Use of Guidelines Brings Gains for Agencies

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Karen Utterback By Karen Utterback 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)

Hospice Agency User GainsUsing Guidelines and Co-Steps in Horizon Homecare™ can lead to productivity gains and increases in clinician and patient satisfaction, conclude speakers during the McKesson Homecare and Hospice 2012 National Users’ Conference.

Visiting Nurse Service of Rochester and Monroe County recorded time savings from documentation, higher regulatory compliance and higher employee and patient satisfaction after convening an interdisciplinary Documentation Implementation Group (DIG) to examine practices, says Beth Dorscheid, vice president of clinical operations. DIG was established in 2011 in response to staff complaints that documentation was onerous and took too much time.

DIG members created interdisciplinary care plans, added standard interventions, replaced some Co-Steps with single-key lookups, developed symptom management interventions and streamlined routine assessments. Visit protocols were revised to reflect these new and updated care plans, explains Yvonne Kimaid, clinical analyst. Results included savings of 15 to 20 minutes per patient in documentation time, a reduction in duplication/redundancy of efforts and higher employee satisfaction.

Another tangible advantage of using home health software was the 8% increase in the agency’s Home Health Compare CAHPS score on the question about whether the consumer was informed and kept up to date about care received in the home.

Concordia Visiting Nurses Association also is using an interdisciplinary approach to creating documentation for its clinicians. The agency developed standard Guidelines for Congestive Heart Failure (CHF) and Chronic Obstructive Pulmonary Disease (COPD) and is working on protocols for type 1 and type 2 Diabetes, notes Kati Podner, clinical staff educator. Guidelines included long-term goals, assessment tools, monitoring and education to keep patients safe, healthy and out of the hospital. Guidelines were integrated into Horizon Homecare so as clinicians achieved goals, they would disappear from the active screen to reduce clutter and allow caregivers to concentrate more on patient care.

Barriers to implementation included knowledge deficits among workers that had to be addressed, modifications to workflow processes and a general resistance to change. However, as Stacy Mathers, clinical informatics director, says, “The process can’t change for one person. It’s all about the patient.”

The results: In one office, use of the tool jumped from 40% initially to 98% now, notes Mathers. Information from the system also has been compiled into a report for local hospitals on their CHF readmission rates.

This is just one real-world example that Horizon Homecare customers enjoy sharing with each other annually to illustrate how their use of the system can improve processes within their agencies and for their patients.

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