Knowing What You Don’t Know

I have been accused, on more than one occasion, of sleeping with the OASIS guidance manual under my pillow. I have always been interested in reading regulations for myself and trying to assist others as we try to separate fact from fiction.

Interest in OASIS is once again on the rise as we face OASIS E implementation on January 1, 2023. As K&K continues to build and expand resources to assist with preparation, it is easy to focus on the “new” items as anything new with be more anxiety producing that familiar content.

I am responsible for gathering scenarios and questions to build our OASIS Knowledge Assessment Tools. At times, I worry that some are “too basic” and represent situations or concepts that those who collect OASIS data should be very familiar with. As an example, M1850 Transferring has clear directions that if someone is using an assistive device AND needs human assistance (AKA – at least supervision), the correct response is “2 – Able to bear weight and pivot during the transfer process but unable to transfer self”. This has been the guidance for years and years at this point which means someone who needs a cane and supervision to safely complete this task would be a “2”.

In our most recent Knowledge Assessment, I included that very same scenario thinking I was balancing out some more challenging items related to recent Q&As. What I am seeing is an overwhelming majority of participants putting response 1 – which is incorrect. Additional frequent errors relate to the M1342 Status of the Most Problematic Surgical Wound and the appropriate use of 88 and 09 as “not attempted” codes in the GG items.

What this tells me is that sometimes our idea of what staff need to be taught about OASIS accuracy is not aligning with the reality of knowledge gaps. What are the trends in your organization when it comes to the need for OASIS corrections? Do you track that? Is it nearly all clinicians or only a few that need follow up? This is why we created the OASIS Knowledge Assessment program to help agencies identify true gaps and make a focused follow up plan to decrease errors, and by extension the need for corrections, moving forward.

As your agency makes a plan for OASIS E, make sure you don’t assume that all of the “old” questions are error free from the point of data collection without the data to confirm that. Even if the responses are correct in the end, it if takes back and forth between reviewer and clinician, resources are being consumed that could be put to better use.