Forward-thinking home care organizations are boosting outcomes and reducing readmissions by creating programs specifically for certain conditions, such as chronic obstructive pulmonary disease (COPD).
One hospital-owned home care organization, Blessing Home Care, has even reported cutting its COPD readmission rate by 50% in one month.
The biggest component of the COPD program at another agency—VNA Healthtrends—is patient education, Teresa Fitzgerald, executive director of product development, tells Home Health Care News.
VNA Healthtrends is a Chicago-based home health agency that currently has operations in Illinois, Indiana, Michigan, Ohio and Arizona.
COPD patients do not always know or understand the root cause for their condition, or for associated flare-ups, according to Fitzgerald. Perhaps a specific household product is triggering an outbreak, but the patient continues to use it, resulting in hospital visits. Once the product or ingredient is identified, though, certain health scares—and hospital readmissions—can be avoided.
VNA Healthtrends also makes sure to evaluate a COPD patient’s level of health literacy as part of the program. The COPD patients in the agency’s care may have all of the necessary equipment to help manage their condition, but they are using it incorrectly, unbeknownst to themselves and to VNA Healthtrends. The agency’s staff members work to ensure their patients know how to use equipment and medication properly and effectively.
“It’s amazing how many people are not using their inhaler correctly,” Fitzgerald said.
Another major aspect of VNA Healthtrends’ COPD program is communication among providers. The agency holds multidisciplinary conference calls once a week on high-risk cases. The rationale, according to Fitzgerald, is that doing so allows everyone to be on the same page, “doing the best they possibly can.”
“All of us providers have to communicate,” Fitzgerald said.
Blessing Home Care, an organization run by Blessing Hospital in Quincy, Illinois, has embraced the element of communication in its COPD program for patients in West-Central Illinois and Northeast Missouri, local newspaper the Herald-Whig reported.
As part of its program, caregivers work with COPD patients to complete a daily self-assessment during the first 30 days of their home care. Blessing Home Care staff members call COPD patients by phone and they complete the self-assessment together. The results are then entered into the Blessing Home Care computer system for trending and tracking, the Herald-Whig reported.
The self-assessment, which is designed to take only around five minutes to complete, asks if the patient is coughing more than usual, if he or she is experiencing more shortness of breath than usual, if his or her sleep is being impacted by their COPD, for a description of their energy level, whether there is chest tightness or discomfort, and whether activities are being restricted by breathing issues.
“This daily process allows a patient to develop self-management techniques,” Hilgenbrinck told the Herald-Whig. “They grow in awareness of their condition, allowing them to pick up signs of a problem sooner and increasing the likelihood they can avoid hospitalization.”
Blessing Home Care also developed a 50-page COPD patient education booklet that caregivers review with COPD patients to educate them about their condition.
The COPD program began in October. During that first month, Blessing Home Care slashed its COPD readmission rate in half to 11%.
While these results are dramatic, VNA Healthtrends Chief Operations Officer Annette Heneghan told HHCN it is important to remember that minor changes can be meaningful.
“Baby steps are steps, and I think sometimes people forget that,” Heneghan said.
Written by Mary Kate Nelson