Q&A: Expert Insight into Home Health Staff Challenges

Interlace Health has been providing digital workflows and forms automation in healthcare for over 30 years. We want to continue to support clinicians in putting People over Paperwork, even as we see health care move outside the walls of a hospital and into the home. Our eSignature for Home Health solution was created to help make the administrative workflows for home health clinicians less cumbersome. We asked our resident home health & hospice expert, Nena Franco Baptiste to share her insight into these challenges. She came to us with 17 years’ experience in home health and hospice and now works as a project manager here at Interlace Health where she works to ensure the solutions are successfully implemented & managed for our customers.

 

What were the most common staff struggles that you saw in home health during your tenure at an agency?

They say you never really know the struggles of someone else until you walk a mile in their shoes. And that is how I uncovered the struggles that clinicians face in home health & hospice, even after I had been working in the industry for many years. That experience came for me when my father was discharged after critical surgery, and we had home care come into our personal space and into our family’s lives to help take care of him. That’s when it really hit me that the field staff are a crucial part of the healthcare journey for patients and family. They manage so much in a single day, and I saw it in a new light. Here are just a few of their daily challenges:

-Juggling their daily caseload

-Managing all the paperwork

-Traveling from each patient to the next, and often back to the office

-Fielding questions from family members

-Serving as a voice between the physician and the patient or family

-Documenting clinical care so the home-based experience is as seamless as the hospital

-Ensuring medical records has what they need to submit billing

-Providing patients with the clinical care they need

 

 

What are some of the impacts you saw specifically related to a paper-based forms process?  

There are 5 main challenges that I saw related to paper-based form processes during my time in home health:

1. A lack of consistency in care & process due to high staff turnover.

Staff retention is an ongoing issue in home health, and the abrupt changes that occur when you have staff with physical paperwork and medical equipment in hand when they resign, can impact several people and slow down the entire process.

2. Juggling multiple patient appointment types in a day.

Staff could have two admissions visits, a 60-day check-in and a rehospitalization visit all on the same day. Treating patients, calming & educating family members, ensuring all paperwork is completed and documenting care are just a few of the to-dos. Having to drive back to the office to scan in all the paperwork after a day like that is a sure cause of burnout.

3. Power of attorney isn’t home.

Maybe the POA couldn’t get off work, the visit was rescheduled, or they are traveling out of state on the day of the visit. Now staff and family are coordinating how to communicate about the appointment, get the forms signed and sent back in a reasonable amount of time.

4. Multiple language needs.

Staff may not have been informed in advance that the patient or family members don’t speak English, and they may not have access to translation services on the spot. Being confined to only the printed forms they have on hand causes patient frustration, staff frustration and delays in care and billing.

5. Mountains of paper for medical records.

Medical records staff are the recipients of these mountains of paper forms that need to be reviewed and filed away. This takes a considerable amount of their time and there is much room for human error.

6. The pre-survey scramble.

Preparing for a JCAHO survey, a CHAP survey, or Medicare survey is a time-consuming endeavor. Everything needs to be perfect and where it is supposed to be, and staff scrambling to ensure this is the case when paperwork is involved are facing an uphill battle.  There will always be that one paper form that gets lost or has a coffee stain on it and it’s hard to read, or it didn’t come through the fax machine. It can be frustrating to experience delays in sending your RAPs into Medicare because you don’t have all your documentation together. I remember preparing for our CHAP survey once and one of the clinicians literally just came in and dumped a huge pile of paperwork out of her bag, with little time to spare. It was a huge mess of paperwork, and it took a few of us half an hour to sort through it all and get organized. It was a race to the finish line that time for sure.

 

 

What are some of the solutions that helped staff the most to juggle these challenges?

The agency I worked for served six different counties so staff could often expect to drive 40+ miles to see one patient, and their daily caseloads were very heavy. Our primary goal was to maintain continuity of care from the hospital or physicians’ office at home and encouraged our staff to build a trusting relationship with the patients and their families. However, with so much to manage in a day, there were many struggles such as late paperwork coming back to the office or staff running out of medical supplies.  The agency tried to make things easier for staff by setting up satellite offices where field clinicians would have a place to get online, pick up paperwork and medical supplies and touchdown to do clinical documentation. However, those were expensive to maintain and had to close due to budget cuts.

The next initiative we implemented to help clinicians manage their days and to improve employee satisfaction was an internal communication channel. This system allowed staff to submit requests for blank forms that we could send out to their homes, or medical supplies we would ship directly to the patient’s home. The goal was to save them a trip to the office and reduce their daily driving time. We hoped it would let staff feel like we were there “taking care” of them while they were out taking care of patients. Those may seem like very small changes, but when staff are overwhelmed, they can have a substantial impact on patient care, staff burnout and care quality. Our staff had a little extra time in their day to focus on patient care and it made a big difference.

But one of the biggest improvements I saw came from digitizing as much of the paper process as was possible. Having a fully electronic consenting process removed the possibility of errors and missing forms. This cut down on staff time, patient frustration, billing delays, survey concerns and expenses. It is a small change, but it makes a big difference.

People Over Paperwork

A small change that makes a big difference. That is a pillar of what People Over Paperwork means to us here at Interlace Health and why we are dedicated to ensuring our solutions are making a difference for all our customers. Book a customized demo for your agency.

Watch how Interlace and others are using technology innovations to enhance home-based care.

 

 

ABOUT THE AUTHOR:

Dessiree Paoli, Director of Product Marketing & Strategy at Interlace Health

Dessiree Paoli is the Director of Product Marketing & Strategy at Interlace Health, a company that transforms workflows by providing clinicians and patients with digital healthcare solutions. She has more than 20 years of experience in driving strategic marketing initiatives, leading teams, and developing integrated campaigns, and she has worked in healthcare for more than 14 years. Connect with Dessiree on LinkedIn. 

 

 

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