Sustain Outcomes with Clinical Pathways

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By Lisa Van Dyck RN MS, 
Eventium LLC (formerly Innovative Healthcare Solutions/VNA First)

Home Health Patient

Home care is poised to be a critical component to success in healthcare reform. Hospitals, accountable care organizations (ACOs) and bundled payment models must control post-acute care to prevent rehospitalizations that decrease quality and drive up costs, and home health is uniquely positioned in this space.

Studies have demonstrated that the use of home care services post-hospital (as compared to other services) reduces hospitalizations, saving Medicare almost $3 billion dollars over a three-year period, according to a study from Avalere Health LLC. But hospitals, ACOs and insurance companies that are potential partners will want to know your agency-specific Home Care Compare scores, particularly your Hospitalization score and your CAHPS satisfaction scores. Future pay-for-performance models for home care anticipate using these scores to determine payment. How do your scores measure up against your competitors in the market?

Your organization must demonstrate how it produces and sustains these high level outcomes and cost savings. You must demonstrate you provide standardized, outcome-driven, evidence-based care that at the same time focuses on the patient, who helps drive their care.

Horizon Homecare and Horizon Hospice users have several tools available to your organization in marketing your status: vna FIRST Home Care Steps® Clinical Pathways, the associated Stoplight (Red Flag) Tools and Step by Step patient education books. For detailed information and examples, visit Innovative Healthcare Solutions. A 60-minute webinar on this topic includes examples of our paper model as well as our electronic pathway models.

Everyone can access informative videos at the Innovative Healthcare Solutions site on these topics:

  • Home Care Steps Protocols
  • Step by Step Patient Education Guides
  • Quick Paths
  • Disease Management Tools
  • Telehealth Pathways
  • Hospice & Palliative Care

Whether or not you use the vna FIRST Pathways, you must show your partners that the outcome-driven patient education tools you provide promote an empowered, activated patient who drives their care and is accountable for their disease management. You also must demonstrate how these tools promote efficient care, focused visits and proper patient and caregiver preparation for future visits, resulting in fewer needed visits to reach high levels of disease management. This is key, since the patient is the biggest variable or influence on outcomes, and—ultimately—payment.

Lisa Van Dyck can be reached at 414-939-8735, ext. 103.

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