The Importance of Providing Training to Informal Caregivers of Hospice Patients: Caregiver Experience With Hospice Care Based on Consumer Assessment of Healthcare Providers & Systems Surveys.

Background: Informal caregivers aid hospice patients at the end of life. Little is known of their preparation and confidence in providing care, and how this relates to experiences of hospice care.

Objective: Examine factors associated with informal caregivers' rating of home hospice care.

Training Opportunities for Managers in Home Health, Hospice, and Community-Based Care Settings.

Objective: The aim of this study was to identify areas for developing management skills-focused continuing education for managers working in home health, hospice, and community-based settings.

Background: Healthcare managers play a vital role in organizations, yet they have a range of management training.

Methods: Researchers conducted a cross-sectional survey of managers at a large Visiting Nurse Association.

"The Crossover to Hospice": Perspectives of Home Healthcare Nurses and Social Workers.

Background: Although home healthcare(HHC) clinicians increasingly provide care to a homebound population with advanced illness and high symptom burden,  we know little about how HHC clinicians navigate discussions about hospice with patients and families in this setting.

Objective: We sought to explore perspectives on transition from HHC to hospice among HHC nurses and social workers.

Design: PQualitative study using semi-structured interviews and thematic analysis.

Early versus late COVID-19 Home Health Care patient population: Shifting sociodemographics and comparable outcomes.

Early in the pandemic when hospitals reached capacity, Home Health Care (HHC) became a critical source of care for COVID-19 patients and continues to be an important source of care for recovering COVID-19 patients. Little is known about the COVID-19 patient population treated in HHC. This retrospective observational cohort follows 1614 HHC patients with a COVID-19 diagnosis and compares an "Early Cohort" between March 31 and May 31, 2020 to a "Late Cohort" between June 1 and December 31, 2020 for differences in: (1) sociodemographic and clinical characteristics (2) health care utilization, and (3) outcomes.

Experiences of Black and Latinx health care workers in support roles during the COVID-19 pandemic: A qualitative study.

Black and Latinx individuals, and in particular women, comprise an essential health care workforce often serving in support roles such as nursing assistants and dietary service staff. Compared to physicians and nurses, they are underpaid and potentially undervalued, yet play a critical role in health systems. This study examined the impact of the coronavirus disease 2019 (COVID-19) pandemic from the perspective of Black and Latinx health care workers in support roles (referred to here as HCWs).

Description, Health Care Utilization, and Outcomes for Home Health Care (HHC) COVID-19 Patients Early in the Pandemic: A Comparison to the General HHC Population.

COVID-19 patients represent a new and distinct population in home health care. Little is known about health care utilization and incremental improvements in health for recovering COVID-19 patients after admission to home health care. Using a retrospective observational cohort study of 5452 episodes of home health care admitted to a New Jersey Home Health Agency between March 15 and May 31, 2020, this study describes COVID-19 Home Health Care (HHC) patients ( = 842) and compare them to the general HHC population ( = 4610).

COVID-19 infection rates early in the pandemic among full time clinicians in a home health care and hospice organization.

Background: Patient-facing health care workers (HCW) experience higher rates of COVID-19 infection, particularly at the start of the COVID-19 pandemic. However, rates of COVID-19 among front-line home health and hospice clinicians are relatively unknown.

Methods: Visit data from a home health care and hospice agency in New Jersey early in the pandemic was analyzed to examine COVID-19 infection rates separately for clinicians exposed to COVID-19-contagious patients, and those without exposure to known COVID-19 contagious patients.

Factors for compliance with infection control practices in home healthcare: findings from a survey of nurses' knowledge and attitudes toward infection control.

Background: Infection is a leading cause of hospitalization among home healthcare patients. Nurses play an important role in reducing infection among home healthcare patients by complying with infection control procedures. However, few studies have examined the compliance of home healthcare nurses with infection control practices or the range of sociocultural and organizational factors that may be associated with compliance.

Does Level of Numeracy and Graph Literacy Impact Comprehension of Quality Targets? Findings from a Survey of Home Care Nurses.

Clinical dashboards that display targets compared to performance metrics are increasingly used by healthcare organizations in their quality improvement efforts. However, few studies have evaluated the extent to which healthcare professionals can readily understand and interpret these data. This study explored associations between measures of graph literacy and numeracy in home care nurses from two agencies (N=195) with comprehension of quality targets presented in a graphical dashboard format.

Technology Innovations for Better Fall Risk Management in Home Care.

Achieving better fall risk management is an integral component of quality home care. The current qualitative study uncovers the challenges and opportunities of home health agencies (HHAs) in achieving better fall risk management. A secondary document analysis was adopted to learn from rich contextual information in fall incident reports recorded in a HHA.

The impact of home care nurses' numeracy and graph literacy on comprehension of visual display information: implications for dashboard design.

Objective: To explore home care nurses' numeracy and graph literacy and their relationship to comprehension of visualized data.

Materials And Methods: A multifactorial experimental design using online survey software. Nurses were recruited from 2 Medicare-certified home health agencies.

The Future of Home Health Care: A Strategic Framework for Optimizing Value.

The Future of Home Health project sought to support transformation of home health and home-based care to meet the needs of patients in the evolving U.S. health care system.

Identifying the key performance improvement domains for home health agencies.

Objective: The objective of this study was to support home health agencies (HHAs) in the United States (US) in their individualized quality assessment and performance improvement (QAPI) initiatives by identifying their key performance improvement domains (KPIDs).

Methods: Qualitative research was conducted by following the Framework method. Rich contextual data were obtained through focus group meetings participated by domain experts.

Medicare home health payment reform may jeopardize access for clinically complex and socially vulnerable patients.

The Affordable Care Act directed Medicare to update its home health prospective payment system to reflect more recent data on costs and use of services-an exercise known as rebasing. As a result, the Centers for Medicare and Medicaid Services will reduce home health payments 3.5 percent per year in the period 2014-17.

Implementation and evaluation of a depression care model for homebound elderly.

Depression affects 14% to 46% of homebound elderly and is costly and disabling. Home health agencies face significant challenges delivering effective depression care. In response, an evidence-based depression care model was developed in a home health agency.

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.

Continuity in the provider of home-based physical therapy services and its implications for outcomes of patients.

Background: A growing body of research suggests that greater continuity of health care is positively associated with improved outcomes of patients. However, few studies have examined this issue in the context of physical therapy.

Objective: The purpose of this study was to evaluate whether the level of continuity in the provider (provider continuity) of physical therapy services was related to outcomes in a population of patients receiving home health care.

Improving functional outcomes in home care patients: impact and challenges of disseminating a quality improvement initiative.

Most older adults are admitted to home health care with some functional impairment related to chronic illness and/or hospitalization. This article describes: (1) the impact of a quality improvement initiative (QI) on functional outcomes of older, chronically ill patients served by a large homecare organization; and (2) key implementation challenges affecting intervention outcomes. Over 6,000 patients were included in two dissemination phases.

Using technology to enhance the quality of home health care: three case studies of health information technology initiatives at the visiting nurse service of New York.

There is a growing recognition among health services researchers and policy makers that Health Information Technology (HIT) has the potential to address challenging issues that face patients and providers of healthcare. The Visiting Nurse Service of New York (VNSNY), a large not-for-profit home healthcare agency, has integrated technology applications into the service delivery model of several programs. Case studies, including the development and implementation, of three informatics initiatives at VNSNY are presented on: (1) Quality Scorecards that utilize process, outcomes, cost, and satisfaction measures to assess performance among clinical staff and programs; (2) a tool to identify patients at risk of being hospitalized, and (3) a predictive model that identifies patients who are eligible for physical rehabilitation services.

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.

The history of quality measurement in home health care.

Quality improvement is as central to home health care as to any other field of health care. With the mandated addition in 2000 of Outcome Assessment and Information Set (OASIS) and outcome-based quality improvement (OBQI), Medicare home health agencies entered a new era of documenting, tracking, and systematically improving quality. OBQI is augmented by the Medicare Quality Improvement Organization (QIO) program, which is now entering the ninth in a series of work assignments, with the tenth scope in the planning stages.