Homecare Guidance - 2019

JAWDA Quarterly Guidelines for (Home Healthcare Providers)
JAWDA Quarterly
Guidelines for (Home
Healthcare Providers)
January 2019
1
Table of Contents
Executive Summary ........................................................................................................................ 3
3. Patient Safety and Clinical Effectiveness ................................................................................ 5
4. Planning for data collection and submission........................................................................... 6
6. Glossary:..................................................................................................................................... 8
7. Facility Submission of Case-mix: ............................................................................................. 9
Home care performance indicators ........................................................................................... 10
2
Executive Summary
The Department of Health (DoH) is the regulatory body of the Healthcare Sector in
the Emirate of Abu Dhabi and ensures excellence in Healthcare for the community
by monitoring the health status of its population.
The Emirate of Abu Dhabi is experiencing a substantial growth in the number of

hospitals, centres, clinics and other healthcare providers. This is ranging from school
clinics and mobile units to internationally renowned specialist, and tertiary
academic centres. Although, access and quality of care has improved dramatically
over the last couple of decades mirroring the economic upturn and population
boom of the Abu Dhabi Emirate, however, challenges remain in addressing further
improvements.
The main challenges that are presented with increasingly dynamic population
include an aging population with increased expectation for treatment, utilization of
technology and diverse workforce leading to increased complexity of healthcare
provision in Abu Dhabi. All of this results in an increased and inherent risk to quality
and patient safety.
DoH has developed a dynamic and comprehensive quality framework in order to

bring about improvements across the health sector. This guidance relates to the
quality indicators that DOH is mandating for quarterly reporting by the operating
Home Healthcare Providers in the Emirates of Abu Dhabi.
The guidance sets out the full definition and method of calculation for patient safety
and clinical effectiveness indicators.
For enquiries about this guidance, please contact jawda@doh.gov.ae
This document is subject for review and therefore it is advisable to utilise online
versions available on the DOH website at all times.
Published: January 2019, Version 3
3
2. Introduction
2.1 The Department of Health – Abu Dhabi (DOH) is the regulatory body of the
Healthcare Sector in the Emirate of Abu Dhabi and ensures excellence in
healthcare for the community by monitoring the health status of the population.
DOH is mandated:
 To achieve the highest standards in health curative, preventative and

medical services and health insurance in the Emirate.
 To lay down the strategies, policies and plans, including future

projects and extensions for the health sector in the Emirate, and to
follow-up their implementation
 To apply the laws, rules, regulations and policies that are issued as
these are related to its purposes and responsibilities; in addition to
what is issued by the respective international and regional
organizations in line with the development of the health sector.
 To follow up and monitor the operation of the health sectors, to

achieve an exemplary standard in the provision of health, curative,
preventive and medicinal services and health insurance
2.2 DOH defines the strategy for the health system, monitors and analyses the
health status of the population and performance of the system. In addition, DOH
shapes the regulatory framework for the health system, inspects against
regulations, enforce standards, and encourages adoption of world – class best
practices and performance targets by all healthcare service providers in the
Emirate of Abu Dhabi.
2.3 DOH also drives programs to increase awareness and adoption of healthy
living standards among the residents of the Emirate of Abu Dhabi in addition to
regulating scope of services, premiums and reimbursement rates of the health
system in the Emirate of Abu Dhabi.
2.4 The health system of the Emirate of Abu Dhabi is comprehensive,

encompassing the full spectrum of health services and is accessible to all
residents of Abu Dhabi. The system is driven towards excellence through
continuous outcome, improvement culture, and monitoring achievement of
specified indicators. Providers of health services are independent,
predominately private and follow highest international quality standards. The
system is financed through mandatory health insurance.
4
In doing so DoH will:

 Drive structure, process and outcome improvements across health
sector
 Put people first and champion their rights
 Focus on quality and act swiftly to eliminate poor quality of care
 Work with stakeholders and apply fair processes.
 Gather information and utilize knowledge and expertise to improve
care.
 Link the care to payment in a way that results in a continuous
improvement and maximize the value of the care provided in Abu
Dhabi.
3. Patient Safety and Clinical Effectiveness

Patient safety is ‘the discipline in the health care sector that applies safety
science methods toward the goal of achieving a trustworthy system of health
care delivery’. Patient safety is also an attribute of health care systems; it
minimizes the incidence and impact of, and maximizes recovery from, adverse
events. Clinical effectiveness is “the application of the best knowledge, derived
from research, clinical experience and patient preferences to achieve optimum
processes and outcomes of care for patients. The process involves a framework
of informing, changing and monitoring practice” Clinical effectiveness is about
doing the right thing at the right time for the right patient and is concerned with
demonstrating improvements in quality and performance.
 The right thing (evidence-based practice requires that decisions about

health care are based on the best available, current, valid and reliable
evidence)
 In the right way (developing a workforce that is skilled and competent to
deliver the care required)
 At the right time (accessible services providing treatment when the
patient needs them)
 In the right place (location of treatment/services).
 With the right outcome (clinical effectiveness/maximising health gain)
Patient safety, clinical effectiveness and patient experience are recognized as
the main pillars of quality in healthcare. In Abu Dhabi, the measurement of
patient safety, clinical effectiveness and patient experience data is intended to
identify strengths and weaknesses of healthcare delivery, drive-quality
improvement, inform regulation and promote patient choice. In addition to data
on harm avoidance or success rates for treatments, providers will be assessed on
5
aspects of care such as dignity and respect, compassion and involvement in care
decisions through patient satisfaction surveys. The inclusion of patient safety,
clinical effectiveness and patient experience for quality performance is often
justified on grounds of its intrinsic value. For example, clear information,
empathic, two-way communication and respect for patients’ beliefs and
concerns could lead to patients being more informed and involved in decision-
making and create an environment where patients are more willing to disclose
information.
4. Planning for data collection and submission

In planning for data collection and submission, healthcare providers must adhere
to reporting, definition and calculation requirements as set out in Section 7
(Home Healthcare Indicator Definitions). Healthcare providers must also
consider the following:
 Nominate responsible data collection and quality leads(s).
 Ensure data collection leads are adequately skilled and resourced.
 Understand and identify what data is required, how it will be collected

(sources) and when it will be collected.
 Create a data collection plan.
 Ensure adequate data collection systems and tools are in place.
 Maintain accurate and reliable data collection methodology.
 Data collation, cleansing and analysis for reliability and accuracy.
 Back up and protect data integrity.
 Have in place a data checklist before submission.
 Submit data on time and ensure validity.
 Review and feedback data findings to the respective teams in order to

promote performance improvement.
 When needed, documentation and tracks will be provided instantly to

DOH or their representative to assure DoH that all due processes are
6
being followed in collecting, analyzing, validating and submitting the

performance
 Failing to submit valid data will be in breach of the licensing condition

and could result in fines being applied, penalties associated with
performance or revocation of license.
5. About this Guidance

This guidance sets out the Patient Safety and Clinical Effectiveness reporting
requirements so as to ensure High quality and safety of healthcare services
offered to patients in the Emirate of Abu Dhabi. The guidance sets out the
definitions, parameters and frequency by which JAWDA Quality indicators will be
measured and submitted to DOH and will ensure that healthcare providers
provide safe, effective and high quality services.
Q. Who is this guidance for?
All DOH Licensed Home Healthcare Providers in the Emirate of Abu Dhabi
Q. How do I follow this guidance?
Each hospital will nominate one member of staff to coordinate, collect, quality
control, monitor and report relevant data as per communicated dates. The
nominated healthcare facility lead must in the first instance e-mail their
contact details (if different from previous submission) to jawda@doh.gov.ae
and submit the required quarterly quality performance indicators through the
online portal.
Q. What are the Regulation related to this guidance?
 Legislation establishing the Health Sector

 DOH Standards for Homecare Health Services in Emirate of Abu Dhabi,
 As per Circular CEO 38/12 issued August 5th 2012 this guidance applies
to all DoH Licensed Home Healthcare Facilities in the Emirate of Abu
Dhabi in accordance with the requirements set out in this Standard
7
6. Glossary:
Target period: The span of time that defines the Jawda reporting period (e.g. a
calendar quarter).
Patient:
A person who is served by, or uses the services of a Department of Health (DOH)
licensed Healthcare Provider for the provision of healthcare services in the home.
Home Healthcare Service Provider:

A Healthcare facility or provider that is licensed by DOH to provide home healthcare
services.
Population:
Unless specified for the indicator, all patients (children, adults, using or not using
devices etc.) served by the home care facility are considered to be included for indicator
measurement.
Adult is defined as 18 years and older.
Applicability of the indicator:

The denominator criteria of an indicator determines the applicability of that indicator.
Certain indicators are applicable to a patient population subgroup or patients with a
particular health condition e.g. Percutaneous Endoscopic Gastrostomy (PEG) Tube
complication rate will apply to patients with a PEG tube.
Some indicators will be applicable to all patients served by the home care facility.
This implies that the denominator count can be different for different indicators.
Patient days: The total number of days during which the patient was served by the
home care facility. Any day/s during which the patient was not served by the home care
facility (e.g. days spent in any acute healthcare facility) would not count towards the
total patient days. The following rules are used when computing patient days:
 The counting stops with
(a) The last record in the target period if that record is a discharge assessment
(b) The last record in the target period if that record is an admission to a
healthcare facility (transfer to another healthcare facility).
(c) The last record in the target period if that record is a death or
(d) The end of the target period is reached, whichever is earlier.
 Include the day of entry but not the day of discharge or admission to a
healthcare facility unless the entry and discharge occurred on the same day in
which case the number of days in the stay is equal to 1.
 While death in facility records end patient day counting, these records are not
used as target records because they contain only tracking information and do
not include clinical information necessary for JAWDA indicator calculation.
8
7. Facility Submission of Case-mix:

The home care patient days are to be classified by the level of care as given in the “HAAD
Standard for Homecare Health Services in Emirate of Abu Dhabi Appendix 5”.
So each home care facility will be submitting the total number of patient days within each
service category for the target period (3 months for quarterly submission) as follows:
Acuity Level (Care Service Patient days for
Level) Code target period
Simple 17-26-1
Intermediate 17-26-2
Intensive 17-26-3
Complex 17-26-4
Self-pay XXXX
Total patient days in the target
period
The coding assignments for the period would be those that are approved by Daman.
*Some of the patients may have an assignment of more than one care level in the target period based on
improvement or worsening of the care level (or possibly conversion from self-pay to insured patient or
vice versa). Please consider the changes of service level during the reporting period e.g. if a patient was
care level 17-26-4 till the 10th of the month and then that patient’s care level changed to 17-14 on
11th; the patient days will be accordingly assigned.
9
Home care performance indicators

Type: Home Health Care Indicator Indicator Number: HC001
KPI Description
Rate of emergency attendance
(title)
Domain Effectiveness
Sub-Domain Emergency attendance
Rate of emergency department visits by the Home Health Care patients

Definition:
without being admitted to the hospital during the measurement quarter.
Population: All patients who are being cared for by the home care facility.
Numerator: Number of all unplanned visits to the Emergency Department

(ED) by home care patients within the measurement quarter. (Count the
attendance rather than the number of patients).
For definition of unplanned care and medical emergency, please refer to DOH
(HAAD) Standard for Emergency Departments.
Denominator: A count of the total number of patient days during the
Calculation: measurement quarter.
The day counts include visits and extended hours of care by licensed healthcare
staff.
Rate: Rate is calculated by the number of ED visits during the measurement

quarter, divided by the total number of patient days during the same period and
multiplying by 1000.
Calculation: [numerator / denominator] x 1000
Reporting Quarterly
Frequency:
Unit of Measure: Rate per 1000 Home Health Care patient days
International Developed locally by modifying similar indicators used by AHRQ, OECD and
comparison if CQC
available
Desired direction: Lower is better
Suggested data
sources and Patient medical records
guidance: Claims
10
Type Home care healthcare Indicator number HC002
KPI Description
Rate of unplanned hospital admission
(title)
Domain Effectiveness
Sub-Domain Hospital admission
Rate of emergency admissions in an inpatient setting of an

Definition: acute care hospital within the measurement quarter among
Home Health Care patients (following the start of home care).
Population: All patients who are being cared for by the home care facility.
Numerator: Number of all Home Health Care patients with

unplanned admissions to any acute care hospital during the
measurement quarter (Count the admission rather than the
patient).
For definition of unplanned care and medical emergency, please

refer to DOH (HAAD) Standard for Emergency Departments.
Calculation: Denominator: A count of the total number of home care patient
days during the measurement quarter.
The day counts include visits and extended hours of care by

licensed healthcare staff.
Rate: Rate is calculated by the number of unplanned admissions
during the measurement quarter divided by the total number of
patient days during the same period and multiplying by 1000.
Calculation: [numerator / denominator] x 1000.
Reporting
Quarterly
Frequency:
Unit of Measure: Rate per 1000 Home Health Care patients days.
International Developed locally by modifying similar indicators used by

comparison if AHRQ, OECD and CQC
available
Desired direction: Lower is better
Suggested data
sources and Patient medical records
Claims
guidance:
11
Type: Home Health Care Indicator Number: HC003
KPI Description
Rate of Deep Vein Thrombosis
(title)
Domain Patient Safety
Sub-Domain Complication
Rate of Deep vein thrombosis (primary or secondary diagnosis)

Definition: for Home Health Care patients aged 18 years and above within the
measurement quarter.
Population All adult patients who are being cared for by the home care
facility.
Numerator: Number of home care patients aged 18 years of age

or older with a primary or secondary new ICD-10-CM Diagnosis
Codes for Deep Vein Thrombosis within the measurement quarter.
Codes:
Primary or secondary ICD-10-CM Diagnosis Codes for Deep Vein

Thrombosis as follows:
I82.401, I82.402, I82.403, I82.409, I82.411, I82.412, I82.413, I82.419,
I82.421, I82.422, I82.423, I82.429, I82.431, I82.432, 82.433, I82.439,
I82.441, I82.442, I82.443, I82.449, I82.491, I82.492, I82.493, I82.499,
I82.4Y1, I82.4Y2, I82.4Y3, I82.4Y9, I82.4Z1, I82.4Z2, I82.4Z3, I82.4Z9,
I82.601, I82.602, I82.603, I82.609, I82.621, I82.622, I82.623,I82.629,
Calculation: T82.897A, T82.897D, T82.897S, T81.72XA, T81.72XD, T81.72XS,
T80.1XXA,T80.1XXD, T80.1XXS, I80.00,
I80.01,I80.02,I80.03,I80.10,I80.11,I80.12, I80.13, I80.201, I80.202,
I80.203, I80.209,I80.211, I80.212, I80.213, I80.219, I80.221,I80.222,
I80.223, I80.229, I80.231,I80.232, I80.233, I80.239, I80.291,
I80.292,I80.293, I80.299, I80.3,I80.8, I80.9
Denominator: A count of the total number of adult patient days

during the measurement quarter.
The day counts include visits and extended hours of care by

licensed healthcare staff.
12
Exclusion: Patients who have had their diagnosis of an inherited or

acquired hypercoagulable condition reviewed and confirmed at the
time of start of the home care services and every 6 months
thereafter by a haematologist.
Rate: Rate is calculated by the number of newly diagnosed adult

patients with deep vein thrombosis during the measurement quarter
divided by the total number of adult patient days during the same
period and multiplying by 1000.
Reporting
Quarterly
Frequency:
Unit of Measure: Rate per 1000 home care (adult) patient days
Mainly using source of AHRQ QI™ Version 4.5, Patient Safety

International Indicators #12, Deep Vein Thrombosis Rate
comparison if
available Also using OECD, CQC of UK with modification following
discussion with local experts and considering local culture.
Desired
Lower is better
direction:
Data sources and Patient records with specific ICD 10 diagnosis and procedure
guidance: codes
Claims
13
KPI
Rate of newly acquired or worsening pressure injury (Stage II and
Description
above)
(title)
Sub-Domain Adverse Events (AE) and Sentinel events
Rate of newly acquired or worsening pressure injury (Stage II and

Definition:
above) among home care patients.
Population All patients who are being cared for by the home care facility.
Numerator: Number of home care patients with newly acquired

pressure injury or with worsening pressure injury Stage II, III, IV,
Unstageable or Deep Tissue Injury (DTI) within the measurement
quarter.
Home care facility associated or worsening pressure Injury (Stage II and

above) ICD- 1O CM Codes:
L89.000,L89.002,L89.003,L89.004,
L89.010,L89.012,L89.013,L89.014,L89.020,
L89.022,L89.023,L89.024,L89.100,L89.102,
L89.103,L89.104,L89.110,L89.112,L89.113,
L89.114,L89.120,L89.122,L89.123,L89.124,
Calculation: L89.130,L89.132,L89.133,L89.134,L89.140,
L89.142,L89.143,L89.144,L89.150,L89.152,
L89.153,L89.154,L89.200,L89.202,L89.203,
L89.204,L89.210,L89.212,L89.213,L89.214,
L89.220,L89.222,L89.223,L89.224,L89.300,
L89.302,L89.303,L89.304,L89.310,L89.312,
L89.313,L89.314,L89.320,L89.322,L89.323,
L89.324,L89.42,L89.43,L89.44,L89.45,L89.500,
L89.502,L89.503,L89.504,L89.510,L89.512,
L89.513,L89.514,L89.520,L89.522,L89.523,
L89.524,L89.600,L89.602,L89.603,L89.604,L89.610,L89.612,
L89.613,L89.614,L89.620,L89.622,L89.623,L89.624,L89.810,
L89.812,L89.813,L89.814,L89.890,L89.892,L89.893,
L89.894,L89.92,L89.93,L89.94,L89.95
14
Guide on stage is defined below;
Category/Stage II: Partial thickness
Partial thickness loss of dermis presenting as a shallow open ulcer with

a red pink wound bed, without slough. May also present as an intact or
open/ruptured serum-filled or serosanguinous filled blister. Presents as
a shiny or dry shallow ulcer without slough or bruising*. This
Category/Stage should not be used to describe skin tears, tape burns,
incontinence associated with dermatitis, maceration or excoriation.
*Bruising indicates deep tissue injury.
Category/Stage III: Full thickness skin loss
Full thickness skin loss. Subcutaneous fat may be visible but bone,
tendon or muscle is not exposed. Slough may be present but does not
obscure the depth of tissue loss. May include undermining and
tunneling. The depth of a Category/Stage III pressure ulcer varies by
anatomical location. The bridge of the nose, ear, occiput and malleolus
do not have (adipose) subcutaneous tissue and Category/Stage III Injury
can be shallow. In contrast, areas of significant adiposity can develop
extremely deep Category/Stage III pressure Injury. Bone/tendon is not
visible or directly palpable.
Category/Stage IV: Full thickness tissue loss
Full thickness tissue loss with exposed bone, tendon or muscle. Slough
or eschar may be present. Often included undermining and tunneling.
The depth of a Category/Stage IV pressure ulcer varies by anatomical
location. The bridge of the nose, ear, occiput and malleolus do not have
(adipose) subcutaneous tissue and these injuries can be shallow.
Category/Stage IV Injury can extend into muscle and/or supporting
structures (e.g., fascia, tendon or joint capsule) making osteomyelitis or
osteitis likely to occur. Exposed bone/muscle is visible or directly
palpable.
Exclusions:
 Patients with pressure injury present at the start of home care

services that stayed the same stage or improved following the
start of home care.
 Home care associated pressure injury Stage I
(ICD- 10 CM Codes: L89.001, L89.011,L89.021,L89.101,L89.111,
L89.121,L89.131,L89.141,L89.151,
L89.201,L89.211,L89.221,L89.301,L89.311,L89.321,
15
L89.41, L89.501,L89.511,L89.521,L89.601,L89.611,
L89.621,L89.811,L89.891,L89.91.
Denominator: A count of the total number of home care patient days

during the measurement quarter.
The day counts include visits and extended hours of care by licensed
healthcare staff.
Rate: Rate is calculated by the number of home care patients with newly
acquired or worsening pressure injury (Stage II and above) during the
measurement quarter divided by the total number of home care patient
days during the same period and multiplying by 1000.
Reporting
Quarterly
Frequency:
Unit of
Rate per 1000 home care patient days
Measure:
International CQC of UK with modification following discussion with local experts

comparison if https://www.npuap.org/wp-content/uploads/2014/08/Quick-
available Reference-Guide-DIGITAL-NPUAP-EPUAP-PPPIA-Jan2016.pdf
Desired
Lower is better
direction:
Manual Data Collection

Data sources Patient medical record or EMR (Medical Chart Review): Skin and Wound
and guidance: Assessment Chart
Internal adverse event system
16
KPI Rate of falls resulting in any injury per 1000 patient days
Description
(title):

Sub-Domain Adverse Events (AE) and Sentinel Events
Definition Falls resulting in any injury per 1000 home care patient days.
Population All patients who are being cared for by the home care facility.
Calculation Numerator:
Total number of patient falls resulting in injury (minor, moderate, major, or
death) to the home care patient in the measurement quarter.
Inclusions: Patient falls with injury: minor, moderate, major, or death.
A fall is an unplanned descent to the floor. Include falls when a patient lands on
a surface where you wouldn't expect to find a patient.
All unassisted and assisted falls are to be included whether they result from
physiological reasons (fainting) or environmental reasons (slippery floor). Also
report patients that roll off a low bed onto a mat as a fall.
The National Database of Nursing Quality Indicators NDNQI definitions for

injury follow:
•None—patient had no injuries (no signs or symptoms) resulting from the

fall, if an x-ray, CT scan or other post fall evaluation results in a finding of no
injury.
•"Minor—resulted in application of a dressing, ice, cleaning of a wound,

limb elevation, topical medication, bruise or abrasion.
•Moderate—resulted in suturing, application of steri-strips/skin glue,

splinting or muscle/joint strain.
•Major—resulted in surgery, casting, traction, required consultation for

neurological (basilar skull fracture, small subdural hematoma) or internal
injury (rib fracture, small liver laceration) or patients with coagulopathy
who receive blood products as a result of the fall.
17
•Death—the patient died as a result of injuries sustained from the fall (not
from physiologic events causing the fall)."
Exclusions:
 Patient falls, but no harm was evident.

 For home care visits, a fall occurring outside the visiting time will be
excluded.
Denominator:
A count of the total number of all home care patient days during the
measurement quarter.
The day counts include visits and extended hours of care by licensed healthcare
staff.
Rate: Calculation: [numerator / denominator] x 1000
Reporting Quarterly
Frequency
Unit Measure Rate per 1000 home care patient days
International https://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit/fallpxtk5
comparison if .html
available
Desired Lower
Direction
Data Source Patient medical records
Incident reports
18
KPI Percutaneous Endoscopic Gastrostomy (PEG) Tube Complication

Description Rate
(title):
Sub-Domain Complication
Rate of complications of Percutaneous Endoscopic Gastrostomy (PEG)
Definition tube among Home Health Care patients.
All patients with a percutaneous endoscopic gastrostomy tube who
Population
are being cared for by a home health care facility.
Numerator:
Number of reported Percutaneous Endoscopic Gastrostomy (PEG)
tube complications during the measurement quarter (count the
incidents rather than the patient).
Secondary or primary ICD-10-CM Diagnosis Codes for Percutaneous
Endoscopic Gastrostomy (PEG) Tube Complication as follows:
K94.20, K94.21, K94.22, K94.23, K94.29

Calculation
Denominator:
PEG tube days: Number of patients with a PEG tube collected daily for
all patients cared by the facility. These daily counts are summed and
only the total days for the measurement quarter are entered.
The day counts include visits and extended hours of care by licensed
healthcare staff.
Rate: Numerator/Denominator * 1000
Reporting Quarterly
Frequency
Unit Measure Rate per 1000 PEG tube days
International
https://www.giejournal.org/article/S0016-5107(14)02050-1/pdf
Comparisons
Desired Lower
Direction
Data sources
Patient medical records
Claims
19

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JAWDA Quarterly Guidelines for (Home Healthcare Providers)

The Emirate of Abu Dhabi is experiencing a substantial growth in the number of

DoH has developed a dynamic and comprehensive quality framework in order to

For enquiries about this guidance, please contact jawda@doh.gov.ae

Published: January 2019, Version 3

 To achieve the highest standards in health curative, preventative and

 To lay down the strategies, policies and plans, including future

 To follow up and monitor the operation of the health sectors, to

2.4 The health system of the Emirate of Abu Dhabi is comprehensive,

In doing so DoH will:

3. Patient Safety and Clinical Effectiveness

 The right thing (evidence-based practice requires that decisions about

4. Planning for data collection and submission

 Nominate responsible data collection and quality leads(s).

 Ensure data collection leads are adequately skilled and resourced.

 Understand and identify what data is required, how it will be collected

 Create a data collection plan.

 Ensure adequate data collection systems and tools are in place.

 Maintain accurate and reliable data collection methodology.

 Data collation, cleansing and analysis for reliability and accuracy.

 Back up and protect data integrity.

 Have in place a data checklist before submission.

 Submit data on time and ensure validity.

 Review and feedback data findings to the respective teams in order to

 When needed, documentation and tracks will be provided instantly to

being followed in collecting, analyzing, validating and submitting the

 Failing to submit valid data will be in breach of the licensing condition

5. About this Guidance

Q. Who is this guidance for?

Q. How do I follow this guidance?

Q. What are the Regulation related to this guidance?

 Legislation establishing the Health Sector

Home Healthcare Service Provider:

Applicability of the indicator:

7. Facility Submission of Case-mix:

Home care performance indicators

Sub-Domain Emergency attendance

Rate of emergency department visits by the Home Health Care patients

Numerator: Number of all unplanned visits to the Emergency Department

Rate: Rate is calculated by the number of ED visits during the measurement

Type Home care healthcare Indicator number HC002

Sub-Domain Hospital admission

Rate of emergency admissions in an inpatient setting of an

Numerator: Number of all Home Health Care patients with

For definition of unplanned care and medical emergency, please

The day counts include visits and extended hours of care by

International Developed locally by modifying similar indicators used by

Type: Home Health Care Indicator Number: HC003

Domain Patient Safety

Rate of Deep vein thrombosis (primary or secondary diagnosis)

Numerator: Number of home care patients aged 18 years of age

Primary or secondary ICD-10-CM Diagnosis Codes for Deep Vein

Denominator: A count of the total number of adult patient days

The day counts include visits and extended hours of care by

Exclusion: Patients who have had their diagnosis of an inherited or

Rate: Rate is calculated by the number of newly diagnosed adult

Mainly using source of AHRQ QI™ Version 4.5, Patient Safety

Type: Home Health Care Indicator Number: HC004

Domain Patient Safety