Seasons Hospice & Palliative Care
Using HealthStream’s Learning Center and Competency Center, Season’s Hospice and Palliative Care receives multiple benefits, including the ability to provide consistent, essential training about end of life care, maintain and manage compliance with federal and other regulations, ensure staff are onboarded effectively and competent to perform their roles proficiently, guarantee staff are up to date in their understanding of every patient’s Plan of Care, and able to prepare efficiently for annual hospice surveys and three-year accreditation surveys.
The hospice industry has been subject to increasing regulation by governmental and accrediting entities. To stay up-to-date in this rapidly changing environment and to continue to provide effective interventions for patients nearing the end of life, continuing education is a must.
At Seasons Hospice & Palliative Care, education makes all the difference in their success. Headquartered in Illinois, Seasons is the fourth largest hospice provider in the United States with 23 Medicare-certified sites across 17 states from coast to coast. At Seasons, consistent delivery of education across all Seasons locations nationwide is critical. This is especially true for items such as regulatory changes, new policies, and protocols. “Seasons has been growing rapidly over the last decade, and we found that it was becoming increasingly difficult to deliver education consistently across all sites and keep track of what education was completed by whom. HealthStream has proven invaluable in this regard, adds Liz Kopochis, RN, MS, CHC, CHPC, Seasons Vice President and Chief Compliance Officer.
As it is at any large organization, tracking training is a huge undertaking. Accreditation reviews and other record-keeping requirements can make assembling information manually a tedious, long-term project. Prior to adoption of the learning management system, Seasons relied on old-fashioned paper methods to track staff training compliance and completions.
Care planning has always been a part of the nursing process, but the most striking difference between a nursing care plan and a hospice plan of care (POC) is its interdisciplinary nature. “Care planning in hospice occurs as the members of the interdisciplinary team (physician, nurse, social worker, chaplain and volunteer) come together and share the findings of their assessments of the patient and family needs,” Tate said. The blending of these assessments into one cohesive plan is the essence of hospice care planning. Because of its complicated nature, however, the plan of care is carefully scrutinized by Medicare; incompleteness can result in penalties. A well-informed staff will understand the POC’s importance and how imperative it is to document all interventions every time.
Seasons’ onboarding process includes a comprehensive review of the Medicare Hospice Benefit, as well as the most recent CMS initiatives, including the Consumer Assessment of Healthcare Providers (CAHPS) survey. The CAHPS survey focuses on the actual experiences of patients/families rather than on satisfaction. CAHPS replaced the Family Evaluation of Hospice Care Survey on Jan. 1 of this year; failure to comply can result in a two-percent reduction in the market basket percentage increase for the next annual payment update.
Seasons has been a HealthStream customer since 2012, when they implemented the HealthStream Learning Center. In mid-2015, they expanded their role with HealthStream by implementing the HCC, HealthStream’s Competency Center.
The compliance capability at Seasons has been improved considerably. “It is critically important to help staff understand what the federal and local governments are looking for,” explains Joanne M. Tate, BSN, CHPN, Seasons Vice President of Education and Staff Development. “People can’t take action to facilitate good outcomes if they don’t know what is expected. Using a learning management system allows us to educate staff on industry regulations as well as on excellent end of life care. Clarifying regulatory or business expectations through a competency management system, during the employee assessment process, and having the tools and resources to train and “check-off” is the very best thing we can do to help our staff and our leaders stay in compliance.”
Learning and education have truly become a strength within the organization. Seasons uses a blended approach to learning that relies on evidence-based and current best practices to ensure the highest-quality patient care. A comprehensive orientation program, webinars, patient vignettes, weekly team meetings, and more comprise Seasons’ robust educational program. “At Seasons, our mission is ‘Honoring Life – Offering Hope,’” Tate added. “This is reflected in every action we take. We support our staff so they can put our patients and families first. Our learning and competency platforms help us maintain an educated, informed staff so that we truly can honor our mission in every patient encounter we have.”
“For us, the key to reinforcing our Plan of Care is to use our learning and competency management systems to their fullest capabilities,” adds Gregory Grabowski, Seasons Vice President of Communications. “Technology like HealthStream’s is an accelerator for Seasons. It’s not intended to ‘sit on the shelf.’ You need to bring it to life, add in your own specific content and make learning tangible and real.”
Our learning and competency platforms help us maintain an educated, informed staff so that we truly can honor our mission in every patient encounter we have.
—Joanne M. Tate, BSN, CHPN, Seasons Vice President of Education and Staff Development
“Our learning management system has been immensely helpful in introducing our employees to CAHPS, adds Gregory Grabowski, Seasons Vice President of Communications. We were able to deploy a recorded session training staff on the CMS requirements with a focus on what the end of life experience should look like for patients and families.
HealthStream has also proven invaluable when preparing for annual hospice surveys and three-year accreditation surveys. “Accreditation ensures that we are meeting industry benchmarks and achieving quality indicators,” adds Balu Natarajan, MD, Seasons Chief Medical Officer. “Accreditation also allows us to achieve a key component of our overall vision and values – to strive for excellence beyond accepted standards.”
“Preparing for any survey is not a one-time annual effort,” Tate explained. “It is an ongoing process of quality improvement in how we collect and look at data, how we operate, and how we educate and hold people accountable. Having electronic systems in place to collect data so we can evaluate it and improve our strategy for good outcomes makes a huge difference. An electronic medical record (EMR) is an essential data collection tool in this day and age, allowing us to focus on data indicators, which identify performance improvement needs. Education is always part of that PI (process improvement) process.”
Not only does Seasons rely on the comprehensive library already built in to its learning management system, Seasons experts have created their own learning modules to train new staff – like they did when Seasons rolled out its upgraded (EMR) in 2014. “We screen-recorded the EMR functionality so people could learn and review without an instructor present. Valuable educator time was then used to guide practice sessions, validate competency using a checklist and assess the quality of the documentation,” Tate said.
“The courses we’ve created are assigned to staff and are auto-populated into their own customized learning page,” reports Kopochis. “Courses are tracked so we can determine completion percentages and follow up on those that have not yet been completed. The investment in a learning management system is worth it for organizations of any size because it saves delivery time and provides consistent information that employees can review as often as they like.”
“We are using HealthStream’s competency and performance centers to not only compose statements and expected behaviors but also to describe the evidence of achievement we are looking for,” Tate added. “Employees will do a self-assessment during the orientation period to help them each understand expectations and identify the things they need to learn.”
To drive certain points home, Seasons will add some of their own content to HealthStream’s existing competency library. For example, to explain the abstract and subjective concept of “trust” in the workplace and between patients and caregivers, a manager can add a video or an article that helps illustrate and solidify the concept even more by individual discipline – as well as supporting excellent patient care and organizational culture.
“It’s not enough to have this tool at your disposal, you have to give it care and attention to maximize its true potential,” Grabowski said. “At Seasons, we’re doing that, and we’re experiencing great results.” “Our business is a very autonomous business,” adds Kate Morrison, RN, National Director of Education. “Our nurses don’t have other nurses ‘down the hall’ that they can confer with when the have a question about a patient. Of course, they can call their Seasons office at any time, but thanks to HealthStream, they also have access to an entire library of resources right at their fingertips--on their laptop or on their smartphone. It’s truly a win-win-win.”