October 2018
HHQI's Underserved Populations (UP) Network monthly newsletter
Quarterly UP Network Webinar | October 18, 2018 | 2-3 p.m. ET
Promoting Medication Adherence
among Older Adults at Home
Many patients have medication adherence and other issues that relate to physical, cognitive, or health literacy impairments. Such issues can affect the management of their medical conditions. Occupational therapists are taught evidence-based management interventions that help patients improve adherence and medication outcomes. This webinar is appropriate for leaders, nurses, therapists, and social workers who want to learn more about medication management strategies and the utilization of occupational therapists.
Expert Presenters:  
Dr. Martha Sanders, PhD, MSOSH, OTR/L, CPE
Dr. Tracy VanOss, DHS, OTR/L, SCEM, FAOTA
Professors of Occupational Therapy
School of Health Sciences, Quinipac University (CT)
This activity has been submitted to Alabama State Nurses Association for approval to 
award 1.25 Nursing contact hours. Alabama State Nurses Association is an accredited approver of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC).

To receive CE credit, participants must watch the webinar and enroll in the corresponding course in HHQI University's  Underserved Populations  course catalog to complete related coursework. 

Step-by-step instructions  will be reviewed at the end of the webinar.
Now Available: July 2018 UP Network Webinar Recording
Check out the  Strategies to Care for Patients in Rural Settings UP webinar recording. Renee Grisham, Director of Nursing, Mississippi HomeCare of Eupora and Diana Lecher, Director, Chadron Community Hospital & Health Services (NE) shares several common barriers with patients living in rural setting and intervention strategies. There are free nursing continuing education credits still available with the recording in HHQI University .  
Save the Dates: 2018 - 2019 UP Network Webinars
All webinars will be held from 2-3 pm 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  UPDate and Educational & Networking Opportunities mailing lists .
September was National Preparedness Month and the perfect  time to ensure patients have or begin working on an emergency plan. The U.S. encounters hurricanes, tornadoes, flooding, droughts, excessive heat, wildfires, and blizzards, and recently, it feels like the country is being hit with a one-two punch. Hurricane Florence wreaked havoc on the Carolinas. Hawaii was hit this year with not only 52 inches of rain from Hurricane Lane but also Kīlauea Volcano's massive eruption. Puerto Rico is still recovering a year later from Hurricane Maria.
We don’t have control over natural disasters, technology failures (e.g., power outages), or acts of terrorism, but we do have the opportunity to prepare and have a plan to persevere through the event. September has been deemed National Preparedness Month to encourage everyone to make a plan and gather supplies. As health care providers, we need to also assist our patients and their caregivers to also prepare. It is difficult enough to deal with the emergency situation as a healthy individual, but it is even harder when a person has physical, cognitive, and/or behavioral health issues; relies on medications; is unable to get out to gather needed supplies prior to the event; or is challenged by poverty or social determinants.
Read September's MyHHQI Blog post, September is National Disaster Preparedness Month: Social Determinants, Health Care Coalitions and Disaster Preparedness , by Barbara Citarella, President & CEO, RBC Limited Healthcare & Management Consultants on more about the effects with various communities.

The Centers for Medicare & Medicaid Services (CMS) requires all healthcare settings to have an Emergency Preparedness plan. The Emergency Preparedness Rule – Federal Register went into effect 11/15/17 for any provider who participates in the Medicare or Medicaid program. There are the Emergency Preparedness Regulations for Home Health Agencies (HHAs) in section § 484.22 that provides unique differences from those of an inpatient setting. Each HHA has to have an emergency plan for the organization including strategies to address patient populations. Communication and coordination are critical elements of the planning. CMS (2017) specifies what needs to be included in the agency’s policies and procedures must minimally address. One of the requirements is:

 “The plans for the HHA’s patients during a natural or man-made disaster. Individual plans for each patient must be included as part of the comprehensive patient assessment, which must be conducted according to the provisions at § 484.55.”

Patients, families, and caregivers should be provided information regarding the HHA's emergency plan and appropriate contact information in the event of an emergency. In addition to the agency’s plan, a plan should be developed for each patient. If the patient does not live in areas where natural disasters occur, plans can be made for the loss of power, heat, fire in house/building, etc. Homecare clinicians have a great opportunity to work with the patient and caregivers to address needs and develop an emergency plan. Clinicians can assess each patient’s home situation, physical status, medical needs, and potential events, especially those that are seasonal. Perhaps the current string of natural events is the perfect time to discuss planning with patients with immediate or possible concerns. Utilize any of the resources in the next section to assist the patient to prioritize and begin setting aside necessary supplies or developing an evacuation plan from the home in the event of fire or flood.  
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-101618