Do You Utilize Clinical Staff To Full Potential? Home Health Aides Can’t Be In The Shadow In PDGM. Position Yourself For Your Future Success!
Kenyon HomeCare Consulting • March 16, 2021
Today, every home health agency is trying to position themselves for success in PDGM. However, one huge missing piece of the puzzle in patient care is the home health aide. As you move forward into big payment reform, make sure you realize outcomes and cost of patient care can greatly improve with proper utilization of your aides. Let’s look at how many agencies see the home health aides now and how we need to transition them as an integral part of a coordinated care.
Our “Bath Aides” Today:
The biggest mistake in the industry is to label your home health aides “bath aides”. When a care plan is developed, it is developed around personal care and bathing, so some clinicians minimize the capability of the aide. Many agencies hire only CNAs. This means we need to see the home health aide as a certified nursing assistant. This means allowing them to work completely within scope of practice and not just doing the bath. Depending upon the state, some aides are allowed to do dressing changes and draw up insulin. Now, this means the agencies need training programs in place and must determine competency of staff completing these tasks. You may feel that not every aide on staff is suited for certain tasks and this is fine. However, in a PDGM world, you will have a difficult time surviving if you do not utilize every discipline to fullest potential within scope of practice. Let’s look at what full potential for your home health aide looks like in PDGM.
PDGM and Aide Utilization:
Our aides always need to have chronic disease at the forefront of care. Considering the majority of the patient population is dealing with chronic disease, every aide needs ongoing education regarding chronic disease care. If you can work with the aides to take a blood pressure, monitor swelling, and weights on a CHF patient, then why wouldn’t you have them do it? If they have been educated and competency is met, then have them understand why these items need addressed every visit and reported on to the nurse. This also includes consideration in the rehab process. SNFs have long recognized the use and value of restorative aides and programs within the facility. Why don’t we use the aide as part of these processes in the home? ROM or assistance with exercises is so often a part of the patient care plan, but most agencies don’t have the aide complete additional ambulation or home exercises with the patient. We teach family members and neighbors to provide skilled care, so why are you having the aides do it?
In PDGM, an aide should get a plan of care with report from the nurse as to specifics of care. This means talking about specifics related to chronic disease, personal care, and therapy focus. The aides should know what specific goals are listed in the care plan. The aide should have care goals related to advancing the patient to independence with personal care and also what specifics need reported as part of routine visits. This way, the aide is engaged in what all the disciplines are working to complete. This promotes an ongoing circle of care that is continually client-focused. This allows the nurse and therapy staff to be plugged into additional data about the patient when they aren’t present in the home. Don’t minimize the role these staffers can play in positive patient outcomes. Remember that they know more about that patient and spend more time with them than all the other disciplines.
Moving Into Aide Utilization Is A Process:
At Kenyon Homecare Consulting, we recognize that a paradigm shift with clinical staff takes time. It also takes education to staff to understand the change. We can help you with the chronic disease education for staff and agencies. We can also assist with on-site training with staff as you transition to client centered coordinated care planning. Call us today at 206-721-5091 or contact us online to see how we can help you with success in PDGM.
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In the rapidly evolving landscape of healthcare, the burden of care is increasingly shifting from clinical facilities to the home. As the population ages, the prevalence of chronic conditions—such as heart disease, diabetes, and respiratory disorders—has reached unprecedented levels. For home care agencies, the quality of service is no longer just about assistance with daily living; it is more and more defined by the clinical competencies and disease-specific knowledge of your field staff. Chronic disease education for home care staff is not a luxury, is a strategic necessity that directly impacts patient outcomes, caregiver confidence, and the business’s bottom line. 1. Enhancing Clinical Outcomes and Safety Home care staff are the "eyes and ears" of the healthcare system. When aides and clinicians are highly educated on chronic disease processes, they can identify subtle shifts in a patient's condition before they escalate into emergencies. · Early Intervention: An educated caregiver can recognize the early signs of fluid retention in a Congestive Heart Failure (CHF) patient or skin changes in a diabetic patient, allowing for proactive adjustments rather than reactive ER visits. · Medication Adherence: Understanding why a medication is prescribed for a specific chronic condition helps staff reinforce the importance of adherence to the patient, reducing the risk of complications. 2. Reducing Hospital Readmissions Hospital readmission rates are a primary metric for home health success. Chronic diseases are the leading cause of "revolving door" hospitalizations. By providing specialized education, agencies empower their staff to implement Evidence-Based Practices at the bedside. When staff can effectively manage symptoms and educate patients on self-care, the likelihood of a patient staying stable at home increases dramatically. This not only benefits the patient but also strengthens the agency’s reputation with referral sources like hospitals and physician groups. 3. Boosting Staff Confidence and Retention The home care industry faces significant challenges with staff turnover. Often, burnout is fueled by the stress of feeling unprepared for complex patient needs. Knowledge is Empowerment: When staff members receive robust training, they feel more confident in their roles. This professional growth fosters a sense of value and belonging within the organization, leading to higher job satisfaction and lower turnover rates. 4. Improving Documentation Accuracy In an era of increased regulatory scrutiny, clinical documentation must be precise. Education on chronic diseases ensures that staff members use the correct terminology and focus on the most relevant clinical indicators during their assessments. · OASIS Accuracy: For Medicare-certified agencies, a deep understanding of chronic conditions leads to more accurate OASIS scoring, which directly influences reimbursement and quality ratings. · Audit Readiness: Well-educated staff produce notes that clearly reflect the necessity of care, making the agency much more resilient during regulatory surveys or audits. 5. Bridging the Communication Gap Effective chronic disease management requires a multidisciplinary approach. A caregiver who understands the nuances of a disease can communicate more effectively with: · Physicians: Providing clear, clinical updates that help doctors make informed decisions. · Family Members: Offering clear explanations and peace of mind to stressed family caregivers. · The Internal Team: Ensuring a seamless transition of care and consistent messaging across all disciplines. Conclusion Investing in chronic disease education is an investment in the agency’s future. By elevating the knowledge of the frontline workforce, home care providers can transform from basic service agencies into high-value clinical partners. In the end, the goal is simple: providing the highest quality of life for patients in the comfort of their own homes, a goal that can only be met through a highly trained and knowledgeable staff. If you do not know where to get comprehensive education for Chronic diseases, contact Kenyon Homecare Consulting at gkenyon@kenyonhcc.com or call 206-721-5091. We are here to help
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