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Chronic Disease Education: How Do You Invest The Time And Money When You Haven’t Seen The Outcomes From It? It Starts Here And Now!

education and successChronic Disease Education continues to be a hot topic as homecare moves into further payment reform. In the past, you have probably done it on hire and maybe something at a yearly competency, right? Well, today, we need to talk about it being an effective part of transition and change within your agency. Here are the steps to make your chronic disease program successful and cost-effective.  

5 Steps To An Effective Chronic Disease Education Program: 

If your program is giving employees a self-study with a test, then you probably haven’t seen changes because of your investment. Maybe you teach it once and that’s where it ends. The bottom line is there must be something to follow-up the teaching to make it work. Here are the steps to make sure your education dollars make a difference.  

Alter Work Flow Of Clinical Staff:  

If you want to make a difference in outcomes, then how the clinical function in the fields and out of it are crucial. Without changing job roles or case conferencing objectives, you really haven’t changed a thing.  

Clinical Documentation Needs To Reflect Chronic Disease Management Collectively:  

We want to see a one patient one care plan methodology. If your nursing, aide, and therapy EMR do not address these items as part of routine visits, then it won’t happen. Examine your EMR for what is currently there. Most therapy notes do not have anything specific to address chronic disease management. This means every individual must remember to document certain things that are not part of what is routine. The same exists for aide staff.  The care plan should address specific chronic disease items within the scope of practice. Make chronic disease management present for all disciplines in a meaningful way that can lead to real-world practice changes.  

Educate Staff Before You Provide Chronic Disease Education:  

This means let your staff know the endgame. Explain the changes to communication and work flow. Instruct as to how the documentation will flow between disciplines to show a collective effort towards chronic disease management. If you don’t make it clear what you expect the difference to be, then don’t expect staff to achieve it. 

Pick Your Program:

Consider something online to allow the training to remain consistent and relevant over time. Many excellent programs allow agencies a certain number of uses over time. This allows the agency to have any clinician complete or repeat the training. Online access allows clinicians the flexibility to access the information around client visits.  If you want to consider onsite, then have a way to obtain a copy of the face-to-face education so it can be used in the future. 

Let Your QI Program Show What Needs To Change:  

As with any clinical process, you will measure this for efficacy. Your agency needs to track items related to chronic disease management. Consider Emergent Care/ Hospital Admissions related to chronic disease exacerbation. It also means looking at specific clinical items such as shortness of breath. Check your congestive heart failure and COPD patients. Did staff initiate effective intervention at times according to your disease management program? Or, if it wasn’t addressed properly, determine why. If it is a lack of knowledge, then train again on your protocols.  

Kenyon Homecare Consulting Has The Online Programs You Need:

At Kenyon Homecare Consulting, we have online chronic disease education programs for both the individual and the organization. Call us today at 206-721-5091 or contact us online for your free 30-minute consultation and see how our program and be the change you need.   

 

Check Your Watch Because It is Time! Clinical Education In Homecare Is The Beginning Of Future Success. Don’t Wait Any Longer!

clinical educationSo, let’s talk about your clinical education. How do you approach it? Have there been changes in the last 10 years? Also, how does staff evaluate it? There are many reasons that agencies hold off on educational programs for staff. Let’s first look at those and then consider why to change the current role clinical education plays in your agency.  

Reasons Agencies Don’t Invest In Clinical Education: 

There always seem to be reasons not to invest in clinical education, but in the long run it is worth it to do so. Let’s look at 5 reasons agencies don’t take that step. 

  • Money: We understand budgets are tight and sometimes education takes the back seat to other money spent.  
  • Time: When your agency is busy, it may seem tough to schedule training and still get patients seen.  
  • Understaffed Already: If you are down staff, then the time factor is more difficult. 
  • Doesn’t Improve Retention: If this is your goal, then losing staff despite additional education is frustrating. 
  • Didn’t Improve Outcomes: Ultimately, this is the goal. Improving outcomes with better prepared nurses is a no-brainer.  

Now, Why You Need To Reconsider Each Of These Reasons: 

Even if the previous list checks several boxes in your agency, it is time to take a second look. Consider the following and why you can justify every dollar and minute spent.  

  • Money: There are economical ways to provide staff training today. Consider online webinars or purchasing training you can use more than once. Training on-site at conferences is always great for staff but is not always affordable for agencies.  
  • Time/ Understaffed: While time spent on training does not generate direct revenue at that moment, it does for future referrals. Specialty programs, well designed chronic disease programs, and clinical teams running as well-oiled machines generate referrals. 
  • Doesn’t Improve Retention: Here’s the thing. If you have been burnt in the past with staff leaving after receiving specialty training, then have them sign an agreement to remain on for 2 years post training. If they are invested in your agency, then it will not be an issue. Now, if they are unwilling, then they probably never were and maybe you train someone else. Staff will be more dedicated when administration invests in a meaningful way to make them better.
  • Doesn’t Improve Outcomes: This is a big one. Maybe the training program is the problem. If you invest in the clinical education, there should be some way planned to incorporate what was learned into practice. Many times, the agency spends the money and that is it. So, you need to be clear what you expect as an agency to change with the direction of the training. Let’s look at how to integrate your clinical education. 

Integration Of  A Clinical Education Program: 

Look at staff education that is relevant to all clinical staff. If you train nurses, but not therapists and aide staff, then how can you expect to have a meaning change in outcomes? Look at programs that tackle clinical issues such as chronic disease management for all clinical staff as well as your agency. This way, it gives you the next step of how to integrate the education into meaningful clinical practice. Online purchases will allow you access to train staff as they come on board and everyone remains on the same page when it comes to clinical approach.  

Kenyon Homecare Consulting Can Help! 

At Kenyon Homecare Consulting, we offer a wide range of educational programs to help your agency. Whether you are looking for integrated chronic disease programs or adding specialty programs, we can help you through the process.  Call us at 206-721-5091 or contact us online for your free 30-minute consultation with a senior consultant today to see how we can help you meet your goals.  

Positive Clinical And Financial Outcomes: Do You Realize How Clinical Education Is The Most Important Cog In The Wheel? Let’s Put It First And Foremost In Your Head And Strategic Plan!

chronic disease educationToday, positive and clinical outcomes are crucial for long-term survival in homecare.  However, often we don’t see how the basis for success with both begins with clinical education. Now, you may not see the connection at first. So, let’s look at how you need to visualize the future of your agency. 

Clinical Education: 

Even the most skilled clinical staff needs education. No one will disagree that homecare is different than any other type of institutional care. Only those who live in the world of home and community-based care understand the complexity of putting all the pieces of patient care together. You may have clinical staff who are excellent in the acute care setting, but struggle with all that must be considered in a successful care plan at home. It takes programming specific to our industry. If you miss this step, your clinical staff won’t be comprehensive and set the patient and your agency up for success. This will be despite best efforts by all concerned. There must a training into homecare that deals with more than computer documentation or Medicare regulations. It is about the paradigm shift to a true integration of care. 

Now, that may seem like an impossible undertaking, but it isn’t. Consider the interdisciplinary team functioning in hospice. There is more communication and collaboration in hospice than with skilled care. However, it shouldn’t be that way. None of us know what the payment system will be down the road, but is it so hard to believe that agencies may be responsible for all aspects of covering patient cost much as hospice does now? Imagine your plan for care if this was the case and let’s look how that effects clinical and financial. 

Clinical And Financial Outcomes: 

Hospice nurses manage patients at home. Whether the visits are at 2:00 am or noon. Symptoms are managed by working closely with physicians to keep the patients at home. The home health side does not always approach the proactive nature of care the same way. But, if the mindset was different going into care and care planning, it could be. If you consider the same hospice type approach to finance, then outcomes would also improve. Hospice nurses often have a better understanding of costs related to visits, treatments, medications, and dressing supplies since it all comes out of a per diem.

Other members of the clinical team such as physicians work differently with orders when the patient is under a hospice program too. Ordering IM Lasix for a patient at home at the beginning of a CHF exacerbation with an additional nursing visit to administer it can easily avoid a hospitalization. This type of treatment would be ordered in a heartbeat for a hospice patient. Let’s get there on the skilled side collectively. It begins with chronic disease education and a paradigm shift to care planning. 

Start With Your Clinical Education Process:

At Kenyon Homecare Consulting, we have chronic disease education for clinicians as well as facilities. It helps to train staff individually and the agency to work towards competency and organizational change. Call us today at 206-721-5091 or contact us online for your consultation today. Let us help you meet your clinical and financial goals. 

Education And Training: Maybe You Need To Start With A Day In The Life Of An Auditor To Make It Stick!

point of viewYou have completed all the education and training to your staff.  You struggle with seeing compliance in CQI results. If you just don’t know why the results don’t match the effort, then consider looking at things like an auditor. Let’s look at how education and training end up off the mark if you don’t connect the dots. 

Education And Training: 

There are so many approaches to educate staff and each agency tends to stick to a certain pattern. Here are several ways agencies use education and training opportunities: 

  • Staff Meetings: The supervisor gives direct education to staff as to standards or protocols set forth by the agency. 
  • Clinical Competencies: Many agencies still utilize a yearly competency to work on staff education collectively. 
  • Online Education: Many agencies find this to be a cost-effective way to train a lot of people. 
  • Seminars or Conferences: Although this is a more costly option, it allows for direct questions and interaction during the session. 

Education and training should improve your outcomes and documentation. Right? If you haven’t linked the clinical practice to the documentation, then you miss what you hope to achieve. 

Look Through The Eyes Of An Auditor: 

This is good advice for anyone in your clinical system. Whether you are a nursing supervisor or administrator, you often know things about patient care that don’t allow you to look objectively at documentation. Often, your clinical staff will do the same thing. Care plans and interventions need to be real for the patient. It isn’t about creating a beautiful care plan in your EMR that doesn’t make sense for the patient. Now, let’s look at this example. 

The documentation may seem complete because EVERYONE knows that patient doesn’t take blood sugar first thing in the morning as fasting. So, the AM reading is always up, right? The auditor sees AM blood sugar readings much higher than what is expected. The nurse is not notifying the MD because it’s a typical result, but it is not clearly documented. Your agency has seen this person off and on for years. The auditor will also see a care plan that doesn’t fit the patient. If the patient never does a fasting blood sugar, why isn’t there a range from the MD applicable to what the patient does? 

Change The Way You Teach:

ICD-10 Coding

How To Win In PDGM With Accurate Coding

At Kenyon Homecare Consulting, we can help with education and training to achieve the change you desire. Whether it is on-site teaching or operational coaching you need, we are here to help you through it. Call 206-721-5091 or contact us online to see how to make change happen for your agency. 

Not Getting The Results From Education And Training You Want? Make Every Penny Count To Get The Outcome You Need From The Money You Invest!

Game ChangerHomecare education is so important, and no one argues that point. Making sure all clinicians have the critical thinking and technical skills is vital to proper patient care. If you put the dollars into education and training without the seeing the benefit, then you need to change something. Let’s look at ways to transform your education and training. 

What’s Your Current Approach? 

Do you have an education and training program for staff above orientation or a typical yearly competency? Is there an educational fund in the agency and if so, is staff aware of it? Also, do you provide additional education based upon outcome data to determine clinical weaknesses? Is the training usually just for an individual discipline? Why do you think there was a lack of return on your investment? 

These are all good question to ask yourself, but also consider how the education and training is delivered. Is it all the same format? Online education, conference attendance, self-studies and internal programs are all good approaches. However, keeping your education and training fresh can be tough if the format is always the same. 

Change The Educational Paradigm: 

Make education and training dynamic by making it inclusive to all clinical disciplines. Now, this doesn’t mean the level of clinical education for the home care aide is the same as the nurse or therapist, but it doesn’t make sense to provide education that doesn’t span the clinical spectrum. If you want to improve chronic disease outcomes, then chronic disease education must be for all those clinicians who see the patient. So, start with your processes first and then seek education that is inclusive of all clinical disciplines functioning as one clinical unit. It is the key to making clinical education successful and not fragmented. It means fully integrated care plans that make sense to everyone providing care. 

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At Kenyon Homecare Consulting, we understand all that goes into having highly skilled staff to provide patient care. It is also important to spend money on education where it makes sense for your agency moving forward. Whether you need chronic disease education for individuals or for your facility clinicians, we can help. We also have the trained and seasoned consultants to help with organizational change to help make it happen. Call us at 206-721-5091 or contact us online for your free consultation with a senior consultant. 

You Give Chronic Disease Education To Your Home Care Staff, But Things Don’t To Improve. Is The Training The Problem? Make Sure Your Training Hits It Out Of The Park Every Time!

hit it out of the parkIt is not new information that chronic disease education is important. Chronic Disease Management is so expensive for the healthcare system and for providers of care as well. Sometimes, you may provide chronic disease education and not get the outcomes you want. It may be the approach of the program you use. Let’s look at why an integrated program is so important. 

You Are A Team: 

The clinicians in the field are members of one team. It often doesn’t present this way. Many times, the aides do their thing as do the therapists and nurses. When each discipline completes “their part”, the patient is discharged. One month later, you receive another referral for the patient who exacerbated the same disease you worked to stabilize. The revolving door of chronic disease begins with a chronic disease program that looks at your care plan differently. 

Chronic Disease Education: 

Teaching on Chronic Disease is not just about teaching each discipline about signs and symptoms. Chronic Disease Education needs to be facility-based and not just on discipline. It needs to pull together a collective management program addressing care planning as well as employee intervention. Many programs are just specifically to teach the aide or nurse what the signs and symptoms of the diseases are and that is it. If you teach something that only deals with memorization, then how do you expect for clinical staff to critically work with facility processes and patients? The two items need to go hand-in-hand. 

Kenyon Homecare Consulting’s Chronic Disease Program: 

This is where Kenyon Homecare Consulting comes into help. We have the facility and clinician-based trainings to move disciplines into a more focused outcome-based model of care. It involves interdisciplinary care and all members of the clinical team provide a vital piece of making a true difference in keeping the patient home. The medical home models need this kind of comprehensive chronic care management. Are you ready? Call us today at 206-721-5091 or contact us online for questions regarding our chronic disease online education. 

Breaking Down The Evolution To The Oasis D Tool. From Clinical Assessment To Data Collection, Why This Document Is More Important Than Ever!

ToolRemember the first Oasis tool? It seemed so cumbersome. Think stapled assessment tool that just made more work for clinical staff. Well, we had not seen anything yet! As the tool has evolved from its original to the current version, the industry has had to evolve too. If you aren’t sure if you are there, then look ahead at how to use the tool to your advantage. 

Well, It Is An Assessment Tool, BUT: 

The reality is that most clinicians see the Oasis as a form to fill out for Medicare. If this is the only way your agency uses it, then more education needs to happen. Lots of clinical information is jammed into that tool. If you think critically about it on a functional and clinical level, then the care plan is effectively created. How many therapists in your agency understand Oasis? Do your nurses critically understand Oasis?  Does therapy read the Oasis after it is completed by the nurse? Is the tool part of initial care coordination? These are all good questions to ask. If staff doesn’t use the tool to properly create a comprehensive care plan, then it is just a form to fill out for Medicare. 

Data Collection: 

Yes, it is a data collection tool for Medicare. So, it needs to be filled out correctly. Not just from a financial standpoint, but also for outcomes.  Oasis changes are made based upon prior years of data. So, if agencies do not take the effort to properly train staff, it hurts the industry. Ongoing errors trigger audits. In the course of a normal record review, how often do you see Oasis discrepancies with other parts of the clinical record? We live in a healthcare world where auditing is here to stay. Don’t set yourself up to fail your ADRs. 

Kenyon Can Help: 

At Kenyon Homecare Consulting, we have senior consultants who can assist with training and operational changes to make your Oasis come together as a tool to make you better. Call us today at 206-721-5091 or contact us online to talk about how we can help train and transition your staff. 

Chronic Disease Program Management: Are You Ready To Make It Work Instead Of Treading Water Doing The Same Old Thing?

PDGMChronic Disease Program Management is one of those things that is sometimes put on the back burner. You worry about finances, referrals and staffing to cover the patients you have as well as being able to staff new ones. Coding and Oasis and compliance are in there too. It may seem one takes the front burner until it boils, and it just becomes a juggling routine. Sound familiar? It is time to make chronic disease management the answer to it all. 

Moving Into PDGM: 

With ACOs and Value-Based Purchasing, agencies got a taste of outcome-based care. The goal was always for a more coordinated effort to manage care in a cost-effective way. The process always meant managing chronic disease related to the costs associated with it. Process changes meant optimizing all disciplines to function at full scope of practice. It also meant coordinating all those moving parts, so everyone worked together. 

Now, with the 2020 initiation of the new payment rules, agencies will have 30-day payments for care. If your payments significantly drop once a patient is on more than 30 days, what do you think happens to the average length of stay for a patient? The goal from the beginning of skilled care was to get the patient independent and back to previous level of function. Only a small number of patients were intended for multiple episodes of care.

Putting Everything Into Place: 

A more coordinated effort into chronic disease management fits directly into an agency’s fiscal survival in PDGM. In order to make this happen, agencies must move full steam ahead with chronic disease education programs that work. Education for disciplines independently don’t address the coordinated effort towards the care plan. It is the difference between disease knowledge versus a true education about disease. Look at programs designed for the discipline itself as well as the agency. This will help you move operations into a coordinated model focused on the care plan and not on tasks by a discipline. 

Chronic Disease Management With Kenyon: 

At Kenyon Homecare Consulting, we have online chronic disease education programs to help you move in the right direction. We also have senior associates who can help you alter operational process if you want on-site assistance. Call us at 206-721-5091 or contact us online for your free 30-minute consultation with a senior associate. 

Moving Into 2020: Wrapping Your Head Around Evolving Clinical Staff Into The New PDGM Model Of Care. By The Way, This Includes Every Person Who Sees The Patient.

changeThis is a big time for transition in homecare. This industry just came off a year with the first changes to the Conditions of Participation in decades. It is a big deal. Now, you are faced with new a payment model for 2020. If you think this is just about payment, then you need to research more about the PDGM model. 

Bye Bye Therapy Thresholds: 

The industry knew this was coming. No longer will there be additional reimbursement related to the number of therapy visits. This is a good change. In order to “see” all members of the homecare team working together, there should not be incongruence in reimbursement for one over the other. Many providers continue to struggle with therapy providers not willing to comply with coordination of care or working towards shared care plan goals. This can’t happen in the PDGM model. 

Working As A True Team: 

This is huge too.  For years, healthcare has pushed to eliminate the silos of care between providers. However, the focus has been from hospital to SNF or SNF to homecare. It has not been focused on homecare discipline to homecare discipline. It is always the assumption that all clinicians within a realm of healthcare already work as a tight knit unit. Reality is, this isn’t the case in so many agencies. If you don’t have true interdisciplinary care and care planning, then it is unrealistic to think it will be successful with outside providers. So, this means fix the issues in your own house before the PDGM model hits and 30-day payments are in place. 

Begin With Education: 

Chronic disease care is the key to a true medical home model. It requires clinicians to be laser-focused on a shared patient care plan. All caregivers need educated about working in this type of model. It means more than nurses rattling off signs and symptoms of a CHF exacerbation. It is more than the aide documenting blood sugar readings. The COPD patient with pulse ox readings from the therapist doesn’t manage chronic disease. These items are all task-related and not about management of the disease. A comprehensive chronic disease management program gives you the paradigm shift you need in a PDGM model. It sets you up to be efficient and profitable. 

Call Us For Help: 

At Kenyon Homecare Consulting, we have comprehensive online disease management programs on the clinician and agency level. Call us at 206-721-5091 or contact us online for more into how chronic disease management is the key to future success.

Continue Fine Tuning Your Chronic Disease Education Program And Its Potential Will Go Through The Roof! See How To Make It A Whole Lot Easier From Start To Finish!

chronic disease educationOk, let’s say you have been in this process of chronic disease management for a while now. You know it is an ongoing process and that chronic disease education must be a major focus. If it seems like you put all the pieces together, then you should be able to see what the puzzle is.  If you can’t, then let’s look at why fine tuning is so important. 

How Involved Are You? 

This is a good question for owners whether you are clinical or not. What do you see in your work flow of chronic disease management? Does conferencing between disciplines happen the way the program was set up? Or, do you see “report” with nothing related to shared care plan goals. If you don’t know the answer, then it’s time to sit in and objectively listen to communication between disciplines during care conference. Often, conferencing can start out with the best of intentions and clinicians start to revert to old habits. Care conferencing and report are two completely different things.  Make changes when needed and be involved in evaluating the program along the way. 

Make Sure You Have A Clear Leader In Chronic Disease: 

Ideally, your clinical manager should be the gatekeeper for care coordination. If you see format that looks more like report than coordinated care planning, then talk with your gatekeeper. It is important to make chronic disease a main focus for your clinical manager. Do not assume the clinical manager can’t be distracted by everything else going on in the office. It is a busy and big job. You need to make sure the clinical manager role can wholly focus on clinical. Don’t have your clinical manager doing things office staff can. Chronic disease education and chronic disease management are too important.  

Kenyon Homecare Consulting Can Help! 

At Kenyon Homecare Consulting, we have online programs for individuals and for agencies. Call us today at 206-721-5091 or contact us online to see if our program is right for you.