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Journal article
Planning the Episode: Home Care Admission Nurse Decision-Making Regarding the Patient Visit Pattern
Home health care management & practice, v 33(3), pp 193-201
01 Feb 2021
PMID: 34267494
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
During home health care (HHC) admissions, nurses provide input into decisions regarding the skilled nursing visit frequency and episode duration. This important clinical decision can impact patient outcomes including hospitalization. Episode duration has recently gained greater importance due to the Centers for Medicare and Medicaid Services (CMS) decrease in reimbursable episode length from 60 to 30 days. We examined admissions nurses’ visit pattern decision-making and whether it is influenced by documentation available before and during the first home visit, agency standards, other disciplines being scheduled, and electronic health record (EHR) use. This observational mixed-methods study included admission document analysis, structured interviews, and a think-aloud protocol with 18 nurses from 3 diverse HHC agencies (6 at each) admitting 2 patients each (36 patients). Findings show that prior to entering the home, nurses had an information deficit; they either did not predict the patient’s visit frequency and episode duration or stated them based on experience with similar patients. Following patient interaction in the home, nurses were able to make this decision. Completion of documentation using the EHR did not appear to influence visit pattern decisions. Patient condition and insurance restrictions were influential on both frequency and duration. Given the information deficit at admission, and the delay in visit pattern decision making, we offer health information technology recommendations on electronic communication of structured information, and EHR documentation and decision support.
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Details
- Title
- Planning the Episode: Home Care Admission Nurse Decision-Making Regarding the Patient Visit Pattern
- Creators
- Paulina S. Sockolow - Drexel UniversityKathryn H. Bowles - University of PennsylvaniaCarl Pankok - Drexel UniversityYingjie Zhou - University of PennsylvaniaSheryl Potashnik - Drexel UniversityEllen J. Bass - Drexel University
- Publication Details
- Home health care management & practice, v 33(3), pp 193-201
- Publisher
- SAGE Publications
- Grant note
- R01 HS024537 / ;
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Information Science; Health Sciences Division
- Web of Science ID
- WOS:000619968100001
- Scopus ID
- 2-s2.0-85100352326
- Other Identifier
- 991019168865604721
UN Sustainable Development Goals (SDGs)
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Nursing