EmailMe Form - QA CALLS

What kind of QA call

New Shift calls (confirmation): 3 calls

Call #1 - Prelim Call - CG: to be made within 15-60 minutes of the call to the CG

Call #2 - Prelim Call to Client/ Client Rep right after CG prelim call

Call #3 - Final QA Call: to be done either towards the end or after the shift to Client/ Client Rep

Name of Client/ Patient *

Who are we contacting for QA Calls for this client?

REMEMBER THAT FOR MANY CLIENTS WE CANNOT CALL CLIENTS DUE TO COGNITIVE IMPAIRMENT. REFERENCE IADL section - 3. QA DEPARTMENT

Name of CG(s) being reviewed *

Date of New Shift you are calling about *

MM / DD / YYYY

B1. New Shift Form - Q #1. Was a new Shift form properly filled out for this shift?

Yes, I see it in that data bank list

No, was not done

No, was not done because CG doesnt have email

No, was not done but CG was prepped by the following manner [fill in]

Open the link to the left and see if that shift was prepped

Section I - Admin

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HISC Person doing Admin

Call #1: PRELIM CALL TO CG************************

Prelim Call - CG (on their cell phone): to be made within 45-90 minutes of the beginning of the shift.

(i) make sure everything is OK and to remind the CG about the important issues from the New shifts form and
(ii) make sure client is happy so far.

Feel them out to see if anything is wrong. Make sure they tell client they are on phone with you and you are just checking to see “if they need anything"

HISC Person doing Prelim Call #1

Chat in New Shift/ QA Channel chat

(*) Was this shift included in the list of calls to be made, which was posted today on the QA channel?

Call #1: PRELIM CALL TO CG was done

Within one hour of the shift starting

Within 5 hours of the shift starting

N/A - this was not a new shift call

Preliminary QA call was not done (state reason)

Call #1: Results

Everything was fine, and I reviewed a little important things from the POC

Everything was fine, no need to review anything

N/A - this was not a new shift call

There was an issue and this is what we did

Call #1: Comments made by CG (verbatim) and your comments given the tone

Call #2: PRELIM CALL TO CLIENT/CLIENT REP************************

Call to see if all is OK and if they “need anything”, but the call is to feel out their voice to see if something is truly wrong. Most will be annoyed with this call but in the end, this call (to “see if everything is OK” is very important

Be careful: if client has dementia and no client rep on site, this call cannot take place

HISC Person doing Prelim Call #2

Call #2: PRELIM CALL TO CLIENT/CLIENT REP was done

Within one hour of the shift starting

Within 5 hours of the shift starting

N/A - this was not a new shift call

N/A - client has dementia, call cannot be made

Preliminary QA call was not done (state reason)

Call #2: Results

Everything was fine, and I reviewed a little important things from the POC

Everything was fine, no need to review anything

N/A - this was not a new shift call

N/A - client has dementia, call cannot be made

There was an issue and this is what we did

Call #2: Comments made by Cient/Client Rep (verbatim) and your comments given the tone

Calls 1 and 2 for this shift were:

COPY AND PASTE

(*) Color =
(*) My Comments =

IMPORTANT

After completing your last preliminary call for the day, please complete columns S and T on NSF spreadsheet and post this in the QA Channel Chat:

I am done with today's preliminary calls. Results were entered in spreadsheet and forms were saved to resume later.

If PC1 or PC2 are red, please create a CC Task to HR with details

Press "save and resume later" at the bottom of this form.

Call #3: FORMAL QA CALL CLIENT/CLIENT REP************************

To be done after shift

See the rest of this form

HISC Person doing Final Call #3 *

Client's Comments

1. Personality fit?
2. CG's performance?
3. Do they want this CG back?
4. Any other comments?

Client's final opinion

ClearCare - Caregiver Preference section - Part 1

ClearCare - Caregiver Preference section - Part 2

Step 1. Update this entire section. Please

1. Review entire section
2. Add Favorites, remove those that are no longer Favorites
3. Add CGs to Do not send that should be there

Step 2. Chat with CMS - Copy and paste the following

(*) CG Preferences section in CC for [Name of Client] are 100% accurate

Chat in New Shift/ QA Channel chat

COPY AND PASTE (include all comments made by client on this call):

(*) Final QA Call to Client:
CG =
CL =

(*) Color was =
(*) Comments =

CG - Is there an opportunity for HR department to review something with this CG?

ClearCare - HR Notes on this caregiver (something HR department should know about what the client said about the CG)

Copy and paste this into the HR task which is related to the CL and CG

REGULAR QA QUESTIONS

If you could change anything about the service, what would that be?

Mention
- what the CGs do
- how the office communicates with them
- how the CGs interact with each other

Explain that this would REALLY help us

ACTIVITY TASKS TO BE CREATED BEFORE I SUBMIT THIS

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CC Tasks, not notes. Instead of doing a CC Note, for every QA report there will be

1 Task in CC assigned to HR
1 separate task to Bal and CMS for patient care related issues (if there are any)

This is 100% clear, at least 1 CC Task every time, and if patient care related issue, I will make 2 tasks

This is not clear, I will call CMS

CC Task #1 - HR CC Activity TASK must be done BEFORE you submit this report

Yes, a TASK with the instructions below was done BEFORE I submitted this report

Not done for the following reason

1. Open Activity section
2. Related to must have both CG and CL
3. Assign it to both Gabriela and Natasha
4. Tag must be either QA Call (New Shift) or QA Call (Regular)
5. Top of the Description must have the following:

GREEN, YELLOW or RED in first line with [Name of Client]

https://app.emailmeform.com/builder/forms/entries/1627226

then copy and paste this: Read the QA form filled out and please make sure

(i) CG is aware of any praises or criticims needed
(ii) Counsel as necessary
(iii) if something is not clear, call the client, CG or whomever
(iv) Update this ENTIRE CC task with how this was resolved BEFORE you turn to complete status
(v) Always add appropriate tag like COMPLAINT
(vi) If appropriate, go to HR Notes section in CC needs to be updated in Pros, Cons or Experience setions

DElete all these instructions from the CC Task so only the problem and the solution are here

CC Task #2 - Patient related CC Activity TASK must be done BEFORE you submit this report if there is something client related (for example, CG did something that affected the client like didnt take care of the client well, report something well etc)

Yes, a TASK with the instructions below was done BEFORE I submitted this report

No task done since nothing involved something Patient Care team needs to be made aware of

1. Open Activity section
2. Related to must have both CG and CL
3. Assign it to CMS and Bal
4. Tag must be QA Call
5. Top of the Description must have the following:

Patient care related issue [summarize]

Please click this link review the report

https://app.emailmeform.com/builder/forms/entries/1627226

Please go to Column W on the NSF spreadsheet and enter the color code for the final QA call (Green, Yellow, Red), with your initials.

Any HR suggestions email

Email

Section I - Admin

Call #1: PRELIM CALL TO CG************************

Call #2: PRELIM CALL TO CLIENT/CLIENT REP************************

Call #3: FORMAL QA CALL CLIENT/CLIENT REP************************

*************REGULAR QA QUESTIONS *************

ACTIVITY TASKS TO BE CREATED BEFORE I SUBMIT THIS

REGULAR QA QUESTIONS