Plunging into Evidence-Based Clinical Content

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Karen Utterback By Karen Utterback 
Vice President, Product Marketing and Strategy, McKesson

Plunge Into Evidence Based Practice for Home Health Clinical ManagementThe pressure for all healthcare providers, and particularly for homecare, to use evidence-based practice (EBP) is increasing from both payers and regulators. However, the amount of resources needed to make sure your agency is up-to-date on every clinical best practice can be overwhelming.

At the 2013 McKesson Homecare National Users’ Conference, Carolyn Humphrey, RN, MS, FAAN, took a deep dive into the processes used to build the clinical content in McKesson Homecare™. The president of CJ Humphrey Associates is a long-time advocate of home health evidence-based practice. She began researching and writing about it 14 years ago and has seen first-hand the negative patient outcomes that result from not using EBP as the basis of clinical practice.

Humphrey worked with the McKesson team for more than a year to help create the evidence-based clinical library found in the home health clinical management functionality of McKesson Homecare with the goal of ensuring that it would help reduce costs in home health and hospice agencies. Humphrey explained that the team began the project with a blank page and a goal of delivering EBP content at the point of care.

“We did extensive research to help ensure we addressed the common conditions in the populations most frequently seen by home health and hospice,” she says. “And we decided to leverage The Omaha System to provide broad EBP content regardless of the specific condition—we started with Omaha and added business rules and logic. The team also made sure the logic included not only EBP, but also respected the clinician’s expertise and had room for patient preference,” adds Humphrey.

Research for the project came from a wide array of sources, including:

  • Peer reviewed research journals, national guideline clearinghouses and EBP resource centers
  • Governmental agencies such as the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC)
  • National professional organizations such as the Wound, Ostomy and Continence Nurses Society (WOCN), the American Physical Therapy Association (APTA) and the American Academy of Pain Medicine (AAPM)
  • Subject-matter experts from a variety of clinical areas
  • Home health and hospice clinical experts at McKesson customer sites
  • Researchers and practitioners using The Omaha System

Humphrey says the cost savings for home health and hospice agencies may come from scaling back or eliminating personnel currently keeping track of EBP and from streamlined documentation. “We’re providing the information that connects the dots,” she says. “To oversimplify, if I’ve done a nutrition assessment and a wound assessment, the patient’s problems from both will automatically show up in the care plan.”

Last but not least, processes are in place for ongoing review, revisions and identification of the clinical content in home health clinical management based on new studies and to collaborate with customers as they identify new EBP and guidelines. As Humphrey puts it, “EBP is not black and white. If it was, we could have written this in three months.”

For more information on how evidence-based practice is transforming home health regulations, download this white paper.

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