Helping Older Adults Improve Their Medication Experience (HOME) by Addressing Medication Regimen Complexity in Home Healthcare.

Home Healthc Now

Orla C. Sheehan, MD, PhD, is an Assistant Professor, Division of Geriatric Medicine and Gerontology, Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland. Hadi Kharrazi, MHI, MD, PhD, is an Assistant Professor, Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland. Kimberly J. Carl, RN, is Director, Home Health Services, Johns Hopkins Home Care Group, Baltimore, Maryland. Bruce Leff, MD, is a Professor, Division of Geriatric Medicine and Gerontology, Center for Transformative Geriatric Research, Johns Hopkins University, Baltimore, Maryland. Jennifer L. Wolff, PhD, is a Professor, Health Policy and Management, School of Public Health, Johns Hopkins University, Baltimore, Maryland. David L. Roth, PhD, is a Professor, Center on Aging and Health, Division of Geriatrics and Gerontology, Johns Hopkins University, Baltimore, Maryland. Jennifer Gabbard, MD, is an Assistant Professor, Wake Forest University, Section of Gerontology and Geriatrics, Winston-Salem, North Carolina. Cynthia M. Boyd, MD, MPH, is a Professor, Division of Geriatric Medicine and Gerontology, Center for Transformative Geriatric Research, Johns Hopkins University, Baltimore, Maryland.

Published: August 2018

In skilled home healthcare (SHHC), communication between nurses and physicians is often inadequate for medication reconciliation and needed changes to the medication regimens are rarely made. Fragmentation of electronic health record (EHR) systems, transitions of care, lack of physician-nurse in-person contact, and poor understanding of medications by patients and their families put patients at risk for serious adverse outcomes. The aim of this study was to develop and test the HOME tool, an informatics tool to improve communication about medication regimens, share the insights of home care nurses with physicians, and highlight to physicians and nurses the complexity of medication schedules. We used human computer interaction design and evaluation principles, automated extraction from standardized forms, and modification of existing EHR fields to highlight key medication-related insights that had arisen during the SHHC visit. Separate versions of the tool were developed for physicians/nurses and patients/caregivers. A pilot of the tool was conducted using 20 SHHC encounters. Home care nurses and physicians found the tool useful for communication. Home care nurses were able to implement the HOME tool into their clinical workflow and reported improved communication with physicians about medications. This simple and largely automated tool improves understanding and communication around medications in SHHC.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5761673PMC
http://dx.doi.org/10.1097/NHH.0000000000000632DOI Listing

Publication Analysis

Top Keywords

nurses physicians
12
care nurses
12
medication regimens
8
tool
7
medication
6
communication
5
nurses
5
physicians
5
helping older
4
older adults
4

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!