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Ankota: Ushering in the Next Generation of Homecare Blog

Ankota's Book of the Year: The Checklist Manifesto

Posted by Ken Accardi on Jan 31, 2011 9:42:00 AM

Before January is over (and yes this is hours away) we wanted to take care of unfinished business for 2010 and one exciting part is to name our book of the year.  The winner for 2010 is The Checklist Manifesto, by Atul Gawande.  Also, the book is now available in paperback for only $9 on amazon.com.

The Checklist Manifesto

Dr. Gawande is a terrific author and storyteller.  He's also able to convey difficult medical topics in a very easy to understand manner.  Home caregivers and nurses have provided better service as a result of checklists but for some reason (maybe egotistical pride) doctors have been less willing to adopt this best practice.  The book makes compelling arguments for why this should change.  One example is the way that Johns Hopkins Medical Center began using checklists in intensive care leading to significant improvement in outcomes (a link to a more detailed story is available below).

Rather than recounting all of the other information and the book, allow me to refer you back to the following previous articles on the Ankota blog:

Before closing, I'd also like to point new readers to Ankota's Book of The Innovator's Prescriptionthe Year for 2009, the Innovator's Prescription.  This fascinating book explains how the US healthcare system evolved and goes on to describe how innovation can transform the industry to provide better care at lower cost.  In my humble opinion, this should be the playbook for implementing health care reform.

Ankota provides software to improve the delivery of care outside the hospital.  Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care.  To learn more, please visit www.ankota.com or contact Ankota 

Topics: Recommended Reading, Elderly Care, Checklists

Need to Educate Home Care Workers about Technologies that Can Help

Posted by Ken Accardi on Jan 27, 2011 7:37:00 AM

Some blog articles take a long time to research and others just Laurie Orlovpop into my inbox.  Today aging in place expert (and my friend) Laurie Orlov shared the news of a study regarding caregivers and technology that I'm now pleased to share with you.  The study was performed by the National Alliance for Caregiving (NAC - not to be confused with NAHC) and was sponsored by United HealthCare.  You can access the study here.

The overall approach to the study was to have "technology-using" non-paid family caregivers evaluate 12 technologies from two angles:

  1. How helpful is the technology
  2. How large are the barriers to adopting the technology

Here's a graph of the results:

useful caregiver technologies

So what can professional caregivers and providers of caregiving technology learn from this?  My thoughts are as follows:

  • Even the technologies that are considered to be the most valuable have boundaries to adoption, so perhaps professional caregivers can differentiate themselves by developing the expertise to get these in place
  • Monitoring technologies, whether telehealth or passive activity monitoring have high barriers (cost, difficulty, fear of bid brother and more).  Again, this might be a case where a professional can help (the classic "I don't trust my son or daughter but I'll listen to a professional)
  • Vendors can benefit by focusing on ease of adoption as a differentiator

As always, please consider this blog article as just an apetizer.  Laurie Orlov has deeper commentary (in her inimitable snarky way) here, and of course you will get a lot more by reading the full study available here.

Ankota provides software to improve the delivery of care outside the hospital.  Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care.  To learn more, please visit www.ankota.com or contact Ankota 

 

 

Topics: Elderly Care, Aging in Place Technology, home care software geek, Home Healthcare Delivery Management

Overcoming Compassion Fatigue is Critical for Home Care Workers

Posted by Ken Accardi on Jan 25, 2011 8:00:00 AM

I've recently read a number of articles about compassion fatigue.  Tired Nurse compassion fatigueIn short, people who focus their lives on caring for others are succeptible to become tired and less compassionate.  Compassion fatigue is also called secondary traumatic stress disorder.  It's a real problem that affects home care workers and other medical professionals including doctors.  There's a lot to learn about compassion fatigue and many sources of information and help.  Click here to google it.

Among the resources available to help, one of the most comprehensive and focused is the Compassion Fatigue Awareness Project has a site here.
Compassion Fatigugue Help Awareness

In reviewing a number of articles with recommendations for overcoming compassion fatigue, here are a few top recommendations:

  1. Recharge your batteries daily: Something as simple as committing to eat better and stopping all other activities while eating can have an exponential benefit on both your psyche and your physical body. A regular exercise regimen can reduce stress, help you achieve outer balance and re-energize you for time with family and friends (click here for source)
  2. Spend plenty of quiet time alone: Learning mindfulness meditation is an excellent way to ground yourself in the moment and keep your thoughts from pulling you in different directions. The ability to reconnect with a spiritual source will also help you achieve inner balance and can produce an almost miraculous turnaround, even when your world seems its blackest.  (click here for source)
  3. Hold one focused, connected and meaningful conversation each day: This will jump start even the most depleted batteries. Time with family and close friends feeds the soul like nothing else and sadly seems to be the first thing to go when time is scarce. (click here for source)
  4. Do the Following (click here for source):  
    • Talk to your doctor or homeopath.
    • Talk to a therapist or pastor.
    • Rest. Eat Right. Participate in moderate exercise.
    • Learn and practice relaxation and/or meditation techniques.
    • Delegate as much of your responsibilities as possible.
    • Take as much time off as possible.

We hope that these suggestions will help you and your caregivers to stay healthy and avoid this debilitating affliction.

Ankota provides software to improve the delivery of care outside the hospital.  Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care.  To learn more, please visit www.ankota.com or contact Ankota 

Topics: Healthy Caregivers, Elderly Care, Home Care Best Practices

Challenges for Home Health Care in 2011

Posted by Ken Accardi on Jan 20, 2011 11:13:00 AM

As a follow up to yesterday's post on the opportunities for home health care in 2011, today we bring you a compilation of challenges for home health care in 2011 from industry expert Stephen Tweed.  This post is reprinted with permission from Home Health Care Today. Copyright 2011 Stephen C. Tweed. To receive a FREE subscription to this newsletter, log on to www.leadinghomecare.com.

 

Challenges for Home Health Care in 2011

by Stephen Tweed

Medicare Reimbursement Cuts
It's no surprise to you that there are cuts coming in MedicareStephen Tweed - Leading Home Care reimbursement beginning in 2011 and continuing for several years. What actions can you take to adapt to these new reimbursement rates?

I was having a conversation with a close friend of mine today who is an expert in the dental industry. He discussed how prices of dental procedures have not gone up in the past ten years, but dentists have increased their personal incomes by being more productive.

We've seen other examples of industries where prices are stable or falling, but companies are able to increase their income through improvements in productivity.

Productivity improvements come from automating and systematizing your business as much as possible. Then, you need to get your people involved in finding ways to make themselves more productive users of their time and talents.

New Physical Therapy Regulations
Changing regulations regarding physical therapy that will affect reimbursement will also affect patient care and staff satisfaction. It has been difficult enough for some agencies to find enough therapists to meet the demand for growth. The new regs will add to that challenge. It means agency leaders need to understand the issues and focus action on addressing these issues.

Face to Face Encounter with Physician
Beginning on April 1, 2011, patients will need to have a face-to-face encounter with their physician up to 90 days before admission to home health, or within 30 days after admission. Most agencies are already working on processes and procedures to document these face to face encounters, and software companies are adding features to help track documentation.

Increasing Competition
In 1997, just before the implementation of the Balanced Budget Act, there were 10,444 Medicare Certified Home Health Agencies. Leading Home Care Newsletter Sign-upThe BBA and the Interim Payment System devastated our industry, and 3,800 agencies went out of business. In 2001, there were 6,681 certified agencies.

At the end of 2009, there were 10,581 home health agencies in business. That's a 58% increase in the number of home health agencies in the past eight years.

Not all of these new agencies were started in your home town. It just feels that way.

There is no doubt that there is much more competition now than there has been since 1997. What are you doing to differentiate your agency from your competitors. Creating competitive advantage in the marketplace is critical in the coming year.

More Sophisticated Sales & Marketing Strategies
In 1997, while there were over 10,400 home health agencies in business, they were not nearly as sophisticated in the areas of sales & marketing. In 2011, you are not only seeing more agencies, but more agencies with more sophisticated sales strategies that are tougher to compete with.

To us, that means there will be a big gap between the growth rates of a few highly successful agencies, and all the rest. Will your agency be among the fast growing agencies, or among "all the others"?

Ankota provides software to improve the delivery of care outside the hospital.  Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care.  To learn more, please visit www.ankota.com or contact Ankota 

Topics: Home Care Industry, Elderly Care, Home Care Best Practices, Health Care Reform

Opportunities for Home Health Care in 2011

Posted by Ken Accardi on Jan 19, 2011 3:40:00 PM

In his first newsletter for 2011, Home health care expert Stephen Tweed shared a compilation of opportunities and challenges for home health care in 2011.  Below we share the opportunities, and tomorrow we'll share the challenges.  This post is reprinted with permission from Home Health Care Today. Copyright 2011 Stephen C. Tweed. To receive a FREE subscription to this newsletter, log on to www.leadinghomecare.com

Opportunities for Home Health Care in 2011

by Stephen Tweed

Increased Public Awareness of Home Health Care
With the aging population, and new laws on health care reform, Stephen Tweed - Leading Home Carethe American public is more aware of home health care than ever in our history. While most consumers still don't totally understand exactly what we do, they at least know that we exist.

That means that more and more consumers will be asking their physicians, discharge planners, and other health care advisers about the availability of home health services. Home health will play a larger role in the conversations between physicians and their patients, and between discharge planners and their patients.
Increased Physician Awareness of Home Health Care
Increased sales efforts by home health agencies, combined with the focus on home and community based care in the Patient Protection and Affordable Care Act (ACA), have provided many physicians with a growing awareness of home health care and the benefits to their patients and to their medical practices.

As physicians become more aware of us, they are more likely to refer patients to home health care if they have a positive experience.


Partnering with Hospitals Around Reducing Re-hospitalizations
The Affordable Care Act (ACA) will have the hospital executives focusing more attention on reducing incidents where patients are readmitted to a hospital with 30 days of discharge. As this provision of the law goes into affect, it will reduce reimbursement for hospitals for patients with heart attack, congestive heart failure, and pneumonia.

It's pretty clear from the data, that home health agencies usingLeading Homecare Newsletter Sign-up telehealth technology can measurably reduce the incidents of patients being re-hospitalized. There's a real opportunity to partner with hospital leadership to implement programs that help patients, help hospitals, help physicians, and help home health.

Preparing for ACOs, IAH, and PCMHs.
Other provisions in the ACA will establish payment mechanisms and demonstration projects to study new methodologies of patient care including Accountable Care Organizations, The Independence At Home project, and Patient Centered Medical Homes.

As more is learned about each of these approaches, we believe there will be exciting new opportunities for home health agencies to partner with other provider groups and facilities to play an important role in the future of health care delivery.

Ankota provides software to improve the delivery of care outside the hospital.  Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care.  To learn more, please visit www.ankota.com or contact Ankota 

Topics: Home Care Industry, Home Care Best Practices, Health Care Reform, transitional care

Home Care Nurses Don't Know Everything...

Posted by Ken Accardi on Jan 13, 2011 9:51:00 AM

One of the services that we provide on the Ankota blog is to share with you some of the interesting writing that we find from others in home care.  We believe that doing this has numerous positive results, as follows: 1) It exposes you to interesting content and good writers who you might be interested in, and 2) to promote social media in home care... Today's blog article comes from Julianne Heydel from Heydel Consulting Services in Baton Rouge Louisianna. 

We Don't Know Everything

by Julianne Heydel 

Here is a list of things that nurses are not taught to any great degree in nursing school:

  1. Business Management
  2. Human Resources and management of people
  3. Quality Assurance
  4. Finances (thank you, God)
  5. Information Technology

Can you run an agency without any of these skills from all of your nurses? What have you done to increase your staff’s proficiency in these areas? If you are a nurse, have you taken any steps to educate yourself in these areas?

Years ago, the CEO of a very large, publicly traded health care company, implemented a policy that all business related books purchased by employees would be reimbursed by the company if the employee wrote a brief synopsis of the book and emailed it to him. I never knew if he was just trying to get around reading the books or if he truly wanted his staff to become well versed in business. Either way, I think it is a great idea. It’s pretty cheap, too unless you have a staff of Evelyn Wood’s speed reading graduates.

Is your education budget limited to OASIS and ICD-9 coding? What about PPS? Do your nurses fully understand how PPS works?

Managing people is difficult for many nurses including myself. We are wired to be compassionate. We tend to be too understanding the fifth time a nurse calls out sick after being seen out dancing by a coworker the night before. Putting systems in place that allow nurses to manage effectively helps them to make information based decisions rather than emotional ones. What systems do you have in place?

There is an entire Quality Assurance Industry out there with amazing publications and websites. In fact, there are studies that show that companies like Toyota and Southwest Airlines who spend the most on Quality Assurance are more successful. But before you can truly implement an effective Quality Assurance Plan, your staff must be educated on the processes. A Quality Assurance Nurse or a consultant cannot complete your Quality Assurance activities single handedly.

Cash and finances are not typically thought of a nursing issue until supply bills are too high or utilization is outside the stratosphere. And yet, when you consider that nurses have homes to run, bills to pay, etc., I think it is insulting to exclude us from financial decisions. We do not need to know how to prepare quarterly statements or cost reports but sharing financial data that is directly affected by nursing practices is a reasonable expectation. Agencies may just find that closer attention is paid to high dollar items and waste.

Finally, I cannot tell you how many times I have been called and asked how to download an attachment or found out that numerous emails I sent were never read because a nurse didn’t read email. When I teach Quality Assurance to a nurse and go to show her how to enter data into a spreadsheet, it is not unusual to find that her computer doesn’t have the software. I ask for reports from Lewis Computers which is used almost exclusively around here and no one seems to know what I am talking about even though I received the same report from a different client using the same System. All of this works for me because I am paid by the hour. The question is, does it work for you?

So, in keeping with the theme of staff development this week, I am encouraging you to develop these skills in your nurses. The organizations that hire any nurse with a license and treat nurses like disposable employees will be short lived as the demands on our industry grown tougher. And the agencies with lower turnover and competent staff will enjoy the challenges ahead.

And of course, if you need help establishing a plan to add to the overall competence in your agency, we are always available to assist by simply calling us at 225-2523-4876.

Haydel Consulting Services

Ankota provides software to improve the delivery of care outside the hospital.  Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care.  To learn more, please visit www.ankota.com or contact Ankota 

Topics: Home Care Best Practices

Managing Home Care in a Snow Emergency

Posted by Ken Accardi on Jan 12, 2011 8:17:00 AM

I'm just bad luck...  Last year around this time I had to cut short a trip with Thomas Jefferson University Hospital in Philadelphia when they shut down the office to manage a Blizzard, and yesterday I had to cut short a set of meetings with Johns Hopkins to get home before a massive snow storm hit the northeast, which it did (after posting this article, I'll go outside and start shovelling the roughly one foot of snow that's fallen so far here in metro-Boston).  So I thought it would be appropriate to share information about managing home care in a snow emergency...

Here are some best practices that we've observed home care organizations follow to manage their operations in the midst of a snow emergency (and some things that Ankota's software does to help):

  • Move Appointments to Avoid the Times when travel is most inhibited: Ankota's scheduling board (screenshot below) shows you all of the planned jobs for the week on a drag and drop interface. so moving jobs forward or back is simple.
  • Make Sure that the jobs with critical timing are dealt with at the appropriate time:  Visits such as "chemo finish" visits for a 48-hour chemo infusion have a very specific time frame for completion.  Ankota's scheduling board let's you know if you've by attempting to move a visit you've violated a scheduling constraint. 
  • Communicate the Changes to the Care-Givers:  Ankota's software changes the visits to a different color when you manually reschedule, allowing you to tell your care workers what changed and what stayed the same.
  • Plan for Two people per car (in the event that it will be impossible to park and one person will need to hover): Although the Ankota software doesn't specifically have a feature for scheduling two people in the same vehicle, we have the ability to change the work shifts easily for the emergency workers and mark the others as unavailable (and to make sure that all of the time sheets come out right).
  • Keep non-essential personnel at home: Ankota's web-based software allows your office staff to operate from their home via their internet connection.
  • Communicate to the Loved-Ones of Your Patients: Ankota's FamilyConnect allows you to send a message out to family members of the people you care for.  By proactively sending a message to all of the families, you can save time for your critical staff.  Also, you can send messages to the families of individual patients/clients using the quick connect feature.  FamilyConnect messages are received by email and/or text message (as selected by the family member)

Below is a screen shot of the Ankota Drag and Drop Schedule Board that allows you to see status and resolve issues at a glance.

Home Care Scheduling Software

We thank you for all you do to provide outstanding home care, even during the thoughest conditions!  If rescheduling was tougher for you than what's described above, please contact us so we can try to help.

Ankota provides software to improve the delivery of care outside the hospital.  Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care.  To learn more, please visit www.ankota.com or contact Ankota 

Topics: Home Care Best Practices, Home Healthcare Delivery Management

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Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Ankota's primary focus is on Care Transitions for Reeadmisison avoidance and on management of Private Duty non-medical home care. To learn more, please visit www.ankota.com or contact Ankota.

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