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 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.

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 Integrating medication risk management interventions into regular automated dose dispensing service of older home care clients – a systems approach

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Heidi Tahvanainen ◽  
Sini Kuitunen ◽  
Anna-Riia Holmström ◽  
Marja Airaksinen
Keyword(s):  
Risk Management ◽  
Home Care ◽  
Medication Reconciliation ◽  
Systems Approach ◽  
Medication Management ◽  
Care Team ◽  
Management Process ◽  
Management Interventions ◽  
Medication Risk

Abstract Background Automated dose dispensing (ADD) services have been implemented in many health care systems internationally. However, the ADD service itself is a logistic process that requires integration with medication risk management interventions to ensure safe and appropriate medication use. National policies and regulations guiding ADD in Finland have recommended medication reconciliation, review, and follow-up for suitable risk management interventions. This implementation study aimed to develop a medication management process integrating these recommended risk management interventions into a regular ADD service for older home care clients. Methods This study applied an action research method and was carried out in a home care setting, part of primary care in the City of Lahti, Finland. The systems-approach to risk management was applied as a theoretical framework. Results The outcome of the systems-based development process was a comprehensive medication management procedure. The medication risk management interventions of medication reconciliation, review and follow-up were integrated into the medication management process while implementing the ADD service. The tasks and responsibilities of each health care professional involved in the care team became more explicitly defined, and available resources were utilized more effectively. In particular, the hospital pharmacists became members of the care team where collaboration between physicians, pharmacists, and nurses shifted from parallel working towards close collaboration. More efforts are needed to integrate community pharmacists into the care team. Conclusion The transition to the ADD service allows implementation of the effective medication risk management interventions within regular home care practice. These systemic defenses should be considered when national ADD guidelines are implemented locally. The same applies to situations in which public home care organizations responsible for services e.g., municipalities, purchase ADD services from private service providers.

scholarly journals Student-Led Fall Prevention Care Management Reduced Fall Risks at Assisted Living Facilities

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 238-238
Author(s):  
Hiroko Kiyoshi-Teo ◽  
Claire McKinley-Yoder ◽  
Erin Lemon ◽  
Olivia Ochoa
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Fall Prevention ◽  
Fall Risk ◽  
Care Management ◽  
Assisted Living Facilities ◽  
Care Needs ◽  
Term Care ◽  
Fall Risks ◽  
The Impact

Abstract Older adults in residential care settings are four times more likely than those not living in care facilities to experience falls. Yet, fall prevention efforts at long-term care settings are under-resourced, under-regulated, and under-studied. To address this gap, we developed and studied the impact of a specialty clinical, Fall Prevention Care Management (FPCM), for nursing students to decrease older adults’ fall risks. We enrolled assisted living residents that facility liaison identified as being high fall risk (fall rates or fall risk were not tracked at the study sites) and MOCA ≥15, in 2 assisted living facilities in Northwest USA. Participants received weekly, 1-hour, individual, semi-structured, Motivational Interviewing-based care management visits by same students over 6 visits. Changes in fall risks were measured by the CDC STEADI assessment (unsteadiness & worry), Falls Self-Efficacy Scale International-Short (FESI-S), and Falls Behavioral Scale (FAB). Twenty-five residents completed the study. Students addressed the following (multiple responses possible): emotional needs (n=23), improved motivation to prevent falls (n=21), and individualized education/coaching (i.e., exercise, mobility aids) (n=10-17). FESI-S score improved from 16.0 to 14.4 (p=.001; decreased fear. FAB score improved from 2.94 to 3.10 (p=.05; more frequent fall prevention behaviors). Frequency of those who felt steady while standing or walking increased (24% to 40%, p=.07) and those who did not worry about falling increased (20% to 36%, p=.08). FPCM clinical offered valuable opportunity to address unmet care needs of older adults to reduce fall risks.

scholarly journals Pre-Existing Inequality: The Impact of COVID-19 on Medicare Home Health Beneficiaries

2021 ◽  
Vol 33 (2) ◽  
pp. 130-136
Author(s):  
William Cabin
Keyword(s):  
Mental Health ◽  
New York ◽  
Home Care ◽  
Population Based ◽  
Home Health ◽  
Physical And Mental Health ◽  
Convenience Sample ◽  
Medicare Population ◽  
Home Health Agencies ◽  
The Impact

There is significant data on the adverse impact of COVID-19 on persons who were poor, minorities, had compromised physical or mental health, or other vulnerabilities prior to the COVID-19 pandemic. A significant portion of the overall Medicare population has such vulnerabilities. The Medicare home health beneficiary population is even more vulnerable than the overall Medicare population based on gender, race, income level, living alone status, and number of chronic conditions. A literature review indicates there is only 1 study on the impact of COVID-19 in Medicare home health on home care workers and none on the impact on home health beneficiaries. The current study is a qualitative study based on interviews of a convenience sample of 48 home care nurses from 9 different home health agencies in New York City between April 1 and August 31, 2020. Six major themes emerged: need for social service supports increased; loneliness and depression increased among patients; physical and mental health conditions became exacerbated; substance use and abuse increased; evidence of domestic violence against patients increased; and there was a limited amount of staff and equipment to care for patients.

Telehealth and Risk Management in Home Health

2003 ◽  
Vol 21 (10) ◽  
pp. 699-701 ◽  
Author(s):  
ELIZABETH E. HOGUE
Keyword(s):  
Risk Management ◽  
Home Health

Ethical Aspects of Pediatric Home Care

PEDIATRICS ◽  
1992 ◽  
Vol 89 (5) ◽  
pp. 920-924
Author(s):  
John D. Lantos ◽  
Arthur F. Kohrman
Keyword(s):  
Health Care ◽  
Home Care ◽  
Home Health Care ◽  
Ethical Issues ◽  
Home Health ◽  
Critically Ill Children ◽  
Traditional Health ◽  
Advanced Medical Technology ◽  
Economic Forces ◽  
Traditional Health Care

This essay is a discussion of ethical issues that arise in the provision of home health care to technology-dependent children. Different ethical norms, especially with regard to the degree of professional responsibility for outcomes, traditionally have applied to home care and hospital care. In particular, parents generally are expected to do their best, but are not expected to have the same specialized knowledge of risks and benefits with regard to particular interventions as health professionals. When home health care involves the use of advanced medical technology, it strains traditional conceptions of parental responsibilities to care for the health of their children at home. It can also strain traditional concepts of professional responsibilities to care for critically ill children in hospitals. We discuss some of the tensions that arise as medical, psychological, and economic forces lead to the increasing use of high technology in the care of children outside of traditional health care institutions.

Sign in / Sign up

Export Citation Format

Share Document