Quality Assurance

When asked in a Family Evaluation of Hospice Care survey conducted by the National Hospice and Palliative Care Organization regarding the care received from Home Hospice of Grayson, Cooke and Fannin Counties, 100% of our respondents say they would recommend Home Hospice to others to care for loved ones, greater than the average of responses for hospices in the State of Texas (98.2%) or the nation (98.3%).

Sadly, only 88% of our respondents feel they were referred to hospice at the right time with the others saying the referral came too late in the disease process. Frequently we receive statements such as, “I wish my Daddy could have known this quality of care for a longer period of time,” or “if only our doctor had told us this kind of help was available sooner.”

Home Hospice of Grayson , Cooke and Fannin Counties

licensed and regulated by the Department of Aging and Disability Services (DADS) of the State of Texas

certified by the Center for Medicare & Medicaid Services (CMS) of the United States

accredited with deemed status by the Community Healthcare Accreditation Program

Indicating Home Hospice meets requirements greater than those of either the DADS or CMS

Quality Assurance/Performance Improvement Committee meets quarterly

Home Hospice of Grayson, Cooke and Fannin Counties is committed to the highest quality end-of-life care and support for both individuals and their family members. This Family Evaluation survey is one tool that we use to monitor how well we achieve our objective of providing that care to each individual whose life we touch. As unrealistic as it is to expect 100% in all categories because we are human and so are the families we serve, that is our goal and this kind of feedback is enormously valuable as we take steps for continuous quality improvement. A sample of the questions are listed in the chart below, along with statistics indicating how Home Hospice compares with others around Texas and the United States. (These results are from Quarter 1, 2010).

Question Summary	Rating for Home Hospice	Average Texas hospice rating	Average National hospice rating
Hospice provided good coordination of care, exhibited knowledge of patient’s history, provided good information & consistent staff	95.1%	91.9%	92.1%
Family was always kept informed of patient’s condition	92.7%	80.5%	79.8%
Hospice made sure patient died on his/her own terms	100%	93%	92.4%
Hospice team clearly explained the plan for patient’s care	100%	96.9%	96.6%
Hospice team always treated patient with respect	97.5%	96%	96.4%
Family received enough instruction on caring for their loved one	100%	97.1%	96.6%
Patient and family received the right amount of spiritual support	97.6%	95.4%	95.8%
Patient received all medical equipment needed	100%	98.3%	99.3%
Would you recommend this hospice to others	100%	98.2%	98.3%

Additionally, there are questions with several possible answers – “excellent, very good, good, fair, poor,” or “always, usually, sometimes, never.” A sample of results from these types questions are listed below.

86.2% of the respondents said their loved one’s personal needs were taken care of always and an additional 13.8% said usually (total 100%).

94.8% of respondents said the Home Hospice team response to evening/weekend needs was either very good (23.7%) or excellent (71.1%).

97.2% of respondents said Home Hospice provided adequate to outstanding emotional support for family and friends of the patient.

100% of respondents stated that the care received while under care of Home Hospice was either very good (14.3%) or excellent (85.7%).

100% of respondents rated the hospice team members who cared for their loved one as either very good (16.7%) or excellent (83.3%).

Home Hospice is an active member of the Texas and New Mexico Hospice Organization. {link to www.txnmhospice.org } The Texas & New Mexico Hospice Organization, grounded in hospice philosophy and standards, advocates excellence in services, promotes ethical practices, and fosters education and research. It assists its membership network to provide care that enhances the quality of life for patients and their families experiencing a life-limiting illness. Seven current staff members and volunteers have been chosen best in their respective disciplines by this prestigious organization.

Home Hospice is also an active participant in the Texas Non Profit Hospice Alliance, {link to www.tnpha.org} a statewide organization committed to compassionate end-of-life care through comfort against physical and emotional pain and individual control of quality of life. The Executive Director of Home Hospice sits on the Board of this organization and through this association, Home Hospice is constantly focused on best practices and innovations in hospice care.

When benchmarked against hospices both within the State of Texas and Nationwide, Home Hospice consistently outperforms other hospices in

Provision of emotional support to the family both before and after their loved one’s death – this is a critical piece of hospice care as the family is a part of the unit of care; they are providing care to someone they love even as they prepare for and struggle with the approaching loss of that person – support, guidance and compassion are crucial for families during this time
Provision of spiritual care in the amount requested / desired by family and/or patient – many of the questions faced during our final journey are spiritual in nature, “What has my life meant? What’s next? Have I made a difference Have I done all I can to make life better for those I love?, among many others. It is important to have a spiritual counselor available for those who wish to explore these feelings, whether they are dying or caring for a dying loved one.
Provision of information on what to expect throughout the dying process Many families tell us that the consistent flow of information is vitally important to them during this time as they seek to balance their own lives with the care of someone close to them. Knowing what to expect takes away much of the fear of the unknown giving them comfort and security throughout the process.
Provision of information on pain management The greatest fear Americans have related to dying is dying in pain. Home Hospice staff members are experts at detecting pain and providing many avenues to achieve comfort – whether the pain is physical, emotional, spiritual, or financial.
Support for patient during sadness or anxiety – Sadness and anxiety are normal reactions to a life limiting illness. Home Hospice seeks to address these conditions on many levels and provides guidance and support to not only the patient, but also to the family.
Having one nurse who was in charge of a patient’s care throughout the experience This provides a continuity of care unmatched in medicine. It allows both the patient and the family to build a relationship of trust and understanding that enhances the hospice experience and increases security and comfort all around.
Taking care of the patient’s personal needs (aide care) Home Hospice aides are outstanding in taking care of patients, helping them to feel comfortable and clean, and in most cases, pampered, even if they are unable to care for themselves. Their compassion matches their skill, and they are well known for adding little extra personal touches that brighten each day for that person.
Patient is treated with respect (100%) Honoring a person’s wishes and treating them with respect and dignity are the pillars of care at Home Hospice. This very important time belongs to each individual and the goals for care and choices should be theirs.
Family had enough instruction in taking care of their loved one (100%) and were confident in doing so Few of us have much experience at caregiving, and even if we have done the tasks before, each person cared for is a different individual and has a different relationship with us. Having experts in the field provide guidance, education and support increases the success we achieve in the experience and that security allows us to enjoy our moments with this very special person.
Team response to evening and weekend needs There is nothing more frightening than a crisis, big or small, at night or on the weekend. Typically, help is not available. Home Hospice has a staff dedicated to meeting your needs during these times. Whether it is a need for additional medication, a change in a person’s condition, the need for emotional support, or a variety of others, our staff is available – day or night – and are just a phone call away. This dedicated staff live locally, making response times as short as they can possibly be. Additionally, Home Hospice maintains a group of highly experienced hospice nurses between the hours of 5 and 9 pm, Monday – Friday, to answer your call and ensure your needs are met. Call us, we’ll be right there.

100% of our respondents say they would recommend HH to others to care for loved ones (this is better than state or national numbers)

Sadly, only 85% of our respondents feel they were referred to hospice at the right time with the other 15% saying the referral came too late in the disease process. Frequently we receive statements such as, “I wish my Daddy could have known this quality of care for a longer period of time,” or “if only our doctor had told us this kind of help was available sooner.