By Melissa Calkins and Ashley Espy 

Panic is in the air.  With the HOPE assessment tool set to replace HIS, hospice teams are racing to prepare—scrubbing workflows, updating systems, and trying to wrap their heads around new clinical documentation demands.  But amid the rush, it's easy to overlook critical gaps: non-clinical staff being left out of planning, unclear timelines, poor communication, or the complete absence of a project lead. 

HOPE isn't just about compliance—it's about execution. 

If we don't step back and ask what's missing, we risk rolling out a system that nobody is truly ready for. 

Understanding the HOPE Tool 

The Hospice Outcomes and Patient Evaluation (HOPE) tool, developed by the Centers for Medicare & Medicaid Services (CMS), is set to transform patient care in hospice organizations. As the successor to the Hospice Item Set (HIS), the HOPE tool offers a more comprehensive and real-time assessment of patient needs, focusing on symptoms, goals of care, and overall condition. It ultimately aims to enhance care quality. 

Unlike HIS, which only requires data at admission and discharge, the HOPE tool collects data at multiple points across the hospice stay, including admission, symptom changes, and discharge. It includes demographic, clinical, and screening data, providing a holistic view of the patient's condition and enabling responsive, individualized care planning. 

Steps to Operationalize the HOPE Tool 

1. Project Planning:  Regulatory changes naturally create anxiety, especially when they span the entire organization.  A solid project plan helps reduce uncertainty, align stakeholders, and keep leadership informed. Include timelines, resources, and ownership of each component (e.g., SFVs, HUVs, assessments).  A clear plan is also a transparent tool for communicating with executives and C-suite leaders about how you're preparing for this major shift. 
2. Training and Education:  All staff—not just clinicians—must be trained on HOPE's structure and intent.  This includes understanding the new assessment time points, terminology, and what accurate documentation entails.  Don't assume clinicians will "just get it." Everyone needs time and clarity. 
3. Practice and Gather Feedback:  This is where change management comes in.  Every transition has phases: preparation, disruption, and stabilization. Expect resistance, confusion, and workflow hiccups—it's normal.  Organizations can smooth the learning curve and reduce stress during go-live by practicing assessments in advance, collecting feedback, and hard-wiring expectations. 
4. Integration with Existing Systems:  Stay informed on how your EMR vendor plans to support HOPE, but don't stop there.  Ask: What won't the EMR do? Who fills those gaps?  Your plan should define responsibilities clearly so nothing falls through the cracks. 
5. Regular Updates and Audits:  Build in routines for checking that data is collected, submitted, and complete.  Who owns this?  When will checks occur? Consistent audits and feedback loops ensure the process remains compliant and high-quality over time. 

Don't Just Implement—Operationalize Every Detail 

Successful implementation requires understanding how assessments fit into daily operations.  Many organizations focus solely on EMR integration or clinical workflows without considering the full system impact. 

Examples of critical operational questions to address: 

• Visit Expectations:  How will required assessment timepoints change current visit patterns? 

• Weekend Coverage:  Are weekend teams prepared and adequately staffed? 

• Patient Transitions:  How will continuity of care be maintained during transitions such as changes in care location, hospital transfers, care level adjustments, or movement to or from the inpatient unit? 

• Communication Flow:  How will assessment triggers be communicated to teams? 

• Quality Checks:  Who reviews documentation gaps and when? How many hours will be dedicated to data review? Will corrections be made in real time?  

• Claim Management:  How will you prevent delays in claims submission and payment related to documentation completion? 

• Internal Point Person:  Who handles HOPE-related questions and troubleshooting? 

Questions like these aren't extras—they're essential.  Skipping key pieces of operations could lead to workflow breakdowns, care delays, and frustrated staff.  This is why project management must go hand-in-hand with clinical readiness. 

Conclusion 

HOPE is more than a new form—it's a culture shift.  Successful implementation requires more than system tweaks and clinical training. It calls for clear project ownership, thoughtful communication, and an organization-wide approach. 

Project management tools are your best defense against chaos.  With them, hospice teams can turn anxiety into action—and ensure that HOPE delivers on its name. 

Melissa Calkins, BS, CSSBB 
Compliance and Process Excellence Manager at Teleios 

Ashley Espy
Clinical Operations Coach at Teleios

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