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Home Health is the Bridge between Patients, Hospitals, and Physicians
Raj Kaushal MD, Chief Clinical Officer and Senior Vice President of Almost Family, recently spoke to us about the growing importance of home health within the healthcare continuum, and especially about Almost Family’s commitment to learning, training, and education. This is an excerpt from our conversation.
Q. How do you see the home health/ personal care industry’s role in overall improvement of the quality of care?
For decades, the focus in U.S. healthcare has been on hospitals and episodic care. In this model, patients came to the hospital for a procedure or emergency—and then they were discharged. Follow-ups were done by physicians. As healthcare evolved, industry realized that our focus only had been on acute care. Because we did not have the most robust post-acute care methodology in place to take care of patients, outcomes were not in sync with costs. Quality, measured in outcomes, was not what people expected from a system heavily invested in large hospitals. We don’t see home health’s role as just providing care in the home; we start with care transitions, from the doorstep of the hospital to safe landing of the patient at home and everything in between. It is important to oversee settling the patient at home and to continue to follow-up for a limited or longer period of time, as necessary.
Q. In an ideal world, how should the healthcare system begin to work across the continuum of care?
Home health plays a pivotal role in building a bridge between the patient, the hospital, and the physician. Almost Family makes a difference in the total outcome for the patient, with services that include ambulation, bathing, and transfer, with a significant impact on patient satisfaction, timely provision of the care, reducing unnecessary hospitalizations, and reducing emergent care. We serve as the eyes and ears for an attending physician; he or she can achieve better outcomes through the benefit of this individual delivery system. Home health has evolved to play a pivotal role in the care continuum. Payers have realized that home care is a cheaper alternative to both re-hospitalization and emergent care. Home healthcare is not only a quality alternative, but it is a cost-effective option for the provision of care. Physicians are realizing that cross-utilization of their team members, whether they are doctors, nurses, or therapists, is lessening the divide between acute care and post-acute care. Using education and training to enhance the competency of care team staff further improves the ability to manage the patient across the care continuum.
Q. What is the role of home care to increase patients’ access to care and make the process easier?
What home care does very well is develop the relationship between the patient and caregiver, becoming almost part of the extended family. Clinicians visit patient homes, they are familiar with the environment; and they know the challenges a patient is facing—including physical challenges, social challenges, and possibly economic challenges. They become part of a holistic solution for the patient; they are not just providing a visit or a modality but rather helping the patient meet economic, social, physical, and environmental needs in a very personalized way. We always say in home care that healthcare is only a phone call away and to call us first. Bringing care to the home and providing access to the patient becomes pivotal in building that continuum of care outcome for the patient, the family, and the payer. More patients served in a less costly environment—with stronger bonding, increased patient satisfaction, improved access, and integration of the acute care provider, physician, and the patient into a continuum of care—becomes the model which we have followed successfully for several years.