Quality of Home Health Care: Luxury or Essential?
Kenyon HomeCare Consulting • March 5, 2021
We hear a lot about “quality of care” in home care, home health and hospice, but seldom is it defined in terms that allow us to quantify what it really means or what it looks like. “Quality” is both objective and subjective. One method of measuring quality is by outcomes, yet even those have subjective elements. So, how do we determine quality? What are the solid elements that will tell us we have quality?
Simply defined, quality is what our home health, home care and hospice customers and payors tell us it is. Expectations drive the quality issue. Since expectations can be broad based on who is defining them, how do we set a list of quality indicators that meet the customer’s expectations? Indicators we can measure.
It is fair to say, because we are in the caregiving business, the first expectation of our customers is that our home care caregivers will care about them and their issues. That sounds pretty simple – until you define what caring looks like and how you’ll measure it. One measurable criteria is following the care plan. Is it being completed as designed? For home care, care plans are developed around the client’s wishes for care. If it is not being followed, we need to know why. It is also regulation that aides follow the plan of care.
Another element of measurable criteria for the care plan is the frequency with which the aide has identified needed changes to the plan and notified the supervisor that the client’s needs have changed. For clinical staff, the frequency of care plan updates and changes are also a clue to engagement and the quality of the care being provided. When the plan of care is not being followed, and there are no updates or changes to the care, it may be an indication that the caregivers are not engaged with the client/patient or are not “tuned in” to the needs and wishes of the client/patient. While this is still a subjective measure, it can be used as an indicator of caring.
A second big issue for customers that relates directly to quality of care is the knowledge of the caregivers and their use of knowledge. Outcome measures, depending on how they are applied, can be a good indicator of expertise and skill in caring. For example, your private duty agency may expect aides to monitor the client’s blood sugar values and report when the values fall outside the range established by the clinician. The aide needs to be taught about blood values, including how to read the monitors and determine if the reading is within or outside the established range. Additionally, the aides need to be taught the presenting symptoms of high and low blood sugar and what to do for the client in each case.
Whatever parameters you set to measure knowledge, they must be indicative of the diseases and disabilities common in the client case load and should be reflected in the ongoing in-service training program for the agency.
With competition becoming increasingly fierce, now more than ever, the agencies that win will be those perceived by their customers as caring and knowledgeable. So, while we all know how to track the agency’s financials and regulatory requirements, you also want to add quality indicators of caring and knowledge to the dashboard.
If you are struggling with trying to figure out how to increase the business of your agency and need some help identifying and applying quality indicators to your agency, Contact us. We’re happy to help. We hear a lot about “quality of care” in home care, home health and hospice, but seldom is it defined in terms that allow us to quantify what it really means or what it looks like. “Quality” is both objective and subjective. One method of measuring quality is by outcomes, yet even those have subjective elements. So, how do we determine quality? What are the solid elements that will tell us we have quality?
Simply defined, quality is what our home health, home care and hospice customers and payors tell us it is. Expectations drive the quality issue. Since expectations can be broad based on who is defining them, how do we set a list of quality indicators that meet the customer’s expectations? Indicators we can measure.
It is fair to say, because we are in the caregiving business, the first expectation of our customers is that our home care caregivers will care about them and their issues. That sounds pretty simple – until you define what caring looks like and how you’ll measure it. One measurable criteria is following the care plan. Is it being completed as designed? For home care, care plans are developed around the client’s wishes for care. If it is not being followed, we need to know why. It is also regulation that aides follow the plan of care.
Another element of measurable criteria for the care plan is the frequency with which the aide has identified needed changes to the plan and notified the supervisor that the client’s needs have changed. For clinical staff, the frequency of care plan updates and changes are also a clue to engagement and the quality of the care being provided. When the plan of care is not being followed, and there are no updates or changes to the care, it may be an indication that the caregivers are not engaged with the client/patient or are not “tuned in” to the needs and wishes of the client/patient. While this is still a subjective measure, it can be used as an indicator of caring.
A second big issue for customers that relates directly to quality of care is the knowledge of the caregivers and their use of knowledge. Outcome measures, depending on how they are applied, can be a good indicator of expertise and skill in caring. For example, your private duty agency may expect aides to monitor the client’s blood sugar values and report when the values fall outside the range established by the clinician. The aide needs to be taught about blood values, including how to read the monitors and determine if the reading is within or outside the established range. Additionally, the aides need to be taught the presenting symptoms of high and low blood sugar and what to do for the client in each case.
Whatever parameters you set to measure knowledge, they must be indicative of the diseases and disabilities common in the client case load and should be reflected in the ongoing in-service training program for the agency.
With competition becoming increasingly fierce, now more than ever, the agencies that win will be those perceived by their customers as caring and knowledgeable. So, while we all know how to track the agency’s financials and regulatory requirements, you also want to add quality indicators of caring and knowledge to the dashboard.
If you are struggling with trying to figure out how to increase the business of your agency and need some help identifying and applying quality indicators to your agency, Contact us. We’re happy to help.
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HOPE Question and Answer Repository
Today, this article will look at little different than out typical articles. We all know the costs of losing employees and trying to hire and train new ones. It is exhausting and expensive. So, we think about our wages and benefit packages all the time. What can we do differently that makes people stay? We can’t change the job and we don’t want to keep people that don’t like the work itself. So, how do we acknowledge employees in a way that is valuable to them and that our businesses can afford to do? 5 Things To Consider About Employee Recognition At Your Christmas Party: 1. Years of Service: These can be based on milestone work anniversaries (5, 10, 15 yrs, etc.). If a person has been at your agency 11 years, you pull them up and acknowledge them in the group of employees who have been there at least 10 years up until the time they hit the 15 years landmark. This way longevity is recognized yearly. 2. Special Employee awards: Now, this may be difficult if your staff is very small, but acknowledge the employee who has gone the extra mile in the job they do. Tell the story. The employee needs to know when the employer is proud of the work that has been done. Consider a plaque or certificate. Don’t minimize the value of the employee having them to display. 3. Acknowledge all employees in the mix: Because we are a clinical industry, the administrative staff is often overlooked on day-to-day operations. Ultimately, don’t miss the chance to acknowledge the employee who was able to catch billing errors or collect on a large account. Staff doesn’t like to hear about money, but those types of collections keep Christmas bonuses in place! So, make sure the other staff knows the accomplishments of the finance department or the office manager that every caller loves to speak to. Don't ever forget the IT staff that is on call more than any clinical person in your agency! 4. Letters from the administration: Add a personal note to your staff either collectively or individually depending on the size of your agency. If you are larger, there are employees you don’t often see or get to talk to on a regular basis, so take the time so send a note with that Christmas bonus. 5. Consider the Christmas bonus: Listen, some of you can afford to do substantial monetary bonuses and that is fantastic. However, if you are not in that position, consider something in its place. Maybe small gas cards go with the letter from administration. With the cost of groceries, consider something that helps with the costs of daily living for employees. Big box gift cards in your area will always be used. You may do a lot of these things on a yearly basis to employees. All this being said, it doesn’t mean there aren’t reasons for acknowledgement throughout the year. However, your annual Christmas party is a good way to do it collectively. Between your annual party, write the individual cards to employees when you hear a patient interaction worthy of praise. Or, maybe you buy a gas card for the employee who has picked up extra shifts and always shows up on time. Ultimately, employees will feel valued. You will not regret the time, effort, and energy put into these efforts. Merry Christmas! If you want help with recruitment and retention strategies for your agency, please call Kenyon Homecare Consulting at 206-721-5091 or contact us online today.