How many times do you get excited about what a change can mean in your organization only to have it not go anywhere? If the answer is a lot, then you are not alone. It can become taxing to constantly attempt to initiate change without seeing the outcomes you want. In order to make meaningful change, you need to start at the very beginning and that’s a deep dive into your current clinical process.
Looking At Your Clinical Process:
One of the biggest errors we make in initiating change in our organizations is by telling what the outcome needs to be without putting together solutions that work in daily operations. For the purposes of this example, we will look at analyzing your chronic disease management program. Here are the steps to deep dive into your program:
- The Who, What, Where, Why, And How Of The Education You Provide: Look at how your educate you clinical staff. Is it mainly the nurses? Do you include the home health aides and rehab staff in the process? Is the training itself something easily accessed and on-demand as new hires come on board and need trained? Or, is it an offering you provide once or twice a year as needed? Do you add incentives to your clinical staff to get them excited about changing up the program when you reward their progress?
- When Is The Last Time You Updated Teaching Materials? Many agencies have the same teaching packets in place from 20 years ago. Not saying it needs thrown out, but updated to incorporate more in-depth teaching. For example, it is common to see an agency have a patient for CHF, then 6 months later the patient exacerbates and ends up back in the hospital. When admitted for the second time, the agency teaches the same packet. Maybe we need a deeper dive into what we should be doing with this patient who has had CHF long-term. What if he knows the s/s of the exacerbation? What if he already knows diet? The question is, what are you missing to better help him prevent the exacerbation? It may not be a compliance issue. What if the shortness of breath that takes him to the hospital is an anxiety problem and not really a cardiac issue? What about this patient’s home situation causes him to always call the squad on a Saturday night? This is digging deeper and making a true difference.
- Is Your Care Plan Discipline-Specific or Discipline-Broad? Discipline-specific means your disciplines do not overlap in goals and interventions. Everyone basically stays in the same swim lane for lack of a better term. The majority of your care plan should really be discipline broad and focused on the specific goals for that patient. If we go discipline-specific, we see very long care plans that are normally canned directly from your EMR for a particular diagnosis.
- Case Conferencing: How often is it? Does it sound more like report than really focusing on the care plan goals specific to the patient? Are there agreed upon interventions and goals put into place for the following week for all disciplines? Are your aides as involved as they should be or do they basically just complete the bath?
- Look At DC Charts: Did the care plan change along the way from admission to DC or does it look the same? If you are completing case conferencing routinely and addressing the care plan directly, things should be changed along the way according to the specifics of the patient.
- Are You Tracking Progress: Use CQI to determine your progress related to specific diseases processes. Pick specific Oasis items to track related to a specific chronic disease. Choose wisely what you track and how you can show marked improvement with your refined chronic disease program. This will be big for you when marketing your investment into the chronic disease management program.
Now, Put Your Changes Into Place:
We suggest one team and one disease at a time. At Kenyon Homecare Consulting, we offer in-depth chronic disease management courses at 8 hours per disease process that are available on demand. You can purchase by individual seats or blocks of seats and we can certify your home health aide staff in chronic disease management. Call us today to see how we can help you with the education ad well as getting your processes into place to make the education successful once in practice. Call us today at 206-721-5091 or contact us online to see how we can help you improve your process outcomes.