Hospital-based Home Health Care Research Articles

Advanced Practice Nurses' Experiences on Patient Safety Culture in Hospital-Based Home Healthcare: A Qualitative Descriptive Study.

Despite the increasing interest in patient safety, most research have been conducted in hospital settings, thereby demonstrating an overall lack of research regarding patient safety culture in home healthcare. South Korea has three types of home healthcare services based on hospitals, public health centers, and long-term care insurance. Home healthcare nurses in hospitals require a master's degree and advanced nursing skills. They play important roles in ensuring patients' safe transition into home health care. This study aimed to explore the experience of patient safety culture among South Korean advanced practice nurses in hospital-based home healthcare. This qualitative descriptive study was conducted through purposive sampling, whereby twenty advanced practice nurses involved in home healthcare were recruited from twelve hospitals located in three different cities throughout South Korea. Face-to-face semi-structured interviews were conducted, and the collected data were analyzed through inductive and deductive content analyses. Three main categories were finally confirmed: (a) teamwork climate, (b) safety climate, and (c) working condition. The sub-categories of the teamwork climate included the collaboration between patients, caregivers, and nurses, collaboration within medical institutions, and collaboration among the individuals involved in community partnerships. The sub-categories of the safety climate included nurses' commitment to patient safety, the associated institutions' commitment to patient safety, and the government's commitment to patient safety. The sub-categories of the working condition included the frontline working environments and the associated institutions' support aimed at ensuring effective working environments. Cultivating patient safety culture is crucial for ensuring the safe transition of patients from acute care hospitals to home healthcare. This study revealed significant aspects of patient safety culture in hospital-based home healthcare, allowing for the continuum of care among the associated patients. Such aspects include communicating with caregivers, building community partnerships, understanding unexpected home environments, and enhancing the safety of nurses.

Hospital Utilization After a Telemonitoring Program: A Pilot Study

The long-term effects of remote monitoring on hospital utilization and health care costs are understudied in home health care. The researchers performed a retrospective study, in a hospital-based home health care agency, to consider the effects of remote monitoring in 326 patients with heart failure 90 days after discharge from services. While statistical significance was not noted, clinical significance suggests that there was a decreased hospital utilization rate and decreased average cost per hospitalization in the remote monitoring group.

Analysis of Services and Cost in CVA Patients by Severity in Hospital-based Home Health Care

Analysis of Services and Cost in CVA Patients by Severity in Hospital-based Home Health Care

Clinical and Financial Evaluation of a Hospital Based Home Health Care Department

Home healthcare agencies are currently under major scrutiny by the federal government initiatives to detect fraudulent practices against Medicare. In order for agencies to be certified for Medicare reimbursement they must meet Medicare Conditions of Participation. The purpose of this Graduate Management Project (GMP) was to conduct the annual evaluation of the M&M Home Health Care Agency required for Medicare Certification and reimbursement and of JACHO requirements. Overall/ the M&M agency was found to be in compliance with Medicare Conditions of Participation. Great strengths of the agency are its clinical caregivers that provide services to patients/ tight financial controls/ and its integrity and focus on compliance with federal and state regulations. However/ there were areas that the agency must improve upon especially in light of the dramatic changes in reimbursement to remain a financially viable operation. A special area of emphasis in this evaluation was the development of a patient satisfaction survey for the agency to replace the existing measurement tool. This pilot project identified the need to incorporate a variety of methods to evaluate patient satisfaction other than a written survey such as telephonic surveys and focus.

Model approach to hospital-based home health care orientation

This article presents a model approach to orientation that assists in familiarizing nurses and ancillary staff with their new roles, with the home environment including family dynamics, and with practice within the guidelines of the accreditation bodies. The ulti mate goals of the model are to achieve a high standard of patient care and to maintain satisfied home health staff.

Home Health Care: Reliability and Validity Testing of a Patient‐Classification Instrument

The purposes of this methodologic, descriptive, correlation study were to assess the reliability and validity of the Easley-Storfjell (ES) patient-classification instrument for home care, and determine to what extent it was useful in a large, hospital-based home health care setting. A model for home health care developed by the investigator was used. Interrater reliability and concurrent validity were established by four nurse-raters using a random sample. Nonparametric bivariate correlational analysis demonstrated that the ES instrument was both reliable and valid at a significant level. In addition, there was agreement between the overall ES category rating and rater frequency of home visits. Intrarater reliability for each of the four nurse-raters on a random sample was at a significant level. The results of this study have important implications for home health care agencies providing care to chronically ill patients.

Case studies of pharmacy involvement in hospital-based home health care : Introduction

Case studies of pharmacy involvement in hospital-based home health care : Introduction

Case studies of pharmacy involvement in hospital-based home health care

Case studies of pharmacy involvement in hospital-based home health care

Legal implications of home health care by nonprofit hospitals

Antitrust considerations and other legal implications of home health-care (HHC) services provided by nonprofit hospitals are discussed, and pertinent legal cases are reviewed. Of the various antitrust laws, the act that is probably most relevant to hospital-based HHC is the Section 13C exemption to the Robinson-Patman Anti-discrimination Act, which allows a nonprofit hospital to purchase drugs for its own use at special discounted prices that would otherwise be illegal. For HHC provided by nonprofit hospitals, a major legal question is the extent to which the Section 13C exemption applies to drugs purchased by a hospital at preferential prices and used to treat the hospital's HHC patients; decisions in the cases of Abbott Laboratories et al. v. Portland Retail Druggists Association and De Modena v. Kaiser Foundation Health Plan have helped to clarify the answer to that question. To avoid allegations of illegal tying arrangements, hospitals should take care that users of their HHC services are not being compelled to purchase or use other hospital services unless they would otherwise do so. Also, hospitals providing HHC services should ensure that the professionals providing those services are aware of and meet the appropriate standards of care for the services rendered to avoid liability for negligence. To be successful in the delivery of HHC services, providers will have to be prepared to address the various legal issues that might arise. Hospital administrators, HHC professionals, and legal counsel should work together as HHC programs develop and evolve.

Marketing considerations in home health care

Methods for conducting a comprehensive analysis of the potential for strategic entry or expansion in the home health-care (HHC) market are discussed. By conducting a comprehensive analysis of the HHC market, hospital pharmacists can evaluate the feasibility of developing and implementing a hospital-based HHC service. A comprehensive market analysis should include an initial assessment of potential product-line offerings, development of strengths-and-weaknesses and opportunities-and-threats profiles, evaluations of competing providers of HHC and regulatory issues, and formulation of a business plan. The potential impact of program structure, operations management, product pricing, advertising and promotion, and marketing controls should also be considered. The hospital pharmacist has a unique opportunity to further the organizational objectives of the hospital by participating in the provision of HHC; a comprehensive market analysis represents a useful method of assessing the benefits and costs associated with providing integrated HHC services.

Hospital-based home health care: Gaining a competitive advantage where everyone benefits

Hospital-based home health care: Gaining a competitive advantage where everyone benefits