OACCAC Education October 2013
Client Services Train the Trainer
Workbook OBP/OBR
Client Services Train the Trainer Workbook OBP/OBR
[ii]
Revision Table
Date Version Author Comments
October 1,
2013
1 Clare Corrado
OBP/OBR Crossword and
Word Search were
created by Stacey
Grammick
Client Services Train the Trainer Workbook OBP/OBR
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Table of Contents
1. Introduction ................................................................. 1
1.1 Learning Objectives for this workbook ...................................... 1
1.2 The Workbook ....................................................................... 1
2. CHRIS – OBP/OBR ......................................................... 2
2.1 CHRIS: Home Care Referral - Intake/Eligibility ......................... 2
3. Add a OBP Service ......................................................... 4
3.1 Exercise 1-Add OBS ............................................................... 4
3.2 Exercise 2- Add Offer ............................................................. 5
3.3 Section 3 Quiz ....................................................................... 7
4. Navigating to the Pathway Details „Action‟ Page ................. 7
4.1 Demo 1 - Navigating to the Pathway Details „Action‟ Page .......... 7
4.2 Demo 2 - Pathway Details „Action‟ Page .................................... 8
4.3 Section 4 Quiz ..................................................................... 10
5. OBP Details Page - CCAC Activities ................................. 10
5.1 Exercise 3 – Change the OBP Start Date ................................. 10
5.2 Exercise 4 – Change the Interval Review Date......................... 11
5.3 Exercise 5 – Submit CCAC Report -Additional Information ........ 13
5.4 Section 5 Quiz ..................................................................... 14
6. OBP Details Page - Responding to SPO events ................. 14
6.1 Demo 3 – SPO Interval Outcome – Request to Change to the
„Correct‟ Pathway ......................................................................... 16
6.2 Exercise 6 – Submit SPO Interval Outcome ............................. 16
6.3 Exercise 7 – Submit SPO Additional Information ...................... 20
6.4 Exercise 8 – Submit 2nd SPO Interval Outcome (Incomplete) .... 21
6.5 Activity Notifications/Requests .............................................. 24
Client Services Train the Trainer Workbook OBP/OBR
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6.5.1 Exercise 9– SPO & Patient Activity Notifications/Requests .................. 24
6.5.2 Exercise 10 – Re-Submit Interval Report and a CCAC Activity
Notifications/Requests ................................................................... 26
6.5.2.1 Exercise 11 – Review CCAC Activity Notifications/Requests ................ 27
6.5.2.1 Exercise 12 – Complete Activity Report for CCAC Activity
Notifications/Requests ...................................................................................... 28
6.6 Exercise 13 – Submit final SPO Outcome & Discontinue SPO
Report ........................................................................................ 29
6.7 Section 6 Quiz ..................................................................... 32
7. Adding a 2nd OBP .......................................................... 32
7.1 Adding a second Pathway ..................................................... 32
7.1.1 Demo 4 – CCAC Add New Pathway Request ..................................... 32
7.1.2 Demo 5 – SPO Add New Pathway Request ....................................... 33
8. Discontinue Pathways & Discharge Wizard ....................... 34
8.1 Demo 6 - Discontinue Pathways – Discharge Wizard ................ 34
9. Discontinue – Supervening Event .................................... 35
9.1 Demo 7 - Discontinue – Supervening Event ............................ 35
9.2 OBP/OBR Cross Word ........................................................... 36
9.3 OBP/OBR Word Search ......................................................... 37
10. Quiz Answers ............................................................... 38
10.1 Section 3 Quiz ..................................................................... 38
10.2 Section 4 Quiz ..................................................................... 38
10.3 Section 5 Quiz ..................................................................... 39
10.4 Section 6 Quiz ..................................................................... 39
10.5 OBP/OBR Cross Word Answers .............................................. 40
10.6 OBP/OBR Word Search Answers ............................................ 41
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1. INTRODUCTION
This workbook contains learning activities and review questions needed to support
your learning. Active learning (which refers to techniques where learners do more
than simply listen to a lecture or instruction) is a very important part of achieving
the learning objectives. You will have the opportunity to hear, see, discover,
explore, and apply the information that you are learning.
Your instructor will provide you with information through lecture, demonstration,
discussion, quizzing and guided practice.
1.1 Learning Objectives for this workbook
After this training session, the participants will be able to:
Understand how to add an OBS and OBP
Understand how OBR Eligibility is determined
Learn how to navigate to the Pathway Details Page
Learn about CCAC only Activities
Understand when you need to review various report types:
o Interval Outcomes (complete/incomplete)
o Variances and Risk Factors
o Activity Notifications and Requests
o Additional Information
o Discontinue SPO/Pathway
Understand where and when Tasks are generated
1.2 The Workbook
This workbook is composed of a series of scenario-based exercises designed to
provide you with the opportunity to systematically practice and apply the CHRSI OBP
OBR functionality as you learn it in the classroom.
Some sections provide Instructor demonstration only.
How will you use the workbook?
Your Instructor will guide you through the activities in the workbook using the client
you have added.
It is important that you follow the exercises as designed to ensure that you
experience CHRIS OBP/OBR as intended.
In each exercise, you will be provided with specific information to enter in a field
when that information impacts on exercises to follow. You will not be provided with
information to be entered in every field that must be completed on a page. In this
case, you can draw from your CCAC experience and enter information that you feel is
appropriate.
(Be sure not to enter any personal information)
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2. CHRIS – OBP/OBR
You may need to add a client and complete the Add Intake Page and Add
Eligibility page for a Home Care Referral.
2.1 CHRIS: Home Care Referral - Intake/Eligibility
Scenario:
You are a hospital Care Coordinator; you have completed your assessment and
determined that the client is eligible for the Home Care Referral.
1. Example of a Home Care - Add Intake Page for your client uses the following table
as a reference.
Intake Page - Field Name Information to be entered
Referral Type Home Care
Referral Date to CCAC Today‟s Date
Assessed Out of Region No
Referral Source Hospital
Referral Contact Name and Phone At your discretion
Presenting Problem Post op surgical care
Client Resides out of Region No
Consent Date Today‟s Date
Consent to Proceed with Assessment Verbal
Intake Team Select a Team
Intake Case Manager Select a name
Assessment Urgency Leave Blank
Primary Care Group Blank
Preferred Language for Service Blank
Specialty Program Blank
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Intake Page - Field Name Information to be entered
Client Population/Sub-
Population/Local Population
*Please leave blank
Treatment Location Blank
Assessing Team Selection Same as Intake Team/Case Manager
2. Select „Save and Add Eligibility‟ for Home Care. Use the following table to
complete the Add Eligibility page.
Eligibility Page – Field Name Information to be entered
*Assessing Team Select a team
*Assessing Case Manager Your name
*Assess Start and End Dates Today‟s date
*Assessment Tool RAI Contact Assessment
*Eligibility Outcome Eligible – Admit to Home Care
*Eligibility Determined Date Today‟s date
*Admit Date Today‟s date
*Payment Liability Other
Primary Care Group Blank
Preferred Language for Service Blank
Speciality Group Blank
Client Population/Sub-
Population/Local Population
*Please leave blank
*SRC 91 - Acute
*Team To a community team-your choice
*Caseload A caseload within the above team-your
choice
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Eligibility Page – Field Name Information to be entered
*Treatment Goal Healing of wound
Primary Diagnosis Add a new diagnosis i.e. Surgical wound
3. Select “Save”
3. ADD A OBP SERVICE
The Authorization and Offer processes for OBP remain essentially the same as for other
Services with a few additional fields.
3.1 Exercise 1-Add OBS
1. Observe the Instructor adding a OBS (Outcome Based Service)
2. Add an OBS Service by completing the Add Service Page. Enter information of your
choice in fields not identified below. However it is important that you enter the following
information as specified here:
Add Service Page - Field Name Information to be entered
Service Type Outcome-Based Wound
Service Delivery Type Outcome-Based Wound –sdt
Local Distinction Select if required for this client in your
CCAC
Treatment Location You must select a Treatment Location.
Geographic Area Select if required for this client in your
CCAC
Focus of Intervention Add if required
Service Plan Goals Add if required
Scenario:
You are a hospital CC and your patient has had surgery and requires wound care at
home. You have completed your assessment and determined that he/she would meet
the criteria for a Surgical wound Pathway and would meet the OBR criteria. The
hospital has informed you that the client will be discharged tomorrow
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Add Service Page - Field Name Information to be entered
Treatment Orders At your discretion
Provider Instructions At your discretion
Service Response Time At your discretion
Service Priority Rating At your discretion
Verbal Confirmation At your discretion
Initial Authorization Date Today‟s date
Date Service Required by At your discretion
Required First Visit Date At your discretion
CC Reassessment Date At your discretion
Service End Date At your discretion
Authorizing CC Your name
3. DO NOT Add Frequency
4. Once you have completed the Add Service Page, select “Save and Add Offer”
What happened when you selected „Save and Add Offer”
What CHRIS level are you in?
Complete the information required for OBP-OBR and navigate back to the
service level to complete the service offer.
3.2 Exercise 2- Add Offer
1. Observe the Instructor completing the Add Offer page and adding the OBP
2. Add an OBP by completing the Add Offer Page. Enter information of your
choice in fields not identified below. However it is important that you enter the
following information as specified here:
Add Offer Page - Field Name Information to be entered
Outcome-Based Pathway Surgical Wound (v1.0)
Pathway Start Date Tomorrow‟s Date
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Add Offer Page - Field Name Information to be entered
Provider Notification Notes At your discretion
Offering Team Select the team
Offer Contact Name Your Name
Service Response Time At your discretion
Service Priority Rating At your discretion
Verbal Confirmation At your discretion
Required Provider Selection Select if required
Offer Date Today‟s date
Date Service Required by At your discretion
Required First Visit Date At your discretion
CC Reassessment Date At your discretion
Outcome-Based Pathway Max. Interval
Date
CHRIS calculates this date based on the
OBP selected and the OBP start date
Provider End Date Enter the same date as above for the OBP
Max. Interval Date
Offer Authorizing CC Your name
3. Once you have completed the Add Offer page, select “Save and Send”
4. CHRIS determines if the patient has met all the 4 eligibility criteria for OBR
5. CHRIS displays the option for you as a Care Coordinator to determine if the
OBP will be OBR or FSS
To be eligible for OBR, ALL four of the following criteria must be met:
1. OBR pathway
2. 19 years of age or older
3. Short Stay Client Population assigned
4. No other active Services
If any one of the OBR eligibility criteria are not met then CHRIS automatically
set the OBP as FFS
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6. Select AGREE and this pathway is OBP-OBR
7. Go to the Notification tab at the Service Offer level to see if the offer was
successfully sent and in the Response tab, accept the offer for the provider.
3.3 Section 3 Quiz
1. True or False
There are three types of OBS (Outcome-Based Services): Orthopaedic, Palliative
and Wound
2. To be eligible for OBR, the following criteria must be met:
a. OBR pathway
b. 19 years of age or older
c. Short Stay Client Population assigned
d. No other active Services
e. All of the above
3. True or False
CHRIS determines if the client meets the OBR eligibility criteria, then YOU
determine if the OBP will be OBR or FFS.
4. NAVIGATING TO THE PATHWAY DETAILS „ACTION‟ PAGE
4.1 Demo 1 - Navigating to the Pathway Details „Action‟ Page
1. Observe the Instructor navigating in CHRIS
You can complete the following and/or add notes to figures provided:
HINT – look for the pathway name hyperlink
Tab/Page Describe the Area that has Hyperlink to go to the
Pathway Details „Action‟ Page
Referral Overview Page
Provider Level
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Navigating to the Pathway Details „Action‟ Page
Referral Level – Overview Page
Provider Level/Outcome-Based Pathway Level
4.2 Demo 2 - Pathway Details „Action‟ Page
The Pathway Details page provides a detailed view of the pathway and displays the
details, history, reimbursement status, Interval and outcome status, and submitted
pathway reports for the pathway that have been submitted by the CCAC and/or SPO.
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This Pathway Details Page:
Provides the ability for SPOs and CCACs to submit and view additional OBP
information such as Exceptions (variances and risk factors); Activity
Notifications/Requests; Supervening Events
Provides the ability for Client Services staff to submit CCAC only outcomes and
for SPOs to view those outcomes
Provides the ability for CCACs and SPOs to generate an outcome report that
displays OBP information for a client
Communicates information about patient‟s care in a timely manner, through the
CHRIS and HPG
Provides notification and tracking for follow-up during Pathway course of
treatment
1. Observe the Instructor navigating in CHRIS
In each section on the Pathway Details page, there are a number of actions
that you can complete and/or review.
The table below describes the sections and associated links and/or activities on
the Pathway Details page.
Section Links and/or Activities
1. Details a. Generate a Pathway Summary Report
b. Link to detail information about the
Pathway<Name>
c. Access the edit hyperlink to edit the Pathway
Start Date
2. History a. Review all events that have occurred during the
course of the OBP
3. Interval Outcomes a. View the list of Outcomes with their due dates
b. Access the Review <Date> hyperlink to change
the Interval Review Date
4. Interval Reports a. Review a pathway report
b. Generate a pathway report
c. Submit a CCAC Pathway Report
d. Submit a SPO Pathway Report
From the Pathway Details page, the SPO and CCAC Team can complete a number of
activities but ONLY the CCAC Team can complete the following activities:
A. Access the edit hyperlink to edit the Pathway Start Date
B. Access the Review <Date> hyperlink to change the Interval Review
Date
C. Submit a SPO Pathway Report (based on your business process)
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4.3 Section 4 Quiz
1. True or False
The Pathway Details page is called the „action‟ page as all communication and
action is generated from this page in both CHRIS and HPG
2. Only the CCAC Team can:
a. Change the OBP Start Date
b. Change the Interval Review Due Date
c. Submit a Pathway report for the SPO
d. All of the above
5. OBP DETAILS PAGE - CCAC ACTIVITIES
Only the CCAC Team can change the Pathway Start Date and the interval Review
Date of an interval outcome.
CCACs are able to submit pathway reports that include additional OBP information
such as Exceptions (variances and risk factors); Activity Notifications/Requests.
When the CCAC Team completes an „Additional Information‟ Report, these notes are
entered in the Client Level Notes Tab
5.1 Exercise 3 – Change the OBP Start Date
You can only edit the Pathway Start Date when the pathway is authorized and no
outcomes, requests, notifications, activities, responses or additional information have
been submitted for the pathway
When a new Start Date is set, CHRIS deletes all Intervals related to the Pathway
assignment and recreates new Intervals based upon the new Start Date in CHRIS and HPG/CHP.
To Change the Start Date
Check the current Review Dates for the outcomes, before changing the start Date
1. Observe the Instructor changing the OBP Start Date
2. In the Details section of the Pathway Details page, select the Edit hyperlink
CHRIS displays the pop-up page to edit an OBP Start Date.
Scenario:
The hospital has contacted you, to advise you that the patient is being discharged
today.
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3. Complete the fields
Field Label Description
*Start Date Change the start date to today‟s date
Additional Info Add any additional comments
*Authorizing CC Your name
4. Select SAVE
5. CHRIS asks you to confirm OBR eligibility, select „Agree‟
6. How has the Pathways Details Page changed?
Expand each section to see if there are any changes
Pathway Details
Sections
Questions? Select Yes/No
Details Has the Start Date
changed?
Yes/No
History Has a new event been
added?
Yes/No
Reimbursement Status Has a core payment
been made?
Yes/No
Interval Outcomes Have the Interval Due
and Review Dates
changed?
Yes/No
Interval Reports Is this area still Blank? Yes/No
5.2 Exercise 4 – Change the Interval Review Date
From the Interval Outcome section, you can change the Interval Review Date.
The New Review Date cannot be:
earlier than Interval Due Date
later than the Provider End Date
less than the Care Pathway Assignment Start Date
later than the Care Pathway Assignment End Date
later than the Care Pathway Assignment‟s Maximum Interval End Date
Scenario:
The SPO has asked the CCAC Team to extend the date of the 1st interval, to
accommodate changes to the Pathway Start Date.
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To change the interval review date
Review the current Review dates for the outcome interval
1. Observe the Instructor changing the Interval Review Date
2. In the Details section of the Pathway Details page, click on the Interval
Outcome section
CHRIS expands the section to display all the Outcomes required for this
pathway
3. Select the first outcome and click on the review <Date> hyperlink
CHRIS displays the pop-up page to edit an OBP start date.
4. Complete the fields
Field Description
Current Review Date The current interval review date (not editable)
*New Review Date Change the Review Date to the following day
*Authorizing CC Your name
5. Select SAVE
6. Expand each section of the Pathway Details „Action‟ Page to see if there are any
changes
Pathway Details
Sections
Questions? Select Yes/No
History Has a new event been
added?
Yes/No
Reimbursement Status Has a core payment
been made?
Yes/No
Interval Outcomes Has the Review Date
changed?
Yes/No
Interval Reports Is this area still Blank? Yes/No
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5.3 Exercise 5 – Submit CCAC Report -Additional Information
In the CCAC Submit Pathway Report page, the Check box „Additional Information‟
provides an opportunity for CCAC (and SPO) to provide additional notes about the
OBP course of treatment that cannot be captured elsewhere in the interval report
When a CCAC submits a CCAC report, the content of the „Additional Information‟ is
saved in the Pathway details page Interval Reports section and in the Client Level
Notes tab. Remember this is your client note.
To complete an Additional Information Report
1. Observe the Instructor adding the „Additional Information‟ report
2. In the Interval Report section of the Pathway Details page, select the „Submit
CCAC Report button
CHRIS expands the section to display the Submit Pathway Report page
3. Check the „Additional Information check box
CHRIS expands this section
4. Complete the fields
Field Description
Additional Information At your discretion i.e. “Receive a call today from the hospital that the patient is being discharged today”
*Reported By Your name
*Reported Date Today‟s date
5. Select the SUBMIT button
6. Expand each section of the Pathway Details page to see if there are any
changes
Pathway Details
Sections
Questions? Select Yes/No
History Has a new event been added? Yes/No
Reimbursement Status Has a core payment been
made?
Yes/No
Scenario:
You complete an Additional Information report to document the reason for changing
the pathway start date and changing the outcome interval review date.
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Pathway Details
Sections
Questions? Select Yes/No
Interval Outcomes Has an Outcome Interval
report been submitted?
Yes/No
Interval Reports Has a report been submitted?
If yes, review the columns:
Where does the hyperlink
take you?
What does the PDF display?
Who Submitted the Report?
What is the Status of the
Report?
What type of report was
submitted?
Yes/No
7. Go to the Client level Notes Tab:
a. Is the information displayed there?
b. What is the subject line for the pathway note?
5.4 Section 5 Quiz
1. True or False
You can only edit the start date when the pathway is authorized and when no
pathway reports have been submitted for the pathway
2. The New Review Date cannot be:
a. earlier than Interval Due Date
b. later than the Provider End Date
c. less than the Care Pathway Assignment Start Date
d. later than the Care Pathway Assignment End Date
e. later than the Care Pathway Assignment‟s Maximum Interval End Date
All of the above
3. True or False
When a SPO submits a Pathway report, any information added within the
„Additional Information‟ report is also saved in the Client Level Notes Tab.
6. OBP DETAILS PAGE - RESPONDING TO SPO EVENTS
Previously only outcome reporting was available on all pathways, now the OBP
Pathway Report form in both CHRIS and HPG are laid out in a similar fashion.
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A single pathway report may contain a combination of different types of OBP
reporting data such as outcomes, exceptions, activity notifications/requests,
additional information, discontinue provider, discontinue pathway or add new
pathway requests.
You can expand and collapse each section of the pathway report independently by
selecting the section check-box, and you can enter data for one or many of the
outcomes, risk factors, activities or requests available in the report.
There are two types of reports that may be submitted depending on the responsible
actor – an SPO report and a CCAC report.
You can submit CCAC pathway reports and SPO pathway reports on behalf of the
service provider.
NOTE: Your CCAC may have business processes in place regarding CCAC
team submitting SPO reports.
For the training purposes only, you are asked to submit reports on
behalf of the SPO in order for you to understand your role and
responsibilities with pathways.
The following exercises and demos describe:
Which SPO Pathway activities have „Review Not Required‟ and „Pending Review
When SGT are generated (SGTs are regenerated nightly until the task is
reviewed)
As you are completing Section 6, complete the following table:
Pathway Reports
Review type
Place a check mark in the appropriate column
CCAC
Activity
Response
Required
Yes/No Review Not Required
Pending Review
Incorrect Pathway
Outcomes (Status = Complete)
Outcomes (Status = Incomplete)
Variances and Risk Factors
Activity Notifications/Requests (CCAC)
Activity Notifications/Requests (SPO/Patient)
Additional Information submitted by CCAC
Additional Information submitted by SPO
Discontinue
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6.1 Demo 3 – SPO Interval Outcome – Request to Change to the
„Correct‟ Pathway
When the pathway is incorrect i.e. Diabetic Leg Ulcer vs. Venous Leg Ulcer:
In the Discontinue Report, the SPO selects;
o Discontinue Reason = “Pathway incorrect‟
o Requested Action= “Discontinue Pathway and add new Pathway”
a request is sent to the Care Coordinator to Agree or Disagree with the SPO‟s
request
When you transition to the correct pathway, this new pathway will have same Start
Date as previous pathway.
To Review Change to the Correct Pathway:
1. Observe the instructor demonstrating CCAC role when the SPO determines that
the pathway is incorrect
2. What is the status of the original and correct Pathway?
3. Is there a task generated for this activity?
4. Where does the CCAC respond to this request?
5. After authorizing the request to discontinue the original pathway and
authorizing the new correct pathway, what is the status of the original and
correct Pathway?
6.2 Exercise 6 – Submit SPO Interval Outcome
Each Pathway outcome is identified as belonging to a single “Responsible Partner”.
The Partner is the CCAC or SPO who is responsible for achieving the Interval
Outcomes and submitting the Interval Reports by the Interval Due Date
Interval Outcomes:
define Interval Goals
contain a collection of Service Outcome Types for each Pathway Event
defines the Outcomes that are reportable in a Pathway Report and must be met
to complete the related Interval
are assigned a Display Order that applies within the Interval to provide a
customizable reading order on Interval Reports
have a status of „Complete‟ or „Incomplete‟
Scenario:
The SPO has confirmed that the pathway is correct and completed and submitted the
outcomes for the 1st interval
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To Submit an SPO Interval Outcome
1. Observe the Instructor Submitting a SPO interval outcome report
2. In the Interval Report section of the Pathway Details page, select the „Submit
SPO Report” button
CHRIS expands the section to display the Submit Pathway Report page
3. Check the box for the first SPO interval report
CHRIS expands this section
4. Complete the fields
Outcomes Value Performed By Performed Date
Holistic patient &
wound assessment
completed
Yes Your name first name with Provider as your last name
Today‟s Date
Correct Outcome-
based pathway
confirmed
Yes Your name first
name with
Provider as your
last name
Today‟s Date
Wound therapy
Initiated
Yes Your name first name with Provider as your last name
Today‟s Date
Patient Discharge
Planning Initiated
for Patient
Independence and
Prevention
Yes Your name first name with Provider as your last name
Today‟s Date
Wound
Measurement
Value (LxWxD)
Your discretion
Your name first name with Provider as your last name
Today‟s Date
Note: You can enter a 0.5 value and if a wound is protruding like a blister or
protruding wound it can be captured as a negative „Depth‟. Negative
depth being -2
5. Select the SUBMIT button
6. Expand each section of the Pathway Details page to see if there are any
changes
Pathway Details
Sections
Questions? Answer the questions
History Has a new event been
added? Yes/No
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Pathway Details
Sections
Questions? Answer the questions
Reimbursement Status Has a core payment been made?
Yes/no
Interval Outcomes Has an Outcome Interval report been submitted?
Yes/No
Interval Reports Has a report been submitted?
Yes/No
What is the Status for the report?
Review Not Required/
Pending Review
What type of report was
submitted (check under the Content column)?
* If your CCAC has set ‘Completed’ Outcome Reports NOT to be reviewed by
CCACs, continue with this section
To Review Pathway Reports:
1. In the Pathway Details Page Interval Section, under the submitted Date column
select the hyperlink
CHRIS displays Review Pathway Report Page
Is there a „Review‟ Check Box available?
2. Select Cancel to return to the Pathway Details Page
Continue to Section
* If your CCAC has set ‘Completed’ Outcome reports to be reviewed by CCACs,
complete this section
To Review Pathway Reports:
3. Go to the Client Level Action button and select the „View Task‟ and select GO
a. Chris displays the task asking you to review the report
b. Select the Outcome Based Activity Summary hyperlink under the Task
Description column to return to the Pathway Details Page
4. In the Pathway Details Page Interval Section, under the submitted Date column
select the hyperlink
CHRIS displays Review Pathway Report Page
5. Add a check mark in the Review box
Once you check the Review box, CHRIS displays the SAVE button
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6. Select the Save button (you would also complete any other action required
based on your CCAC business processes)
7. You are returned to Pathway Details page and the report is marked as
“Reviewed Completed <Date Reviewed>”
8. Go to the Client Level Action button and select the „View Task‟ and select GO
a. Is the task still displayed?
Continue to Section
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6.3 Exercise 7 – Submit SPO Additional Information
Additional information (unlimited free text) can be submitted in an interval report by
either partner SPO or CCAC.
Summary notes contain additional information about the OBP course of treatment
that cannot be captured elsewhere in the interval report
Based on your CCAC business process for frequency reporting, this area can be used
to update frequencies for the OBP-FSS pathways
To complete an Additional Information Report
1. Observe the Instructor adding the „Additional Information‟ report
2. In the Interval Report section of the Pathway Details page, select the „Submit
SPO Report button
CHRIS expands the section to display the Submit Pathway Report page
3. Check the „Additional Information check box
CHRIS expands this section
4. Complete the fields
Field Description
Additional Information At your discretion i.e. “Client staying with daughter for a few days”
*Reported By Your name first name with Provider as your last
name
*Reported Date Today‟s date
5. Select the SUBMIT button
6. Expand each section of the Pathway Details page to see if there are any
changes
Pathway Details
Sections
Questions? Fill in the answers
Reimbursement Status Has a core payment been made?
Yes/No
Scenario:
The next Outcome Interval report is not due for another 2 weeks and the SPO is
submitting an „Additional Information‟ report to inform the CCAC that patient is going
to stay with her daughter for a few days and the daughter will contact the SPO if
there is any concern about the wound.
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Pathway Details
Sections
Questions? Fill in the answers
Interval Outcomes Has an Outcome Interval report been submitted?
Yes/No
Interval Reports Has a report been submitted?
Yes/No
What is the Status for the report?
Review Not Required/
Pending Review
What type of report was
submitted (check under the Content column)?
To Review an Additional Information Report:
1. Go to the Client Level Action button and select the „View Task‟ and select GO
a. Chris displays the task asking you to review the report
b. Select the Outcome Based Activity Summary hyperlink under the Task
Description column to return to the Pathway Details Page
2. In the Pathway Details Page - Interval Section, under the submitted Date
column select the hyperlink
CHRIS displays Review Pathway Report Page
3. Add a check mark in the Review box
Once you check the Review box, CHRIS displays the SAVE button
4. Select the Save button (you would also complete any other action required
based on your CCAC business processes)
5. You are returned to Pathway Details page and the report is marked as
“Reviewed Completed <Date Reviewed>”
6. Go to the Client Level Action button and select the „View Task‟ and select GO
a. Is the task still displayed?
6.4 Exercise 8 – Submit 2nd SPO Interval Outcome (Incomplete)
Surgical Wound Outcome-Based Pathway second interval outcome is due 21 to 28
days based on the pathway Start Date and there must be a 20 to 30% reduction in
the wound size.
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To submit the 2nd incomplete interval report:
1. In the Interval Report section of the Pathway Details page, select the „Submit
SPO Report button
CHRIS expands the section to display the Submit Pathway Report page
2. Check the box:
for the 2nd SPO interval report and enter the same measurements as
the 1st report
for “Additional Information” report and enter information at your
discretion
3. Select the SUBMIT button
4. What happens when you select the Submit button
When an incomplete outcome report is submit, a message is displayed:
“The submitted report contains unmet outcome(s). Please submit one or
more Variances and Risk Factors in the report.”
5. Check the box for the Variances and Risk Factors
CHRIS expands this section and displays three (3) types of Variances and risk
Factors (Clinical, System, Patient/Caregiver)
6. Add a check mark next to the “Pain” and “Nutrition” items under the Clinical
section
CHRIS expands the items
7. Complete the fields
Scenario:
The SPO submitted the outcomes for the 2nd interval (Incomplete outcome: In this
exercise, to submit an incomplete report, you are going to submit the wound same
measurements reported in the first outcome report)
Variances and Risk Factors are also known as Exceptions. These
variances are barriers or risk factors that are affecting or may affect patient
outcomes during the OBP course of treatment.
These variances/risk factors are customized according to the three
Outcome-Based Service (OBS) types (Wound, Ortho, and Palliative)
Variances and Risk Factors:
Are submitted in an interval report by a SPO or CCAC (each partner
is notified when a variance report is submitted)
May be submitted independent of outcomes
Must be submitted when outcomes are reported as unmet
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Outcomes Reported by Reported Date Additional
Information
Pain Your name first name with Provider as your last name
Today‟s Date “pain in surgical site”
Nutrition Your name first name with Provider as your last name
Today‟s Date “Poor eating habits”
8. Select the SUBMIT button
9. Review the Pathway Details page
10. In the Pathway Details Page - Interval Outcome Section: Check the 2nd report
and note if there are any additional information about the wound displayed.
11. Expand each section of the Pathway Details page to see if there are any
changes
Pathway Details
Sections
Questions? Fill in the answers
Reimbursement Status Has a core payment
been made? Yes/No
Interval Outcomes Has an Outcome Interval
report been submitted? Yes/No
Interval Reports Has a report been
submitted? Yes/No
What is the Status for the report?
Review Not Required/
Pending Review
What type of report was submitted (check under
the Content column)?
To Review Outcome and Variances and Risk Factors Reports:
12. Go to the Client Level Action button and select the „View Task‟ and select GO
a. Chris displays the task asking you to review the report
b. Select the Outcome Based Activity Summary hyperlink under the Task
Description column to return to the Pathway Details Page
13. In the Pathway Details Page - Interval Section, under the submitted Date
column select the hyperlink
CHRIS displays Review Pathway Report Page
14. Add a check mark in the Review box
Once you check the Review box, CHRIS displays the SAVE button
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15. Select the Save button (you would also complete any other action required
based on your CCAC business processes)
16. You are returned to Pathway Details page and the report is marked as
“Reviewed Completed <Date Reviewed>”
17. Go to the Client Level Action button and select the „View Task‟ and select GO
a. Is the task still displayed?
6.5 Activity Notifications/Requests
Activity Notifications/Requests are submitted in an interval report by the SPO or
CCAC on behalf of the SPO.
When the SPO or Client is arranging the activity, the CCAC is notified and a review is
not required.
When the SPO directs the CCAC to complete an activity, you will need to complete a
review and activity response.
Activity Definition CCAC Task
Activity
Notification
Activity notifications are
intended to notify the CCAC that
the SPO and/or Client is
arranging an activity such as an
inter-professional referral
Reviews are not required
Activity
Notifications
/Requests
Activity requests are intended to
direct the performance of an
activity by the CCAC
1. Review the Information
2. Complete the Activity
Response i.e. arrange a
community referral
6.5.1 Exercise 9– SPO & Patient Activity Notifications/Requests
To Submit an SPO/Patient Activity Notifications/Requests Report
1. Observe the Instructor Submitting a SPO Activity Notifications/Requests report
Scenario:
With the slow progress with wound healing, the SPO is submitting an Activity
Notifications/Request to notify the CCAC that the SPO is arranging to have the
patient see the Special Physician and the patient is arranging to see a nutritionist
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2. In the Interval Report section of the Pathway Details page, select the „Submit
SPO Report button
CHRIS expands the section to display the Submit Pathway Report page
3. Check the box for the Activity Notifications/Requests
CHRIS expands this section
4. Under the Select responsible partner, Inter-Professional Services section
„Special Physician‟, select the SPO radio button
5. Under the Select responsible partner, Inter-Professional Services section „Nut‟,
select the Client radio button
6. Complete the fields
Outcomes Referred By Referral Date Additional
Information
For both:
„Special Physician‟ and
„Nut‟
Your name first name with Provider as your last name
Today‟s Date At your discretion
7. Select the SUBMIT button
8. Expand each section of the Pathway Details page to see if there are any
changes
Pathway Details
Sections
Questions? Fill in the answers
History Has a new event been added?
Yes/No
Reimbursement Status Has a core payment been made?
Yes/No
Interval Outcomes Has an Outcome Interval report been submitted?
Yes/No
Interval Reports Has a report been
submitted? Yes/No
What is the Status for the report?
Review Not Required/
Pending Review
What type of report was submitted (check under the Content column)?
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To Review SPO/Patient Activity Notifications/Requests Report
9. In the Pathway Details Page - Interval Section, under the submitted Date
column select the hyperlink
CHRIS displays Review Pathway Report Page:
Is there a Review check box?
What is the status of the report?
6.5.2 Exercise 10 – Re-Submit Interval Report and a CCAC Activity
Notifications/Requests
To resubmit the 2nd Interval and a CCAC Activity Notifications/Requests
Report
1. Observe the Instructor resubmit the 2nd interval report and a CCAC Activity
Notifications/Requests report
2. In the Interval Report section of the Pathway Details page, select the „Submit
SPO Report button
CHRIS expands the section to display the Submit Pathway Report page
3. Check the box for the 2nd interval report and Activity Notifications/Requests
4. Complete the fields:
2nd Interval Report:
Outcomes Value Performed By Performed Date
Wound
Measurement
Value (LxWxD)
Numbers to
correspond to
50% healing
Your name first name with Provider as your last name
Today‟s Date
Activity Notifications/Requests
Under the Select responsible partner, Community section „Adult Day Program‟,
select the CCAC radio button
Outcomes Referred By Referral Date Additional
Information
Adult Day
Program
Your name first name with Provider as your last
Today‟s Date “pain in surgical site”
Scenario:
The SPO is re-submitting the 2nd interval (wound healed 50%) and a CCAC Activity
Notifications/Request to arrange for the patient to attend an Adult Day Program
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Outcomes Referred By Referral Date Additional
Information
name
5. Select the SUBMIT button
6. Expand each section of the Pathway Details page to see if there are any
changes
Pathway Details
Sections
Questions? Fill in the answers
History Has a new event been
added? Yes/No
Reimbursement Status Has a core payment
been made? Yes/No
Interval Outcomes Has an Outcome
Interval report been submitted?
Yes/No
Interval Reports Has a report been submitted?
Yes/No
What is the Status for the report?
Review Not Required/
Pending Review
What type of report was
submitted (check under
the Content column)?
7. To review and complete CCAC activities continue to the next two sections
6.5.2.1 Exercise 11 – Review CCAC Activity Notifications/Requests
To Review CCAC Activity Notifications/Requests Report:
1. Go to the Client Level Action button and select the „View Task‟ and select GO
a. Chris displays the task with 2 descriptions:
Activity Request has been received and requires a response -
reported date: 2013-09-18 Activity Type requested: 'Adult Day
Program' Owner: CCAC
Report has been received and requires review - 2013-09-18
Report contents: 'Activity Notifications/Requests'
b. Select the Outcome Based Activity Summary hyperlink under the Task
Description column to return to the Pathway Details Page
2. In the Pathway Details Page - Interval Section, under the submitted Date
column select the hyperlink
CHRIS displays Review Pathway Report Page
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3. Select Review check box
Once you check the Review box, CHRIS displays the SAVE button
4. Select the Save button (you would also complete any other action required
based on your CCAC business processes)
5. You are returned to Pathway Details page and the report is marked as
“Reviewed Completed <Date Reviewed>”
6. Go to the Client Level Action button and select the „View Task‟ and select GO
a. Is there a task displayed?
b. Return to the Pathway Details Page
6.5.2.1 Exercise 12 – Complete Activity Report for CCAC Activity
Notifications/Requests
To Complete an CCAC Activity Report
1. In the Pathway Details Page Interval Section, select the Submit CCAC Report
button and CHRIS displays Review Pathway Report page
2. Select Activity Response check box
CHRIS expands the “Activity Response” item
3. Complete the fields
Outcomes Action Reported
By
Reported
Date
Additional
Information
Activity
Response
Community
Services: Adult
Day Program
From the Action drop down select, „Completed’
Your Name Today‟s Date Add any appropriate information
4. Select the SUBMIT button
5. Expand each section of the Pathway Details page to see if there are any
changes
Pathway Details
Sections
Questions? Fill in the answers
History Has a new event been
added?
Yes/No
Reimbursement Status Has a core payment
been made?
Yes/No
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Pathway Details
Sections
Questions? Fill in the answers
Interval Outcomes Has an Outcome
Interval report been
submitted?
Yes/No
Interval Reports Has a report been
submitted?
Yes/No
What is the Status for
the report?
Review Not Required/
Pending Review
6. Go to the Client Level Action button and select the „View Task‟ and select GO
a. Is there a task displayed?
b. Return to the Pathway Details Page
6.6 Exercise 13 – Submit final SPO Outcome & Discontinue SPO
Report
When the SPO has submitted all the outcomes and reports then the SPO should
send a „Discontinue SPO” request to indicate that the SPO is no longer be
responsible for the patient care.
To Submit an SPO Interval Outcome and Discontinue Report
1. Observe the Instructor Submitting a SPO interval outcome report
2. In the Interval Report section of the Pathway Details page, select the „Submit
SPO Report” button
CHRIS expands the section to display the Submit Pathway Report page
3. Check the box for the:
Discontinue Report
Final SPO interval report
CHRIS expands these sections
4. Complete the fields for the reports:
A. Final SPO Report
Outcomes Value Performed By Performed Date
Scenario:
The SPO is submitting final interval outcome report and as the wound is healed
submitting “SPO Discontinue” report (there is no further role for the SPO).
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Outcomes Value Performed By Performed Date
Wound
Measurement
Value: 0 x 0 x 0 Your name first name with Provider as your last name
Today‟s Date
B. Discontinue Report
Field Information to be entered
Reason Treatment complete – goals met
Requested by Your name first name with Provider as your last name
Requested Date Today‟s Date
Additional Info Your discretion
Requested Action Discontinue SPO
5. Select the SUBMIT button
6. Expand each section of the Pathway Details page to see if there are any
changes
Pathway Details
Sections
Questions? Answer the questions
Detail Section What is the „Partner Status?‟
SPO-Active/ SPO-
Discontinued Requested
History Has a new event been added?
Yes/No
Reimbursement Status Has a core payment been made?
Yes/No
Interval Outcomes Are all the intervals
completed? Yes/No
What is the Status for
the report? Review Not Required/
Pending Review
To Review Pathway Reports:
7. Go to the Client Level Action button and select the „View Task‟ and select GO
a. Chris displays the task asking you to review the report
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b. Select the Outcome Based Activity Summary hyperlink under the Task
Description column to return to the Pathway Details Page
8. In the Pathway Details Page Interval Section, under the submitted Date column
select the hyperlink
CHRIS displays Review Pathway Report Page
9. Select Review check box
Once you check the Review box, CHRIS expands the page to include
Discontinue SPO fields
(You can change the radial button to „Disagree‟ and view the changes then
return the radial button to „Agree‟)
10. Complete the fields with the radial button at „Agree‟
Field Information to be entered
New Provider Status Date Today‟s Date
Authorizing CC Your name
11. Select the Save button (you would also complete any other action required
based on your CCAC business processes)
12. You are returned to Pathway Details page and the report is marked as
“Reviewed Completed <Date Reviewed>”
13. Expand each section of the Pathway Details page to see if there are any
changes
Pathway Details
Sections
Questions? Answer the questions
Detail Section What is the „Partner Status?‟
History Has a new event been added?
Reimbursement Status Has a core payment been made?
Interval Outcomes Are all the intervals reviewed/completed?
14. Go to the Client Level Action button and select the „View Task‟ and select GO
a. Is the task still displayed?
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6.7 Section 6 Quiz
1. True or False
SGTs are regenerated nightly until the task is reviewed
2. True or False
Variances and Risk Factors are barriers or risk factors that are affecting or may
affect patient outcomes during the OBP course of treatment.
3. When the SPO submits an Activity Notifications/Request reporting that
the SPO and/or the patient is arranging an activity such as an inter-
profession referral:
a. A task is generated to remind you to review the report
b. This is only a notification that the SPO and/or Patient are arranging an
activity
c. A task is not generated as you do not need to review the report
d. B and C
4. Core payments are sent from CHRIS to the SPO when PLOs were met,
which interval outcomes were PLOs:
a. Each interval outcome
b. First interval outcome
c. Second Interval outcome
d. Last final Interval outcome
e. A and B
7. ADDING A 2ND OBP
7.1 Adding a second Pathway
„Add New Pathway‟ request can to be used to add a second pathway to existing
service only
When a second pathway is added and authorized by the CCAC to an existing OBP-
OBR, the second pathway:
is OBP-FFS
has NO FFS visit payments released during the period the second pathway
overlaps with the OBR (until Day X)
Has FFS payment released on the start date of the warranty period
A second pathway may be requested by the CCAC or SPO
7.1.1 Demo 4 – CCAC Add New Pathway Request
1. Observe the Instructor
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2. From the Provider Level/Details Tab/Outcome-Based Pathways, select the „add
pathway button‟
3. Complete the fields
Field Information to be entered
*Pathway Select a pathway
*Start Date Today‟s date
Additional Info Your discretion
*Authorizing CC Your name
4. Select Save
5. Review the following:
a. From the Provider Level/Outcome-Based Pathways hyperlink, review the
Pathway status of each pathway
b. For each pathway, navigate to the Pathway Details page and review the
Details section
7.1.2 Demo 5 – SPO Add New Pathway Request
1. Observe the Instructor
To Review SPO Add New Pathway Request:
2. Go to the Client Level Action button and select the „View Task‟ and select GO
a. Chris displays the task asking you to review the report
b. Select the Outcome Based Activity Summary hyperlink under the Task
Description column to return to the Pathway Details Page
3. Which Pathway Details Page is displayed?
4. In the Pathway Details Page Interval Section, under the submitted Date column
select the hyperlink
Scenario:
You receive a fax from the patient‟s physician stating that there is a second wound.
Scenario:
The SPO has added a new pathway as there is a second wound that requires
treatment
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CHRIS displays Review Pathway Report Page
5. Select Review check box
Once you check the Review box, CHRIS expands the page to include Add New
Pathway fields
(You can change the radial button to „Disagree‟ and view the changes then
return the radial button to „Agree‟)
6. Complete the fields with the radial button at „Agree‟
Field Information to be entered
Start Date Today‟s Date
Additional info Your discretion
*Authorizing CC Your name
7. Select the Save button (you would also complete any other action required
based on your CCAC business processes)
8. You are returned to Pathway Details page and the report is marked as
“Reviewed Completed <Date Reviewed>”
9. Review the following:
a. From the Provider Level/Outcome-Based Pathways hyperlink, review the
Pathway status of each pathway
b. For each pathway, navigate to the Pathway Details page and review the
Details section
8. DISCONTINUE PATHWAYS & DISCHARGE WIZARD
8.1 Demo 6 - Discontinue Pathways – Discharge Wizard
1. Observe the Instructor
2. The first page of the Discharge Wizard displays:
a. Outcome-Based Pathways Outstanding Activity Requests
If there are any outstanding activity requests displayed, the Report
Date hyperlink navigates you to the Activity response page
b. Outcome-Based Pathway Interval Reports requiring Review
If there are any reports requiring review, the Submitted Date hyperlink
navigates the Review Pathway Report Page
c. Outcome-Based Pathways grid:
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If there are any active pathways, the Pathway<name> hyperlink
navigates you to the Discontinue Report page
9. DISCONTINUE – SUPERVENING EVENT
Supervening events are events which:
identifies conditions that determine that Patient is no longer eligible for the
pathway
occurs independently of (i.e. are not caused by) the pathway itself that affect
the quality of treatment
9.1 Demo 7 - Discontinue – Supervening Event
1. Observe the Instructor
The SPO discontinues the pathway as the client is moving to live with her
daughter in another city. The SPO has submitted a Discontinue Report
2. In the Pathway Details Page Interval Section, under the submitted Date column
select the hyperlink
CHRIS displays Review Pathway Report Page
3. Select Review check box
Once you check the Review box, CHRIS expands the page to include
Discontinue SPO fields
(You can change the radial button to „Disagree‟ and view the changes then
return the radial button to „Agree‟)
4. Complete the fields with the radial button at „Agree‟ and „Save‟
5. Review the Pathway Details Page:
Details section: Reimbursement type, disposition, etc.
Event section: What new events have been added?
Reimbursement: What has change?
Interval Outcome: What has changed?
Interval Report: Are there any pending reports?
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9.2 OBP/OBR Cross Word
DOWN ACROSS
2. _____ with patients and the health care
team is key to improving everyone‟s care
experience
3. _____ focus on achieving defined results
within a defined time period
4. _____ is an example of the type of category
of pathways available
5. What occurs for the providers when PLOs
are completed and goals met?
1. What is consistently measured?
6. What is shared with the health care
team?
7. What pathways are based on
9. What the health care team focuses on
10. What is required initially by the Care
Coordinator to determine which pathway
is most suitable?
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8. What is collaborative initiative between
CCACs and SPOs?
9.3 OBP/OBR Word Search
ACCOUNTABILITY
ASSESSMENT
CARE
COLLABORATION
CONSISTENCY
CONTRACTS
EREFERRAL
EVIDENCE
INNOVATION
JOURNEY
PATHWAYS
PILOTS
PUBLIC
QUALITY
REMIMBURSEMENT
SATISFACTION
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EVOLUTION
FLEXIBILITY
HIPS
SUCCESS
TEAM
WOUND
10. QUIZ ANSWERS
10.1 Section 3 Quiz
1. True or False
There are three types of OBS (Outcome-Based Services): Orthopaedic, Palliative
and Wound
True
2. To be eligible for OBR, the following criteria must be met:
f. OBR pathway
g. 19 years of age or older
h. Short Stay Client Population assigned
i. No other active Services
j. All of the above
All of the above
3. True or False
CHRIS determines if the client meets the OBR eligibility criteria, then if eligible
for OBR, YOU determine if the OBP will be OBR or FFS.
True
10.2 Section 4 Quiz
1. True or False
The Pathway Details page is called the „action‟ page as all communication and
action is generated from this page in both CHRIS and HPG
True
2. Only the CCAC can:
a. Change the OBP Start Date
b. Change the Interval Report Due Date
c. Submit a Pathway report for the SPO
d. All of the above
All of the above
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10.3 Section 5 Quiz
1. True or False
You can only edit the start date when the pathway is authorized and when no
pathway reports have been submitted for the pathway
True
2. The New Review Date cannot be:
a. earlier than Interval Due Date
b. later than the Provider End Date
c. less than the Care Pathway Assignment Start Date
d. later than the Care Pathway Assignment End Date
e. later than the Care Pathway Assignment‟s Maximum Interval End Date
f. All of the above
All of the above
3. True or False
When a SPO submits a Pathway report, any information added within the
„Additional Information‟ report is also saved in the Client Level Notes Tab.
False
10.4 Section 6 Quiz
1. True or False
SGTs are regenerated nightly until the task is reviewed
True
2. True or False
Variances and Risk Factors are barriers or risk factors that are affecting or may
affect patient outcomes during the OBP course of treatment.
True
3. When the SPO submits an Activity Notifications/Request reporting that
the SPO and/or the patient is arranging an activity such as an inter-
profession referral:
a. A task is generated to remind you to review the report
b. This is only a notification that the SPO and/or Patient are arranging an
activity
c. A task is not generated as you do not need to review the report
d. B and C
B and C
4. Core payments are sent from CHRIS to the SPO when PLOs were met,
which interval outcomes were PLOs:
a. Each interval outcome
b. First interval outcome
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c. Second Interval outcome
d. Last final Interval outcome
e. B and D
B and D
10.5 OBP/OBR Cross Word Answers
DOWN ACROSS
2. _____ with patients and the health care
team is key to improving everyone‟s care
experience
3. _____ focus on achieving defined results
within a defined time period
4. _____ is an example of the type of category
of pathways available
5. What occurs for the providers when PLOs
1. What is consistently measured?
6. What is shared with the health care
team?
7. What pathways are based on
9. What the health care team focuses on
10. What is required initially by the Care
Coordinator to determine which pathway
is most suitable?
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are completed and goals met?
8. What is collaborative initiative between
CCACs and SPOs?
10.6 OBP/OBR Word Search Answers
ACCOUNTABILITY
ASSESSMENT
CARE
COLLABORATION
CONSISTENCY
CONTRACTS
EREFERRAL
INNOVATION
JOURNEY
PATHWAYS
PILOTS
PUBLIC
QUALITY
REMIMBURSEMENT
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EVIDENCE
EVOLUTION
FLEXIBILITY
HIPS
SATISFACTION
SUCCESS
TEAM
WOUND