Nurse burnout has long been a challenge for home health care companies, as care delivery in the home comes with certain expectations and requirements that may not be typical of other care settings. But in many ways, the COVID-19 crisis that began in early 2020 made in-home care even more challenging for nurses and other care providers whose top priority was maintaining safety of patients while ensuring continuity of care.
“In a hospital, the environment is set up to support the clinician. It’s designed for efficiency of the workforce. In the home, the situation is different every day, and the clinician has to constantly conform to a new environment,” says Michael Johnson, practice president, home health for BAYADA Home Health Care, who has worked in both hospital and in-home settings.
This uncertain environment is one stressor that can lead to nurse burnout, he says, along with other factors such as the lack of proximity to colleagues when a question or patient issue arises. Nurses in the home support patients not just physically, but emotionally, and they typically find themselves involved in family and personal dynamics, all while being responsible for documentation of the visit.
“In home health you get the meaningful connection….However [also] when you are in patients’ homes the documentation required is extremely onerous,” Johnson says. “The thing that stresses clinicians is the amount of work that is not directly related to taking care of patients.”
“Our growth is going to depend on our ability to make the experience for clinicians at BAYADA superior to any other place,” Johnson says. “Technology and processes can help us do that. It’s our primary strategic objective as a practice this year because we are really seeing the impact of burnout.”
Johnson identifies three critical factors to reduce nurse burnout in 2021.
The time spent on work not directly related to patient care can be frustrating, particularly in light of the challenges due to lack of support for home health nurses who typically are working independently. And much of the onus is on the nurse when it comes to communicating with family, the primary physician, and other participants in the care process such as DME providers.
“People can be great clinicians, but they may not have the best communication tools available to them,” says Rob Stoltz, VP of business development for Citus Health, a digital care coordination platform serving the in-home care industry. “Many times the nurse leaves the home health visit and has to coordinate with the DME provider. Then a family member calls with a question about equipment. Everyone is making phone calls on a one to one basis, which is inefficient.”
Citus Health offers a platform to facilitate communication between family members, care providers and the patient, enabling real-time updates as they take place. This can be key to preventing the nurse from being the center of patient-related communications and allowing him or her to focus more on patient care.
Easing documentation access
An electronic health record (EHR) is a critical part of any plan of care, as it documents the patient’s journey. Making the information accessible, however, is another way to ease the burden on nurses in the home.
“EHRs are good at collecting data, but not serving it up quickly to provide insights on next steps and communicating easily to colleagues,” Johnson says.
Further, documentation that needs to be signed by physicians to ensure CMS timelines are being met can be difficult to access and deliver in a timely manner.
Technology platforms like Citus Health enable electronic forms and signatures from home health physicians and other parties who need to sign patient-related documents. This can be done wherever they are, rather than having to be in person. It also reduces the burden of the nurse or caregiver who is coordinating those documents in the home.
Citus Health recently released its “App-less” eSignature feature which speeds up the process capturing these critical signatures because it does not require the signer to log into a portal or an app.
Among the key frustrations of home health nurses is the lack of coordination between those involved in the care plan — from physicians to therapists, pharmacists and others. A single hub for the information can reduce the frustration and lead to a better experience for the patient, family, and importantly, the care provider.
“[In the home] you as the nurse primarily serve as the case manager… you are coordinating the home-based care plan with others,” Johnson says. “In the hospital, you could read the [physical therapist’s] note, or the OT’s and run over to the OT department. In the home-based care setting, that person might be on the other side of town. This is definitely a place where technology could make things better in terms of reducing the burden on the clinician.”
A care coordination platform can also save precious time for nurses so they can focus on what matters most — the patient. In turn, this improves the experience for the clinician to serve his or her purpose in providing care. And, when the care coordination platform easily integrates into the organization’s EHR, as the Citus Health platform does, it means any data captured on the platform can be automatically added to the patient record.
It can also serve as a competitive advantage, as in the case of BAYADA home health.
“Health care is a team sport if it’s done well,” Johnson says. “Technology can make sure every player is in the right place at the right time and achieving their full potential.”
This article is sponsored by Citus Health. To learn more about how Citus Health can help your organization improve communication and collaboration to reduce nurse burnout, visit CitusHealth.com.