met:

f. OBR pathway

g. 19 years of age or older

h. Short Stay Client Population assigned

i. No other active Services

j. All of the above

All of the above

3. True or False

CHRIS determines if the client meets the OBR eligibility criteria, then if eligible

for OBR, YOU determine if the OBP will be OBR or FFS.

True

10.2 Section 4 Quiz

1. True or False

The Pathway Details page is called the „action‟ page as all communication and

action is generated from this page in both CHRIS and HPG

True

2. Only the CCAC can:

a. Change the OBP Start Date

b. Change the Interval Report Due Date

c. Submit a Pathway report for the SPO

d. All of the above

All of the above



10.3 Section 5 Quiz

1. True or False

You can only edit the start date when the pathway is authorized and when no

pathway reports have been submitted for the pathway

True

2. The New Review Date cannot be:

a. earlier than Interval Due Date

b. later than the Provider End Date

c. less than the Care Pathway Assignment Start Date

d. later than the Care Pathway Assignment End Date

e. later than the Care Pathway Assignment‟s Maximum Interval End Date

f. All of the above

All of the above

3. True or False

When a SPO submits a Pathway report, any information added within the

„Additional Information‟ report is also saved in the Client Level Notes Tab.

False

10.4 Section 6 Quiz

1. True or False

SGTs are regenerated nightly until the task is reviewed

True

2. True or False

Variances and Risk Factors are barriers or risk factors that are affecting or may

affect patient outcomes during the OBP course of treatment.

True

3. When the SPO submits an Activity Notifications/Request reporting that

the SPO and/or the patient is arranging an activity such as an inter-

profession referral:

a. A task is generated to remind you to review the report

b. This is only a notification that the SPO and/or Patient are arranging an

activity

c. A task is not generated as you do not need to review the report

d. B and C

B and C

4. Core payments are sent from CHRIS to the SPO when PLOs were met,

which interval outcomes were PLOs:

a. Each interval outcome

b. First interval outcome



c. Second Interval outcome

d. Last final Interval outcome

e. B and D

B and D

10.5 OBP/OBR Cross Word Answers

DOWN ACROSS

2. _____ with patients and the health care

team is key to improving everyone‟s care

experience

3. _____ focus on achieving defined results

within a defined time period

4. _____ is an example of the type of category

of pathways available

5. What occurs for the providers when PLOs

1. What is consistently measured?

6. What is shared with the health care

team?

7. What pathways are based on

9. What the health care team focuses on

10. What is required initially by the Care

Coordinator to determine which pathway

is most suitable?



are completed and goals met?

8. What is collaborative initiative between

CCACs and SPOs?

10.6 OBP/OBR Word Search Answers

ACCOUNTABILITY

ASSESSMENT

CARE

COLLABORATION

CONSISTENCY

CONTRACTS

EREFERRAL

INNOVATION

JOURNEY

PATHWAYS

PILOTS

PUBLIC

QUALITY

REMIMBURSEMENT



EVIDENCE

EVOLUTION

FLEXIBILITY

HIPS

SATISFACTION

SUCCESS

TEAM

WOUND

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