"Homecare is the most cost effective way to give care," says Joyce Korzen, RN, MS, FACHE senior vice president of joint venture operations at LHC Group., LHC Group works with nurses, therapists and aides to ensure quality care is provided through local hospital and healthcare agencies The nurses, aides and therapists deliver non-emergency medical care to homebound patients. "Homecare reinforces the plan of care for a patient as well as provides medication management, weight management, blood pressure services, dietary instruction and education on self-management." Ms. Korzen offers the following four best practices for ACO homecare nurses.
1. Home medicine regiment. When patients leave the hospital, they often take a wide variety of medications with them. Each different medication has separate instructions about how many doses to take as well as specific times and days to take them. For many patients, especially older adults, the instructions can become confusing. "A lot of the time patients wind up back in the hospital because they don't understand how to take their medication," says Ms. Korzen. To combat this, the homecare nurse can bring different colored bags to the patient's house. In one bag, the nurse places pills the patient should take that day while the other bag should hold the unneeded medication.
2. Educate patients on self-assessment skills. As part of patient education, homecare nurses should be able to work with patients on identifying side effects of their medication. Some side effects, such as minimal shortness of breath, are not medical emergencies. If patients can tell the difference between side effects and health problems, they can prevent potential readmissions. "A lot of times patients decide to go to the emergency room if they experience side effects," says Ms. Korzen. "Before they go, we encourage them to call the homecare nurse. The nurse can assess whether they need to go or whether they can do something else."
3. Teach-back patient education. When patients return home, they should understand how to manage their treatment in order to continue improving their health. Just providing patients written or verbal instructions does not ensure they understand how to take care of themselves. Ms. Korzen says having the patients "teach-back" the treatment methods to the physician or homecare nurse helps them remember and gain confidence in their treatment. "We often think we educate the patient by talking at them, but we know today the best education is to have the patient teach their treatment back to us," says Ms. Korzen. "When patients go home, they get a whole discharge package from the hospital. That's a lot of information. We make sure all that information is understandable by the patients. If they have questions, we can answer them."
4. Front-load visits to at-risk patients. If a physician pegs his or her patient as at high-risk for readmission, the homecare nurse should increase the frequency of visits to that patient immediately after he or she returns home. If the homecare nurse front-loads visits to at-risk patients, the nurse is more available to answer the patient's questions and provide additional medication and treatment education support for a patient that may otherwise have quickly returned to the hospital for support.
In addition to the extra visits, the homecare nurses increase phone contact with these patients. "If the physician thinks they have a patient that is not doing well at home, we are able to step in and prevent a hospital admission," says Ms. Korzen.
Learn more about LHC Group.
Read other information about ACOs.
- 11 Things to Know About Accountable Care Organizations
- To Run ACOs, Hospitals Need to Change Their Business Model
- What Makes or Breaks a Successful ACO: Q&A With Dartmouth Brookings Pilot Participant Monarch Healthcare’s COO Ray Chicoine
1. Home medicine regiment. When patients leave the hospital, they often take a wide variety of medications with them. Each different medication has separate instructions about how many doses to take as well as specific times and days to take them. For many patients, especially older adults, the instructions can become confusing. "A lot of the time patients wind up back in the hospital because they don't understand how to take their medication," says Ms. Korzen. To combat this, the homecare nurse can bring different colored bags to the patient's house. In one bag, the nurse places pills the patient should take that day while the other bag should hold the unneeded medication.
2. Educate patients on self-assessment skills. As part of patient education, homecare nurses should be able to work with patients on identifying side effects of their medication. Some side effects, such as minimal shortness of breath, are not medical emergencies. If patients can tell the difference between side effects and health problems, they can prevent potential readmissions. "A lot of times patients decide to go to the emergency room if they experience side effects," says Ms. Korzen. "Before they go, we encourage them to call the homecare nurse. The nurse can assess whether they need to go or whether they can do something else."
3. Teach-back patient education. When patients return home, they should understand how to manage their treatment in order to continue improving their health. Just providing patients written or verbal instructions does not ensure they understand how to take care of themselves. Ms. Korzen says having the patients "teach-back" the treatment methods to the physician or homecare nurse helps them remember and gain confidence in their treatment. "We often think we educate the patient by talking at them, but we know today the best education is to have the patient teach their treatment back to us," says Ms. Korzen. "When patients go home, they get a whole discharge package from the hospital. That's a lot of information. We make sure all that information is understandable by the patients. If they have questions, we can answer them."
4. Front-load visits to at-risk patients. If a physician pegs his or her patient as at high-risk for readmission, the homecare nurse should increase the frequency of visits to that patient immediately after he or she returns home. If the homecare nurse front-loads visits to at-risk patients, the nurse is more available to answer the patient's questions and provide additional medication and treatment education support for a patient that may otherwise have quickly returned to the hospital for support.
In addition to the extra visits, the homecare nurses increase phone contact with these patients. "If the physician thinks they have a patient that is not doing well at home, we are able to step in and prevent a hospital admission," says Ms. Korzen.
Learn more about LHC Group.
Read other information about ACOs.
- 11 Things to Know About Accountable Care Organizations
- To Run ACOs, Hospitals Need to Change Their Business Model
- What Makes or Breaks a Successful ACO: Q&A With Dartmouth Brookings Pilot Participant Monarch Healthcare’s COO Ray Chicoine