Field Trip Review
Information
The long-term care service provider that I have chosen for this field trip review was the community-based services and more specifically, home health care. The person that I have interviewed for this field trip review was Jill Ciao, he is a physical therapist and clinical manager for Cornerstone Home Health Care.
Short Literature Review
In the article, “Home Care: More than Just a Visiting Nurse”, the authors mentioned that the patients are transitioned roughly since going from the hospital to their own home is a big change in the patient’s environment. The title of the article itself makes an impact that the nurses do not just visit these patients but that they actually make such a big impact on the patients’ path to recovery. Romagnoli, Handler, & Hoccheiser (2013) mentioned that home health care providers need to understand the environment of the patient’s home and know the skills and capabilities of their employees more. The home health care providers must understand all of these because the patients really are mostly alone until the next visit of the employee or the caregiver. This is an essential for the care providers but it has been seen that this is one of the big problems of the field. Romagnoli et al. (2013) mentioned in their article that home health care providers rarely know the environment of their patient’s home. It is rare for the home health care providers to go to each and every one of their patients’ home especially since there is a lot of patients getting referred to them everyday. It is highly unlikely that home health care providers have seen all of their patient’s home which is a critical issue in my opinion because the patient is at risk for communication. If the home health care providers do not know the blueprint of the patient’s house, it will be a rough transition from the hospital to their homes. It is not only a rough transition for the patient but for the employee too. Home health care is all about the communication of the patient, caregiver, and the home health care agency itself. Problems will arise if there is even one miscommunication since the patient is mostly at home. Home health care really does have its advantages though because it has been shown that patients really do improve a lot at their own homes and it is definitely less expensive than being in a hospital. Landers et al. (2016) states in their article that there was about $25 million savings for home care in just one year. Many patients also have expressed that they liked being independent in their own home rather than being restraint at the hospital being watched constantly by hospital employees (Landers et al., 2016). Although, there are risk for being at home, there is a lot of benefits especially when communication and transition from hospital to home is smooth.
The website, John Hopkins Medicine, have summarized what types of home health care services are offered. The website mentions that home health care services have a lot to offer depending on the situation of the patient. Some home services can include doctor care, nursing care, physical care, occupational care, speech therapy and many more (“Types of Home Health Care Services”, n.d). The website also mentions that nursing care is the most common of all the home health care services. Nursing care will depend on the needs of the patients and that consultations are done with the doctor and the nurse will then be informed of that and be set up with the patient. Matthews (2005) also stated that there is studies that show that home care actually does help the patients more in comparison to being in hospitals as they have more freedom in at their own homes and they are also much more less expensive than staying in the hospitals.
Summary of Interview
In the interview, I talked with Jill Ciao as mentioned above and he is a physical therapist and clinical manager for Cornerstone Home Health Care. The first question that I asked Jill was how long they have been in business and what has changed for them during those years. Jill stated that Cornerstone started in 2007 and they have moved around during those times. In 2016 though was when they made a move to Joliet, in where their major office is at now. They have been a home health care since 11 years ago and that they have grown as a company altogether. By moving to Joliet, they were able to cover a larger space for the community. He also stated that as they got bigger, they got the capability of being able to hire more outstanding employees to help the needs of the patients more. Jill also said that as a company gets bigger, they are able to get more connections or networking within the community so that more patients will be referred to them or be knowledgeable about the agency.
My second question was what type of services they offer at Cornerstone Home Health Care. Jill answered that there is a vast range of treatments that Cornerstone offers to their patients. They offer nursing services which provides safety assessment, wound care or dressing, iv therapy, diabetes management and education and much more. They also have physical therapy services, occupational therapy, speech therapy, medical social services, home health aide services and laboratory services. He provided more information on physical therapy as he knew more about this service; he stated that physical therapist treats the patients with exercises to strengthen the muscle of the patients and reduce the pain of it.
My third question was how does the agency make sure that the patients are satisfied with the quality of the care that the home care provides them with. Jill answered that their entire staff has a conference every few months to make sure that the employees are up to date and informed with all the latest news within the field and to make sure that the quality is kept to a standard. He also said that the entire staff is trained to make sure that they are able to communicate well with the patients and able to respond accordingly once a situation happens. Jill also stated that they have a website and there is a page for a survey for the client satisfaction survey. They have made this survey to know not only about the feedbacks the patients or family members have of agency but also to know how to improve the quality of care that their employees should be at. To make sure that the quality is kept to a standard; they have random monthly checkups with the employees. For example, since Jill is a physical therapist, there would be a day in a month where an administrator will follow him to see how he works with the patients to make sure that he is following the right protocols of health guidelines and also keeping the care quality to a standard.
My fourth question was about if they accepted insurance. He said that they do accept Medicare and Medicaid and private pay for insurance. Although there are requirements for some of these insurance. For Medicare, it is required that patients are homebound while on the home health care service, this means that the patients find it hard to leave their home and that this is required by Medicare or they might refuse to pay for the patient and that there are only some times or situations that there is permission to leave home. Jill also mentioned that Medicare does cover nursing care, physical therapy, occupational therapy and more but what they do not is homemaker services and meal delivery.
My fifth question was how do they make sure that communication is effective between the patients or more specifically, do the patients know about their rights and responsibilities. Jill answered that before they do get referred and start with their home health care process, the patients are involved and talked about with before. He said that the patients are all informed about the care they will be provided with and how many times the employee or caregiver will be visiting them, how they are supposed to participate in the plan of care, and many more. Jill did state that basically, they tell all of their patients about all the information they need so that they are fully informed about their rights and responsibilities. Jill did state that the patients have responsibilities too as the employees do and that they should be complete and accurate about all their history of illnesses and their pain conditions.
My sixth question was how they recruit staff. Jill personally told me about how he applied for the job. First, he said that he has heard about this agency from a good friend and that friend recommended him to look into Cornerstone Health Agency more. He then called the agency to learn more about them and asked to set up a meeting with them. He was then called to submit the required requirements and was interviewed. He stated that the interview focused on what he could bring to the agency and how he can improve the work field. He said that they looked for employees that are adaptable and would be able to handle transitions smoothly so they looked at the communication skills of the potential employee a lot because home health care really is all about the communication.
Visual Tour
Cornerstone Home Health Care Agency has 3 floors. There is a security guarding before you get in the building. Upon entering the building, there was a secretary as soon as you enter the premises. The first floor was just a basic office blueprint. Jill mentioned that the first floor was where the patients or companies with referred patients would meet to talk about what they could offer for the patient. First floor is the meeting place for the patients and the employees of the agency. Upstairs, there was a lot of cubicles for the employees. I have learned that home health care providers do a lot of paper works. Jill mentioned that the agency always has to be up to date with paper works so that there is no miscommunication with the patients and the agency itself. It keeps track of every visit and logs that the employees make and how the patients are feeling with every visit log. They also have their own website for their employees since they do a lot of online work now since it is easier and can keep and look for information easier. They have a database in where the agency can keep track of the visits and paper works that the employees are doing. It also notifies the employee of missing data or visits that they still need to do. Overall, the office was structure very well.
Commentary
Personally, I thought that Cornerstone Home Health Care was a very good company. They were very committed to the health of their patients and they made sure that the quality is kept to a standard. They had a lot to offer as a home health care provider and I really appreciated that all of their staff was welcoming. I found it interesting that they did conferences and had a supervisor follow their staff at least once a month to make sure that every staff is doing their work as well as they can. The supervisor has a checklist in how well the employee is doing. It is also good that they have a client satisfaction survey because it helps them improve as a company as they are still growing. Because they do the monthly check-ups with their staff at the home of their patients, it is guaranteed that they know how the home environment of their patients look like. Above the literature review, Romagnoli et al. (2013) mentioned that health care providers did not have a complete understanding of the environment of the patient but because of this, Cornerstone has taken a step in making sure they are up to date with the home environments of their patients. Mattson (2018) states in her article that one of the fastest growing home health care company focuses on their client satisfaction. She stated that they they really focus on the employees that they employ and that they make sure that they train and retain the staff that they have so that it can lead to the company growing and having more success. Cornerstone is definitely following the path of this as they really try to make sure that their clients are satisfied with the care that they are receiving. Not only that, they make sure that the patients have their rights and responsibilities. By having the consumers know what they to do or what they are receiving, it is making sure that there is mutual respect between the staff and patient. The only thing I could see for improvement is their responsiveness. Since they do close as an office, there is room for improvement with their responsiveness during non business hours. They accept referrals 24/7 but they have not mentioned if they do keep up with telephone calls from patients for 24/7 although a lot of this could be solved because most of the patients do live with their family or are in a facility with care.
References
Home Care 101: The Basics of Providing Patients With All the Comforts of Home. (2005, August 08). Retrieved from https://www.birminghammedicalnews.com/news.php?viewStory=184
Landers, S., Madigan, E., Leff, B., Rosati, R. J., McCann, B. A., Hornbake, R., … Breese, E. (2016). The Future of Home Health Care: A Strategic Framework for Optimizing Value. Home Health Care Management & Practice, 28(4), 262–278. https://doi.org/10.1177/1084822316666368
Mattson, K. (2018, September 12). An Inside Look at 3 of the Fastest-Growing Home Care Providers. Retrieved from https://homehealthcarenews.com/2018/09/an-inside-look-at-3-of-the-fastest-growing-home-care-providers/
Romagnoli, K. M., Handler, S. M., & Hochheiser, H. (2013). Home care: more than just a visiting nurse. BMJ quality & safety, 22(12), 972-4.
Types of Home Health Care Services. (n.d.). Retrieved from https://www.hopkinsmedicine.org/healthlibrary/test_procedures/urology/types_of_home_health_care_services_85,p00606