“Do you have an advance directive?” This is one of the first questions a patient is asked when admitted to a Kindred facility. “The goal of an advance directive is to make sure that patients are making informed decisions and that we’re following their wishes,” says Kathee Paradowski, Clinical Informaticist Consultant in Kindred’s Hospital Division. All patients who do not have an advance directive are educated/counseled on the importance of creating one. They are also encouraged to designate a power of attorney for health care who can speak for them if they become so sick they are unable to speak for themselves.
I found this article about staffing issues in Home Health to be quite interesting for several reasons:
1.) Their definitions of home health vs. home care. We look at “homecare” as being an umbrella term to capture medical home health and non-medical home care, but we may need to rethink this.
2.) How we are differentiated by many of our competitors due to the background checks and drug screenings that our employees undergo?
3.) Also how we are differentiated by our certification and accreditation?
Editor's Note: Leigh White is Kindred Healthcare's Senior Director of Communications for the PeopleFirst Homecare and Hospice Division.
ProTouch, Kindred’s proprietary electronic medical record (EMR) system, helps clinicians paperlessly access and manage important patient information including vital signs, medications, progress notes and lab and radiology results. ProTouch monitors in patient rooms are continually updated as needed, and interface with a patient’s ventilator in order to provide real-time respiration information. Recent enhancements to the system include documentation and display of multi drug-resistant organisms with flagged alerts, and improvements to the searchability of transcribed reports including display by date, report type, dictator and signature status.
The next big thing? ProTouch will soon be available as an app for the iPad, allowing our clinicians to access and update important patient information even more efficiently.
. “We’re a health care organization and this is a health care issue, so we believe we should support our staff by offering this service at no cost.” The free vaccinations are available from October 1 through March 31 each year.
According to Silliman, staff is the most likely source for bringing the flu virus from the community to the Kindred facilities. “Our patients are at high risk,” she says. “Many of them are immunosuppressed. Many have comorbidities. It’s easy for them to catch the flu. If a staff member’s child comes home with the flu and the staff member hasn’t been vaccinated, that staff member can catch it and spread those germs to our patients before they realize they are sick. Staff members who aren’t vaccinated can also catch the flu from patients or other non-vaccinated employees and take it home to their families. By getting as many people vaccinated as possible, we’re decreasing the risk of more people spreading the flu and getting sick.”
On November 29, TEDMED, a multidisciplinary community of innovators and leaders dedicated to creating a better future in health and medicine, held a panel discussion via webcast titled The Caregiver Crisis. Members of the panel included upper-level management from the Center for Long Term Care Research & Policy, the National Family Caregivers Association, the Case Management Society of America, the Families and Health Care Project, and CarePlanners. This thought-provoking discussion raised many points:
Kindred’s leadership has been discussing these and related issues in other forums as well. Said Sean Muldoon, MD, MPH, FCCP, Senior Vice President and Chief Medical Officer for the Kindred Healthcare Hospital Division: “We have talked about caregivers taking increasingly greater roles in care in the last few days prior to discharge from post-acute care.”
Good hand hygiene is critical in preventing the spread of influenza. All employees should perform hand hygiene before patient contact; after patient contact; after contact with blood, body fluids, or contaminated surfaces (even if gloves are worn); before invasive procedures; and after removing gloves. “All of our hospitals have alcohol-based gel in the hallways and in the patient rooms to make it easy for staff, patients and visitors to practice good hand hygiene,” says Sheila Fletcher, Infection Prevention and Control Clinical Specialist in Kindred’s Hospital Division.
Most Kindred facilities use “Secret Shoppers” to make sure employees are following hand hygiene protocols. “Secret Shoppers are volunteers who monitor physician and staff hand hygiene practices,” says Fletcher. “They are encouraged to step in and speak up if they see someone who fails to perform hand hygiene or is not doing it appropriately.”
Providing 24-hour care to a loved one is a difficult job, and caregivers are often so focused on taking care of their family member that they don’t take time out for themselves. November is National Family Caregiver Month, which is a good time to remind family caregivers that they need an occasional break. Kindred provides short-term respite for caregivers who need a few days, or even a few weeks, off. “Patients who are brought to our facilities for respite care are given a private or semi-private room in our rehab suite,” says Zachary Ballard, Admissions Coordinator for Kindred Nursing and Rehabilitation -Bashford. “We provide nursing care, along with comfort and support, to the patient until he or she is able to transfer back to the home environment.”
November is National Hospice and Palliative Care Month, a time to recognize those who care for our patients at the end of life’s journey. Kindred’s hospice program utilizes a team approach that includes nurses who provide case management and hands-on care, home health aides who help patients with activities of daily living, social workers who help with community resource needs and social support, and spiritual care coordinators who support the patient and family through prayer and other types of spiritual support. “We also have volunteers who visit with patients and sometimes provide respite for family members,” says Kristina Basicker, Director of Operations, PeopleFirst Home Care & Hospice.
Invited speaker Seth Kahan, author of the book “Getting Change Right: How Leaders Transform Organizations from the Inside Out,” challenged Clinical Impact Symposium participants to take the experience of the last two days back to their own facilities and use it to effect positive change.
Mr. Kahan described four stages of transformation, beginning with what he labeled “the call.” This could be something like a sudden promotion, a new opportunity, the illness of oneself or a family member, or, in this case, the decision to attend the symposium. The threshold stage, said Mr. Kahan, is the point when a person crosses from the normal reality to the reality of the ritual – arriving at the hotel, checking in, the adjustment of the mind to the process. “Time out of time.” The transition to a place where we have permission to have long conversations about topics we care about, and think deeply about things we normally might not have time to think about, Mr. Kahan said.
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