OASIS Alert

Published on Tue Apr 27, 2010 PDF

Read right-to-left or risk inaccurate responses, experts warn.

For the first time in OASIS history, you have to answer a table of questions in both M2250 and M2400 -- and those tables can be quite misleading.

Problem: When you tackle the questions from left-to-right, the first response you hit is "No." "Our industry doesn't always read an entire item before selecting a response," points out Rhonda Will with Fazzi Associates in Northampton, Va. In this case, without reading the entire item, a clinician could answer "No" when "NA" is more appropriate, she says.

Solution: Rather than start with the question, head to the right side of the table and start with the description of "NA," Will suggests. Consider these two examples:

Example A (M2250): You patient entered the episode with a pressure ulcer, but it doesn't require moist-wound healing.

Reading strategy: Reading from left-to-right, your clinician may select "0" because the patient has no pressure ulcer that needs moist-wound healing. However, the correct response is "NA." Answering "0" might indicate that you aren't basing your treatment on the correct principles or that your physician hasn't sent an order. By answering "NA," you show clearly that there is no need for these measures.

Example B (M2400): Your patient exhibited some mild depression symptoms. After a thorough assessment, you determined she did not meet the criteria for depression. The physician agreed and didn't order an intervention for depression.

Reading strategy: If your clinician starts answering this question on the left, she might answer "0" because no intervention was ordered. However, if she starts on the right, she'll correctly answer "NA" because the reason there is no intervention is the patient didn't need one, Will says.

Bottom line: Coach your clinicians to always read the item tables from right-to-left so that they can rule out applicability before they attempt to choose a "Yes" or "No" answer.

Resource: For more OASIS C tips and solutions, access Fazzi Associates' free 45-minute webinar entitled "OASIS C Best Practices Project" at www.screencast.com/t/ZTY4YWQzNmIt or on Fazzi's website at www.fazzi.com.