The Wall Street Journal recently printed a disturbing article! It was about the Hospital at Home and Transition projects springing up around the country and the success they are achieving. The alarming information was that hospitals are using their own nurses and nurse practitioners to provide this service for the senior population. This is both a challenge because of the use of their own staff and a cause to celebrate because they now recognize the need for our types of services.
The article reads as follows:
“Existing research on house-call programs point to their benefits. A study published last June in Health Affairs showed that costs for patients in a Hospital at Home program at Albuquerque, N.M.-based Presbyterian Healthcare Services were 19% lower than for similar inpatients, in part because of shorter stays, and fewer lab and diagnostic tests. Patients with conditions including pneumonia, congestive heart failure and urinary-tract infections who are sick enough to require hospitalization and live within 25 miles are “admitted” in their home. They are then visited daily by a physician and once or twice daily by nurses who administer infusions and perform routine lab tests and procedures.”
t’s no secret that the salaries and wages of home care staff is considerably less than hospital based staff. Home health is much more cost effective. Additionally, home visits are what Home Care staff are trained for. They do not need to factor home visits into their already busy inpatient schedule like the hospital staff nurse and nurse practitioners. This new opportunity, however, will require home care nurses and aides to become better educated about the acute aspects of chronic diseases and the care required. In addition, this will require a much closer relationship with the acute environments, including physician groups. We will be looking at true partnerships with each partner bringing their specialty to the mix for the benefit of the patient, as well as, other entities, like insurance plans, that share in the responsibility of caring for the patients.
CMS has indicated that there are 5 chronic diseases that account for over 80% of all Medicare expenditures. These diseases are COPD, CHF, Diabetes, Dementia, and Depression. To prepare for this opportunity, as mentioned above, all home care staff will need to become experts in caring for all phases of these diseases, as well as, the medications and treatments that are specific to each disease. Many nurses working in the home health field are familiar with and can provide adequate services for these diagnoses, however, adequate will not be enough for the future partnerships. All must become expert in those diseases and the management thereof.
While there is significant course work available to educate clinical staff on the 5 chronic e diagnoses, there is very little for the home care aides who must become our eyes, ears and noses in the home. Who spends the most time with these clients/patients? It is the home care Aide. Therefore, in order for an agency to partner with a Hospital at home, a Medical Home or an ACO, training and education for the home care aides must become a priority and it must be comprehensive.
This is a major change for the health care industry. Up to now, home care aides have been relegated to the role of “baby sitters” and not fully utilized to the benefit of the client/patient or the home care agency. We envision the training and education for the aides to be 8 to 12 hour courses for each diagnosis. The course material will focus on those areas the Aides will need to know to properly notify the nurses and help manage when the client/patient has an exacerbation of their disease.
The home care agencies that survive into the future will be those who see the future coming and prepare themselves with expert staff and data to provide the outcomes and client/patient satisfaction levels required by the potential partnerships.
If your agency is like many other agencies, the budget and available training staff for training is limited. If you need assistance with this critical endeavor to get in front of the future of your home care agency, visit our online system at Kenyon HomeCare Consulting to schedule a consultation now.