PEOPLE ARE individuals, so it shouldn't be surprising to any provider that home health patients have individualized needs as well. What works for one 40-year-old male patient might not work for another 40-year-old male patient.

Figuring out just what each oxygen patient needs has been a challenge for Nancy Mendoza, RRT, and her respiratory therapists at Honolulu-based Respiratory Homecare Specialists, a full-service respiratory provider started by Mendoza in 1984.

"For several years, we had been trying to figure out an objective way to rank our patients so that we would know whom to see and when," Mendoza says. "We started this business by visiting everybody at the same interval, which of course was unrealistic. So the questions arose: How do we determine whom we see and on what frequency do we want to see them-both for equipment management and clinical services?"

Enter the Home Oxygen Patient Acuity Assessment questionnaire, or HOPAA. Developed by Michael Henry, RRT and currently a surveyor for the Joint Commission on Accreditation of Healthcare Organizations, and Dave Hyde, RRT and a ventilation clinical specialist for Mallinckrodt Inc., HOPAA is an objective assessment tool designed to educate providers about their oxygen patients-and more accurately assess their individual needs.

Mendoza, who has been using the questionnaire for two years now, says it has helped her and her staff serve customers on a truly case-by-case basis. "We were seeing patients who maybe didn't need to be seen that frequently, and we were missing patients who may have needed to be seen more frequently," Mendoza recalls. "We couldn't justify why we needed to visit some patients every 30 days and others every 90.

"We knew in our minds what we wanted and needed," she continues, "but we hadn't figured how and why to differentiate between patients. That's why this tool is so handy: It's a useful component in our total evaluation process."

The questionnaire covers four main categories.

* One section, the patient profile, covers the patient's personal information, such as age, diagnosis, living situation and the like.

* The next section deals with the patient's functional limitations, such as impaired vision and/or hearing, arthritis, cognitive abilities and more.

* The form then reviews the type of equipment the patient will be using and to what extent.

* The last section examines the patient's home environment, covering everything from heating devices to the presence of pets and the dwelling's cleanliness.

Each question throughout the tool has a point value. At the end of the patient interview, the RT simply totals the points and checks to see if the number classifies the patient as High Acuity or Standard/Normal. >From there, the RT can make a more precise determination regarding the frequency of visits. This whole process, Mendoza reports, takes between 15 to 20 minutes.

For all her praise, she is also quick to point out that this tool is only a tool. As such, it should be used in conjunction with other clinical assessments-and not as an end-all test. "Some of the questions may need to be revised for specific companies," she says. "But once you tailor it to your needs, I would recommend using it."

That makes sense. After all, companies have individual needs, too.