HQAA Blog

Think about this: In many/most cases, a patient’s first experience with -- and impression of -- your organization happens when they are set up on equipment and admitted to service.  Thus, when your organization delivers equipment or supplies for the first time, or when your respiratory therapist sets up your respiratory device, or when a pedorthist “fits” someone for diabetic shoes, they are forming an impression that will be with them for a long time.  It’s certainly possible they will talk to their friends and family about that experience. 

A few years back, at 5:00am Saturday during the coldest February Northern Minnesota had seen in decades, a longtime home care patient’s oxygen concentrator failed.  The patient’s wife retrieved an E cylinder that was for back up from the guest bedroom and proceeded to try to open the gauge.  Her husband—the patient—tried as well but neither could get the tank to open.  The couple was a little panicky because the patient had been using oxygen continuously for over a year with only a few moments here and there off oxygen.  Regular delivery for portable cylinders was Monday, and they were down to two small portable cylinders with a total of about one hour of oxygen combined. 

Memorial Day Weekend, the end of the kid’s school year, or the first day of June all mark the beginning of summer for most of us.  Sure, scientists will tell you that summer begins with Summer Solstice, around June 21^st, the day the Sun is the farthest north; but we all start our summer season based on man-made demarcations and arbitrary dates and times.  For many of us, summer means swimming pools, picnics, a long break from school, and of course, summer vacations. 

Last month, we looked at fire safety in the DME industry.  Safe oxygen storage and fire prevention/safety were mentioned, but not in the detail a subject so important deserves and requires.  Handling, providing, storing, processing, and manufacturing oxygen comes with its own unique set of potential hazards and therefore its own set of guidelines and safety measures.  

I’ve known two DME owners whose businesses were destroyed by fire.   In one case, a consulting customer of mine owned a DME in a Upstate New York strip plaza.  Two doors down was a laundromat and fire broke out and actually traveled through the walls.  The structure remained standing, but their inventory and the entire interior of their storefront were destroyed by smoke and water, despite the best efforts of the fire department.  The second case was a business in the south, located in a rented warehouse in a rather remote location.  The fire was arson, and investigators eventually prosecuted the building’s owner for arson and insurance fraud.  In both cases, the businesses had adequate insurance, and the owners rebuilt.  However, in both cases, the owners bemoaned their losses, suffered terrible inconvenience, and recounted stories of the irreparable harm the fires did to their operations. 

Ask any business owner in just about any industry—DME included—what makes their company successful, and invariably, most answer that PEOPLE are the key to their success.  No business plan, idea, or philosophy is complete without human resources, both internal (employees) and external (consultants, service providers, advisors, etc.).  The people you need internally include most of the departments on your organizational chart.  But what about the external people that help your business operate efficiently, legally, and with purpose? 

I remember filling out paperwork for the first formal job I ever had – a dishwasher and busboy for a restaurant.  Some family friends owned the restaurant, so the paperwork was a formality.  I remember that it included an application and some kind of a note from my parents since I was under 16 years of age.  I didn’t have a driver’s license or a passport, so it’s anybody’s guess what I used for identification or if they even asked for it.  I also remember that the simple paperwork seemed intrusive and complicated. 

New Year’s Day --with its resolutions, new beginnings, and fresh start attitude-- is a perfect time of year to reflect on continuous improvement and making ourselves better as not only individuals, but as companies set up to serve the public and our customers.  It is also a good time to review ways to improve our bottom line, our operational efficiencies, our general attitude, and our business practices.  This sometimes requires revisiting mistakes from our past, things we did wrong, and looking at how we’ve improved them.  Deficiencies from our past surveys are certainly a worthwhile thing to look at it in an effort to improve.

The holiday season is a time for merriment, good food and drink, decorating home and workplace, holiday parties, gift-giving, and cheer. It’s also a time for giving. When I visit home medical equipment companies in November and December--whether for consulting purposes or accreditation surveys—I sometimes ask about the holidays and what an organization does to celebrate the holiday season. The replies offer insight into the corporate culture and speak to the character of the companies.

I notice with great interest and growing optimism about the future of our industry that the trend seems to be increasingly about giving, sharing, and community service and moving away from the stereotypical office party of days past (think Mad Men).

I’ve heard a wide variety of customs and practices including gift exchanges, taking turns working at Salvation Army kettle drive locations, pot lucks that include inviting the patient/customers, volunteering at a soup kitchen, or simply getting together outside of work for a nice dinner together. These parties and other shared experiences serve several useful purposes. They promote a culture of togetherness and “family”—a sense that the organization you work for is more than a job, it’s a group of people working together for a common goal. They also give team members an opportunity to get to know their co-workers better by sharing a meal or a conversation at a deeper level than possible during work hours. The holiday service projects give employees a chance to work on shared projects which promotes team building. Hopefully, they are also a fun way to spend time together with co-workers to build deeper and friendlier relationships.

One of my consulting customers specializes in mobility: basic wheelchairs all the way up to custom rehabilitation equipment. They also do home modifications such as chair glide systems and building accessible ramps. They are a quality company that was accredited long before it was a requirement because they wanted the community to know their commitment to doing things right. They told me a story about their Christmas “project” last year. The Christmas project was something they elected to do in lieu of a party. The company gave them time off to do it and supported the project financially. Every employee from top to bottom, including the owners, had skin in the game and participated.

It seems that a family in their small town needed medical equipment. The driver delivered the equipment and supplies and identified several hazards around the house as he assessed their environment. He documented his findings and discussed them with the family, who said they could not afford to make many of the changes that were suggested. On a return visit, he noted that they had made some of the changes that were not particularly costly including removing area rugs and moving furniture around so that the family members with mobility problems could navigate the household.

Three generations were living in the house: a couple along with several children, and also a grandchild. The couple both had serious medical problems that made mobility challenging. They needed a ramp to get in and out of the house, and would also benefit from scooters. The husband had COPD and heart problems, which limited his ability to get out and walk; and his wife was a diabetic and an amputee, who got around in the house okay, but could not go out without a wheelchair (or scooter).

The driver mentioned the family again at an organization-wide meeting and discussion ensued. Eventually, the company decided to help the family by building an accessible ramp on their front porch/entrance to the house. They discussed plans with their home modification department and of course, the family. They got consent from the family and an estimate of material costs. The owner donated the material with the stipulation that staff would pitch in and “donate” their labor. The team effort kicked in and the ramp was built in a few days in October 2017.

In the course of working at their house, the owner was talking to the family about accessibility and decided to also make a few minor modifications in their bathroom for enhanced safety. These included grab bars in several places. The owner recounted how “making these small, seemingly insignificant improvements was easy for us—it’s what we do”. He also noted that these improvements were no big deal for his staff, but meant the world to the family.

When the project was finished, the team was so inspired by the good feeling they got and the appreciation the family exhibited that they decided to work together to get the couple scooters. The warehouse manager reminded the team that they had a “trade in” scooter in the obsolete area that could be fixed up easily. The owner bought parts, authorized repair/refurbishing, and considered getting another scooter for the couple. When he called his vendor/sales rep to ask for pricing and explained what they were wanting to do, the rep actually donated a scooter from his demo inventory!

The day before Thanksgiving, 2017, DME staff stopped back at the home to deliver two shiny scooters to a family in need. Along with the scooters, they brought a 20 lb. turkey and several pumpkin pies from a local bakery.

In the DME storefront, hanging on a wall above their license, a copy of the Supplier Standards, and a picture of the store on the day it opened hangs a Christmas card with a beautiful note from the family and a picture of the couple with their children and grandchild visiting a huge outdoor Christmas light display. The card reads, “Made possible by the generosity of a company made up of some of the most caring people we are blessed to have in our lives." 

Incorporate and emphasize giving in your holiday traditions, and you’ll be richly rewarded with a great feeling of satisfaction that is better than any gift exchange or party. And keep your eye on the ball: despite the tough reimbursement climate and the many challenges that face our industry today, most of us got into this line of business and work because it was a caring profession. Keep caring no matter what!

HAPPY HOLIDAYS everybody.

Many in the home medical equipment industry equate policy manuals to their accreditation inspections. And of course, these bulky tomes are certainly a large part of the accreditation and survey experience for every DME. Policy manuals serve as the road map for how work gets done within an organization, a set of rules for the organization, and the document that defines the structure, function, and philosophy of the organization. Let’s look at what a policy manual should contain and how it impacts not only accreditation, but also the overall day-to-day operation of an organization.