Continuity in home health care: is consistency in nursing personnel associated with better patient outcomes?

A growing body of evidence suggests that patients who receive coordinated and uninterrupted health care services have better outcomes, more efficient resource utilization, and lower costs of health care. However, limited research has considered whether attributes of continuity in home health care service delivery are associated with improved patient outcomes. The present study examines the relationship between one dimension of continuity of care, consistency in nursing personnel, and three patient outcomes: hospitalization, emergent care, and improvement in activities of daily living.

Implementing a transitional care program for high-risk heart failure patients: findings from a community-based partnership between a certified home healthcare agency and regional hospital.

Provisions within the recently passed health reform law provide support for new approaches to reducing the high cost of care for clinically complex patients. This article describes the characteristics of a recent transitional care pilot initiative that aims to reduce hospital readmissions among high-risk heart failure patients. The program was designed and implemented through a joint collaboration between a Certified Home Healthcare Agency and regional hospital.

Evidence-based practice improvement: merging 2 paradigms.

This article presents a new model, Evidence-Based Practice Improvement, for improving patient care. The model merges 2 extant paradigms currently used for quality improvement initiatives-evidence-based practice and practice or performance improvement. The literature expounds on the virtues of each of these approaches, yet no authors have moved beyond parallel play between them.

The linkage between employee and patient satisfaction in home healthcare.

Greater accountability for patient outcomes, reduced reimbursement, and a protracted nursing shortage have made employee and patient satisfaction results central performance metrics and strategic imperatives in healthcare. Key questions are whether the two interact and if so, how can that relationship be leveraged to obtain maximum gains in both employee and patient satisfaction. This article examines the experience of a large, nonprofit home care agency in exploring these issues.

Spreading improvement strategies within a large home healthcare organization.

This article describes the process of the spread of improvement strategies to improve relationships between professional and paraprofessional service providers within a large home healthcare organization and its partnering home health aide vendors. We describe the method for spreading the strategies, which emerged from a learning collaborative, and the successes and challenges of the spread. Two case studies highlight how the attributes of innovations and the methods for spreading them can influence the effectiveness of an improvement effort.

Building bridges in academic nursing and health care practice settings.

The purpose of this article is to describe the development and implementation of a shared position with a focus on evidence-based practice (EBP) between the Visiting Nurse Service of New York and the Lienhard School of Nursing, Pace University. A preexisting relationship between the two institutions in providing student experiences in a community setting paved the way for the evolution a new collaborative effort. The shared position was initially conceived by two of the authors as an outcome of research they were conducting in the home care setting, which tested a model of mentoring frontline nurses in the EBP process on health care professional and patient outcomes.

FAMILY CAREGIVERS: caring for older adults, working with their families.

As the U.S. population ages and health care costs soar, family and friends are called upon increasingly to provide care.

Home care nursing for older adults: state of the science.

This article describes the state of the science of home care nursing for older adults and its implications for clinical practice. Selected peer-reviewed research articles published since 1990 were reviewed and categorized into five broad areas: nursing classification studies, critical transitions in the illness trajectory, family education and support, specific conditions prevalent in home care, and population diversity. The science of home care nursing has progressed considerably since 1990 with increasing sophistication of research conceptualization and design and increasing numbers of studies published.