Technology Innovations for Better Fall Risk Management in Home Care

2018 ◽  
Vol 44 (7) ◽  
pp. 15-20
Author(s):  
Güneş Koru ◽  
Dari Alhuwail ◽  
Onimi Jademi ◽  
Uchenna Uchidiuno ◽  
Robert J. Rosati
Keyword(s):  
Risk Management ◽  
Home Care ◽  
Fall Risk ◽  
Technology Innovations

scholarly journals How Can Home Care Patients and Their Caregivers Better Manage Fall Risks by Leveraging Information Technology?

2016 ◽  
Vol 3 (4) ◽  
pp. 137-144 ◽  
Author(s):  
Dari Alhuwail ◽  
Güneş Koru ◽  
Eun-Shim Nahm
Keyword(s):  
Information Technology ◽  
Risk Management ◽  
Home Care ◽  
Fall Risk ◽  
Single Case ◽  
Health Agency ◽  
The United States ◽  
Health It ◽  
Physician Practices ◽  
Fall Risks

Objectives: From the perspectives of home care patients and caregivers, this study aimed to (a) identify the challenges for better fall-risk management during home care episodes and (b) explore the opportunities for them to leverage health information technology (IT) solutions to improve fall-risk management during home care episodes. Methods: Twelve in-depth semistructured interviews with the patients and caregivers were conducted within a descriptive single case study design in 1 home health agency (HHA) in the mid-Atlantic region of the United States. Results: Patients and caregivers faced challenges to manage fall risks such as unmanaged expectations, deteriorating cognitive abilities, and poor care coordination between the HHA and physician practices. Opportunities to leverage health IT solutions included patient portals, telehealth, and medication reminder apps on smartphones. Conclusion: Effectively leveraging health IT could further empower patients and caregivers to reduce fall risks by acquiring the necessary information and following clinical advice and recommendations. The HHAs could improve the quality of care by adopting IT solutions that show more promise of improving the experiences of patients and caregivers in fall-risk management.

scholarly journals Identifying Home Care Clinicians’ Information Needs for Managing Fall Risks

2016 ◽  
Vol 07 (02) ◽  
pp. 211-226 ◽  
Author(s):  
Dari Alhuwail ◽  
Güneş Koru
Keyword(s):  
Risk Management ◽  
Home Care ◽  
Fall Risk ◽  
Information Needs ◽  
Weight Bearing ◽  
Home Health ◽  
Health It ◽  
Essential Information ◽  
Management Interventions ◽  
Fall Risks

SummaryTo help manage the risk of falls in home care, this study aimed to (i) identify home care clinicians’ information needs and how they manage missing or inaccurate data, (ii) identify problems that impact effectiveness and efficiency associated with retaining, exchanging, or processing information about fall risks in existing workflows and currently adopted health information technology (IT) solutions, and (iii) offer informatics-based recommendations to improve fall risk management interventions.A case study was carried out in a single not-for-profit suburban Medicare-certified home health agency with three branches. Qualitative data were collected over a six month period through observations, semi-structured interviews, and focus groups. The Framework method was used for analysis. Maximum variation sampling was adopted to recruit a diverse sample of clinicians.Overall, the information needs for fall risk management were categorized into physiological, care delivery, educational, social, environmental, and administrative domains. Examples include a brief fall-related patient history, weight-bearing status, medications that affect balance, availability of caregivers at home, and the influence of patients’ cultures on fall management interventions. The unavailability and inaccuracy of critical information related to fall risks can delay necessary therapeutic services aimed at reducing patients’ risk for falling and thereby jeopardizing their safety. Currently adopted IT solutions did not adequately accommodate data related to fall risk management.The results highlight the essential information for fall risk management in home care. Home care workflows and health IT solutions must effectively and efficiently retain, exchange, and process information necessary for fall risk management. Interoperability and integration of the various health IT solutions to make data sharing accessible to all clinicians is critical for fall risk management. Findings from this study can help home health agencies better understand their information needs to manage fall risks.

scholarly journals Examining Fall Recurrence Risk of Homebound Hispanic Older Adults Receiving Home Care Services

2017 ◽  
Vol 15 (1) ◽  
pp. 20-26
Author(s):  
Guillermina R. Solis ◽  
Jane Dimmitt Champion
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Home Health Care ◽  
Fall Risk ◽  
Health Care Services ◽  
Home Care Services ◽  
Recurrence Risk ◽  
The United States ◽  
Care Services ◽  
Risk Of Fall

Introduction: Unintentional falls and injuries is a major problem among older adults and the fourth cause of death in the United States. A previous fall event doubles the risk of recurrence and lessens the person’s quality of life. Hispanic older adults have higher rates of disability and lower independent functioning due to poor medical health and risk for fall recurrence. Most fall studies focus on fall risk with few studies on fall recurrence in older adults receiving home health care services unrelated to fall incident. Method: A descriptive pilot study of 30 homebound Hispanic older adults receiving home care services who reported a fall within 3 months was conducted by a multidisciplinary team to evaluate risk of fall recurrence. Results: A heightened risk for fall recurrence was identified with high number of chronic illnesses, high intake of medications, vision problems, and prevalence of urinary incontinence. Conclusion: Findings highlight significant number of intrinsic factors for fall risk recurrence and injuries in a Hispanic older adults population that is homebound and receiving home care services. A multidisciplinary evaluation and culturally appropriate interventions to lessen the risk of fall recurrence are recommended.

scholarly journals Assess the Performance and Cost-Effectiveness of LACE and HOSPITAL Re-Admission Prediction Models as a Risk Management Tool for Home Care Patients: An Evaluation Study of a Medical Center Affiliated Home Care Unit in Taiwan

2020 ◽  
Vol 17 (3) ◽  
pp. 927
Author(s):  
Mei-Chin Su ◽  
Yi-Jen Wang ◽  
Tzeng-Ji Chen ◽  
Shiao-Hui Chiu ◽  
Hsiao-Ting Chang ◽  
...  
Keyword(s):  
Risk Management ◽  
Cost Effectiveness ◽  
Home Care ◽  
Readmission Rate ◽  
Prediction Models ◽  
Medical Center ◽  
Management Tool ◽  
Receiver Operating Curve ◽  
Limited Information ◽  
Net Reclassification Improvement

The LACE index and HOSPITAL score models are the two most commonly used prediction models identifying patients at high risk of readmission with limited information for home care patients. This study compares the effectiveness of these two models in predicting 30-day readmission following acute hospitalization of such patients in Taiwan. A cohort of 57 home care patients were enrolled and followed-up for one year. We compared calibration, discrimination (area under the receiver operating curve, AUC), and net reclassification improvement (NRI) to identify patients at risk of 30-day readmission for both models. Moreover, the cost-effectiveness of the models was evaluated using microsimulation analysis. A total of 22 readmissions occurred after 87 acute hospitalizations during the study period (readmission rate = 25.2%). While the LACE score had poor discrimination (AUC = 0.598, 95% confidence interval (CI) = 0.488–0.702), the HOSPITAL score achieved helpful discrimination (AUC = 0.691, 95% CI = 0.582–0.785). Moreover, the HOSPITAL score had improved the risk prediction in 38.3% of the patients, compared with the LACE index (NRI = 0.383, 95% CI = 0.068–0.697, p = 0.017). Both prediction models effectively reduced readmission rates compared to an attending physician’s model (readmission rate reduction: LACE, 39.2%; HOSPITAL, 43.4%; physician, 10.1%; p < 0.001). The HOSPITAL score provides a better prediction of readmission and has potential as a risk management tool for home care patients.

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