Identifying Home Care Clinicians’ Information Needs for Managing Fall Risks

Abstract

KeywordsHome health agencies, health information technology, quality of care, workflow, information management SummaryObjectives: To help manage the risk of falls in home care, this study aimed to (i) identify home care clinicians' information needs and how they manage missing or inaccurate data, (ii) identify problems that impact effectiveness and efficiency associated with retaining, exchanging, or processing information about fall risks in existing workflows and currently adopted health information technology (IT) solutions, and (iii) offer informatics-based recommendations to improve fall risk management interventions. Methods: A case study was carried out in a single not-for-profit suburban Medicare-certified home health agency with three branches. Qualitative data were collected over a six month period through observations, semi-structured interviews, and focus groups. The Framework method was used for analysis. Maximum variation sampling was adopted to recruit a diverse sample of clinicians. Results: Overall, the information needs for fall risk management were categorized into physiological, care delivery, educational, social, environmental, and administrative domains. Examples include a brief fall-related patient history, weight-bearing status, medications that affect balance, availability of caregivers at home, and the influence of patients' cultures on fall management interventions. The unavailability and inaccuracy of critical information related to fall risks can delay necessary therapeutic services aimed at reducing patients' risk for falling and thereby jeopardizing their safety. Currently adopted IT solutions did not adequately accommodate data related to fall risk management. Conclusion:The results highlight the essential information for fall risk management in home care. Home care workflows and health IT solutions must effectively and efficiently retain, exchange, and process information necessary for fall risk management. Interoperability and integration of the various health IT solutions to make data sharing accessible to all clinicians is critical for fall risk management. Findings from this study can help home health agencies better understand their information needs to manage fall risks. BackgroundHome healthcare, referred to as home care henceforth, is defined as episodic and intermittent secondary care services provided to home-bound patients in their homes. Serving mostly the elderly [1], home care involves skilled care services provided by nurses, physical therapists, occupational therapists, speech therapists, social workers, and home aides [2]. Home care is a critical component in the continuum of care for many patients who require recuperative and rehabilitative services after hospital discharges [3][4][5][6]. It enables patients to achieve better recovery, gain strength, regain functionality, and become independent more quickly [7]. Home care is an important component of the overall healthcare industry in the United States (US) with a projected increase in its utilization and expen...

Home health nurse decision-making regarding visit intensity planning for newly admitted patients: a qualitative descriptive study

“…Health information technology provides hope to facilitate the timely and efficient collection and transmission of patient information across care settings to support care decisions. The value of health information technology on care planning and care provision in HH was recently established (Alhuwail & Koru, 2016; Sockolow, Bass, Eberle, & Bowles, 2016; Sockolow, Bowles, Adelsberger, Chittams, & Liao, 2014). One potential strategy is to promote the use of a standardized document such as the Continuity of Care Document within electronic medical documentation.…”

How Can Home Care Patients and Their Caregivers Better Manage Fall Risks by Leveraging Information Technology?

“…The 2015 HHCAHPS results reported that 16% of patients said that their home care team did not discuss their medications, pain, or home safety with them ( 53 ). To improve the experience of patients and caregivers in fall-risk management and score higher on HHCAHPS surveys, HHAs could adopt solutions such as patient portals that could help them improve the communication and reinforce the education of patients and caregivers about fall risks and home safety ( 54 , 55 ), investigate providing the patients and caregivers access to the clinical notes in the electronic health record ( 56 ), and examine care coordination problems and enhance information sharing with hospitals and physicians by leveraging health information exchange solutions ( 57 ).…”

Barriers and Benefits of Information Communication Technologies Used by Health Care Aides

“…15 Saari et al 15 identified technology as having the ability to facilitate effective communication and address information gaps for health care aides. Consequently, opportunities for ICT intended for health care aides include features of portability, 44 ubiquity, 45 interoperability, 46 communication tools to assist care plans, 43 and integration with remote care, telemonitoring, and assistive technologies. 36 To our knowledge, no comprehensive review has studied the range and extent of ICT used by health care aides to support their workflows and practice.…”

“…We classified the selected studies in five groups, according to the main purpose of ICT use by health care aides: (1) improve everyday work (n ¼ 12, 30%), 46,[51][52][53][54][55][56][57][58][59][60][61] (2) access electronic health records for home care (n ¼ 9, 22.5%), [62][63][64][65][66][67][68][69][70] (3) facilitate client assessment and care planning (n ¼ 9, 22.5%), [71][72][73][74][75][76][77][78][79] (4) enhance communication (n ¼ 7, 17.5%), 2,40,80-83 and (5) provide care remotely (n ¼ 3, 7.5%). 35,84,85 Fig.…”