December 2016
The Quarterly Newsletter of the HHQI Underserved Populations (UP) Network


Quarterly UP Network Webinar | January 19, 2017 | 2-3pm ET
The Value of Home & Community-Based Service Organizations

Register now to learn more about Home & Community-Based Services (HCBS) and how partnering with a quality-focused organization can improve patient outcomes. It is important to find the right HCBS partner that focuses on quality improvement. During this webinar, you will hear from an organization that is using data to formally drive quality improvement.

Guest Speakers: 
Tammy Rhoades, BA, CEO
Tina Trimbath, RN, OT, BS
Alleghenies United Cerebral Palsy
Now Available: October 2016 UP Network Webinar Recording

The Life Maps: Treating the Whole Patient, Not Just the Disease  webinar (60 minutes) provided  information  about All  About You! Home Care Services' innovative model that addresses patient's psychosocial needs in order to improve outcomes. Agency leadership 
and clinicians can learn more about the four areas of the agency's Life Maps Model: Personal Support, Safe Living Support, Psychosocial Support & Community Support.  Free Nursing (ANCC) CEs available.
Save the Dates: 2017 UP Network Webinars

All webinars will be held from 2-3pm ET.  As soon as more details are available, they will be accessible via the UP page on the HHQI website and emailed directly to those who are subscribed to our  Educational & Networking Opportunities mailing list .

January 19:
The Value of HCBS Organizations
April 20:
Topic TBD
July 20:
Topic TBD
October 19:
Topic TBD


The Bureau of Labor Statistics (2015) finds home health aides are the fastest growing professional group in the nation and the demand will continue to grow with the addition of the Baby Boomers. There were more than 913,000 aides working as home health aides (variety of settings) in 2014. The anticipated growth rate for this group is 38% which is much faster than the average 7% growth for most fields (Bureau of Labor Statistics, 2015). There were almost 350,000 home health aides employed in home health agencies in 2014 (Avelere, 2015). 

Home health aides have an important role to help older people age at home (Boerner, K., 2016). Aides have a unique relationship with patients in a home environment. Important information may be shared with the aide rather than with the nurse or therapist. The aides are the 'eyes and ears' when the nurse or therapist is not present.

Aides can play a vital role in reducing hospitalizations or emergency department (ED) visits. Front-loading visits (an evidence-based practice) can coordinate the visits to avoid duplicate visits on same day. The aides need to have education to identify early changes and a patient-centric care plan that includes what to report and to whom.
Highlight the great work your aides are doing with your interdisciplinary teams to assist with patient management. Below are two MyHHQI Blog posts that aides have written about their role as part of a healthcare team. 
There are numerous pilots being tested to expand the roles for home health aides throughout the country. The Huffington Post's Blog (8/19/16) describes one specific pilot. New York State Department of Health recently completed an 18-month study by providing advanced training to home health aides in three home health agencies in New York City. Their results show 24% fewer ED visits. In this pilot, a new position was created and salary adjusted for the "senior aide" position. 

The advanced training included areas of medication review, physician appointment oversight, and symptom monitoring. The senior aides also served as a coach and liaison to other aides.
The use of computer tablets were utilized to answer questions on the patient's medical condition. The assessment identified potential early changes in health status that allowed for interventions by the healthcare team. Advanced training initiatives like this and  the Advanced Home Care Aide Apprenticeship program in Washington State are taking place across the country.

A home health aide's role can be expanded within the current federal and state guidelines. HHQI provides examples of specific actions to engage/educate your aides into specific improvement areas within many of the Best Practice Intervention Packages (BPIP). For example, below is an excerpt from the Fundamentals of Reducing Hospitalizations BPIP (p. 43).

Aide Actions:
  • Know your agency's hospitalization reduction plan.
  • Take vital signs and report if outside of documented ranges unless it is against agency or state policy.
  • Report any unusual signs and symptoms (e.g., skin breakdown, behavior changes , falls, or problems with medications).
  • Notify nurse or therapist if seeing or hearing of any medication issues noted.
  • Adhere to the instructions on the Home Health Aide Care Plan and recommend needed updates to the nurse or manager.
  • Encourage/reinforce the use of any patient tools designed to help the patient know when to call the agency with problems (e.g., Call Me First Poster, ZONE or Stoplight Tools, agency booklets/magnets, etc.).
Quality Assurance & Performance Improvement (QAPI) is another evidence-based process to improving patient and clinical outcomes. Including a home health aide on the Performance Improvement Project (PIP) team can garner great insight and innovation with project interventions.



HHQI University Now Offers Home Health Aide Courses

HHQI is excited to announce the addition of a new online course catalog in HHQI University designed for home health aides! Courses in the new Home Health Aide catalog are appropriate for home health or hospice aides and community health workers. And like all things HHQI, they are absolutely free.
The first 1-hour course in the Home Health Aide catalog, Heart Attack & Stroke Risk Factors, Signs & Symptoms, includes videos, online activities, and a short post-test. Everyone who successfully completes the course by scoring at least 80% on the post-test will earn a certificate of attendance which is available immediately. Learn how to register and complete this course today!
HHQI also has a plethora of patient tools and materials that can be utilized for home health aide education.  Some examples include:
  • Diabetes Patient Education Tools & Multimedia Modules
    • Diabetic Feet & Shoes patient education tool
    • Signs and Symptoms of Hypoglycemia and Hyperglycemia tools
    • Diabetes Self-Care Patient Module (8 minutes)
    • Healthy Eating Patient Module (13 minutes)
    • Prediabetes and Signs & Symptoms of Diabetes Patient Module
      (10 minutes)
Additional Resources
For more information or to suggest future UP topics or speakers,  please contact us at Visit our website t learn more about  HHQI .

This material was prepared by Quality Insights, the Medicare Quality Innovation Network-Quality 

Improvement Organization supporting the Home Health Quality Improvement National Campaign, 

under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. 

Department of Health and Human Services. The views presented do not necessarily reflect CMS policy. 

Publication number 11SOW-WV-HH-ADL-121616