In healthcare delivery sequence, home care services are situated downstream from acute and post-acute care (skilled nursing facilities.)  One of the primary goals of home care is to help patient transition back into home environment.  Nurses, Therapists, Home health aides and other interdisciplinary team members such as Social Workers, Nutritionists work together to coach patient and caregiver to adjust to their "new normal."  This interdisciplinary team also teaches patients and caregivers a very important skill of self-triage - Who to call when (nurse versus a physician or 911.) 

I believe that the value proposition of home health services is not highlighted sufficiently when patients are initially setup with home care services.  

I hypothesize that patients who discontinue home care services within the first week do not fully appreciate the value of home care services.  My advice for healthcare systems and home care agencies is to build...

Multiple studies conducted (referenced below) have found a substantial decrease in the number of non–COVID-19 hospitalizations across a range of diagnoses during the peak COVID-19 period.

The decrease was observed for exacerbations of chronic conditions (heart failure, COPD), acute medical events that typically require inpatient management (myocardial infarction, appendicitis), and injuries.  Most of these studies relied on diagnostic codes, which have imperfect capture of both COVID-19 and other diagnoses.

To summarize the trends observed above, clearly patients with chronic conditions accessed fewer acute care and post discharge services as compared with years prior.  Can we safely conclude that some of acute and post acute care services accessed in years prior could have been excess or unnecessary? 

One of the theory outlined in a study was that due to the COVID pandemic, patients started practicing better infection prevention and...

In the past few blogs, I have talked about clinical management of vulnerable high-risk population in home care.  I want to use the algorithm (see below) as an example to demonstrate the standardized approach.  I suggest home care agencies  use the following operational processes for high-risk patients: 

1.  At start of care, obtain patient specific parameters and orders from the physician (NP, PA) managing patient's home care services
2. Establish baseline vitals, infection status, pain level (comfort function goal,) functional capacity (e.g. use 6 minutes walk test), behavioral status, etc.
3. If/when patient's condition deviates from baseline for the worse, initiate the protocol and go down the decision tree.  

Algorithm below is an example of pneumonia management in field.  If you are a home care agency looking to develop similar processes, 

1. Work with your referring physicians and hospital systems to establish protocols for the specific patient...