Abstract

As home health care providers are confronted with a capitated care environment, the challenge for survival is to provide patients chronically ill with heart failure, the least costliest care in a time constrained and cost contained environment without compromise to quality while ensuring decreased use of emergency department visits and rehospitalizations. Specific to home care, innovation to meet this challenge can be operationalized by network communication incorporating an integrated pathway of service delivery; an interactive patient education manual that can be computer generated; utilization of cardiac mentors in the delivery of care as service office resources; incorporation of a telemanagement and telemonitoring system to enhance patient compliance; and a systematic approach to outcome measurement. Since incorporation of these new frontiers, Advocate Home Health Services has realized a hospital readmission rate of only 4.8% in 30 days or less from last rehospitalization when compared to the national average of 23%.

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