The Effect of Frontloading Visits on Patient Outcomes

Abstract

Frontloading, providing 60% of planned visits in the first 2 weeks of the home healthcare episode, was tested in two groups of patients: insulin-dependent patients with diabetes and patients with a primary diagnosis of heart failure. Frontloading was effective for patients with heart failure, decreasing rehospitalization by more than half (39.4-16%), with fewer visits (15.5 vs. 9.5) and equal clinical outcomes and patient satisfaction. There were no significant differences in outcomes for patients with diabetes.

Frontloading and Intensity of Skilled Home Health Visits: A State of the Science

“…A review of the literature began with OVID/Medline and PubMed using frontloading as the search term. Forty-eight articles were found but only 1 article related to frontloading visits in home health was found (Rogers, Perlic, & Madigan, 2007). Due to this low number of studies, Scopus was then employed to search for additional studies that have cited the original seminal work of Rogers et al (2007).…”

“…Forty-eight articles were found but only 1 article related to frontloading visits in home health was found (Rogers, Perlic, & Madigan, 2007). Due to this low number of studies, Scopus was then employed to search for additional studies that have cited the original seminal work of Rogers et al (2007). A total of 10 publications have cited Rogers and colleagues’ (2007) study providing three additional studies for inclusion in this review (Madigan et al, 2012; Markley, Sabharwal, Wang, Bigbee, & Whitmire, 2012; Riggs, Madigan, & Fortinsky, 2011).…”

“…Due to this low number of studies, Scopus was then employed to search for additional studies that have cited the original seminal work of Rogers et al (2007). A total of 10 publications have cited Rogers and colleagues’ (2007) study providing three additional studies for inclusion in this review (Madigan et al, 2012; Markley, Sabharwal, Wang, Bigbee, & Whitmire, 2012; Riggs, Madigan, & Fortinsky, 2011). Seven of the 10 articles that cited Rogers and colleagues (2007) were not research studies designed to further our understanding of the impact of frontloading.…”

“…A total of 10 publications have cited Rogers and colleagues’ (2007) study providing three additional studies for inclusion in this review (Madigan et al, 2012; Markley, Sabharwal, Wang, Bigbee, & Whitmire, 2012; Riggs, Madigan, & Fortinsky, 2011). Seven of the 10 articles that cited Rogers and colleagues (2007) were not research studies designed to further our understanding of the impact of frontloading. These seven articles merely cited Rogers and colleagues, describing that frontloading has been found to reduce the need for hospitalization among skilled home health patients and were, therefore, not included in this analysis.…”

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

“…Providing more visits in the first few weeks of the HH episode allows nurses to maximize teaching opportunities, provide surveillance, and identify issues early on, thus contributing to decreased rates of rehospitalization (Rogers, Perlic, & Madigan, 2007). This practice has been referred to in the literature as frontloading , recently defined as providing “at least one nursing visit on the day of or day after hospital discharge and at least three nursing visits (including the first visit) in the first posthospital week” (Murtaugh et al, 2017, p. 5).…”