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Preguntas y Respuestas: Visión experta sobre el desafío del personal de atención medica domiciliaria

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Spanish Translation by: Nena Franco Baptiste

Interlace Health lleva más de 30 años proporcionando flujos de trabajo digital y automatización de formularios en el sector sanitario. Queremos seguir apoyando a los médicos para que pongan a las personas por encima del papeleo, incluso cuando vemos que la atención médica se traslada fuera de las paredes de un hospital y dentro del hogar. Nuestra solución de firma electrónica para la atención médica en el hogar se creó para ayudar a que los flujos de trabajo administrativo sean menos molestos para los médicos de atención en el hogar. Le pedimos a nuestra experta en salud domiciliaria y cuidados paliativos para residentes, Nena Franco Baptiste, que compartiera su visión sobre estos desafíos. Llegó a nosotros con 17 años de experiencia en atención médica domiciliaria y cuidados y ahora trabaja como gerente de proyectos aquí en Interlace Health, donde trabaja para garantizar que las soluciones se apliquen y administren con éxito para nuestros clientes.

 

¿Cuáles fueron los problemas más comunes del personal que vio en la atención médica en el hogar durante su permanencia en una agencia?

Dicen que nunca sabes realmente las luchas de otra persona hasta que caminas una milla en sus zapatos. Y así es como descubrí las luchas que enfrentan los médicos en la salud en el hogar y los cuidados paliativos, incluso después de haber estado trabajando en la industria durante muchos años. Esa experiencia llegó para mí cuando mi padre fue dado de alta después de una cirugía crítica, y tuvimos que recibir atención domiciliaria en nuestro espacio personal y en la vida de nuestra familia para ayudar a cuidarlo. Fue entonces cuando realmente me di cuenta de que el personal de campo es una parte crucial del proceso de atención médica para los pacientes y sus familias. Lidian con mucho en un solo día, y lo vi bajo una nueva luz. Estos son solo algunos de sus desafíos diarios:

-Hacer malabarismos con su carga diaria de casos.

-Gestión de todos los trámites.

-Ir de un paciente a otro y, a menudo, de regreso a la oficina.

-Responder a las preguntas de los miembros de la familia.

-Servir como voz entre el médico y el paciente o la familia.

-Documentar la atención clínica para que la experiencia en el hogar sea tan fluida como la del hospital.

-Asegurarse de que los registros médicos tengan lo que necesitan para enviar la facturación.

-Proporcionar a los pacientes la atención clínica que necesitan.

 

¿Cuáles son algunos de los impactos que vio relacionados específicamente con el proceso de formularios en papel?  

Hay 5 desafíos principales que vi relacionados con los procesos de formularios en papel durante mi tiempo en el cuidado de la salud en el hogar:

  1. Falta de consistencia en la atención y el proceso debido a la alta rotación de personal.

La retención del personal es un problema constante en la atención médica en el hogar, y los cambios abruptos que ocurren cuando se tiene personal con papeleo físico y equipo médico en la mano cuando renuncian, pueden afectar a varias personas y ralentizar todo el proceso.

  1. Hacer malabarismos con varios tipos de citas de pacientes en un día.

El personal podría tener dos visitas de admisión, un registro de 60 días y una visita de hospitalización, todas en el mismo día. Tratar a los pacientes, calmar y enseñar a los miembros de la familia, asegurarse de que se complete todo el papeleo y documentar la atención son solo algunas de las tareas pendientes. Tener que conducir de regreso a la oficina para escanear todo el papeleo después de un día como ese es una causa segura de agotamiento.

  1. El poder legal no está en casa.

Tal vez el POA no pudo salir del trabajo, la visita fue reprogramada o están viajando fuera del estado el día de la visita. Ahora el personal y la familia están coordinando cómo comunicarse sobre la cita, cómo obtener los formularios firmados y enviados de vuelta en un período de tiempo razonable.

  1. Múltiples necesidades lingüísticas.

Es posible que el personal no haya sido informado con anticipación de que el paciente o los miembros de la familia no hablan inglés, y es posible que no tengan acceso a servicios de traducción en el acto. Limitarse solo a los formularios impresos que tienen a la mano causa frustración al paciente, en el personal y retrasos en la atención y la facturación.

  1. Pilas de papel para el registro médico.

El personal de registros médicos es el destinatario de estas pilas de formularios en papel que deben revisarse y archivarse. Esto toma una cantidad considerable de su tiempo y hay posibilidad de un margen de error humano.

  1. La lucha previa a la encuesta.

Prepararse para una encuesta de JCAHO, una encuesta de CHAP o una encuesta de seguro médico (medicar) es una tarea que requiere mucho tiempo. Todo debe estar perfecto y el personal que se esfuerza por garantizar que este sea el caso cuando se trata de papeleo se enfrenta a una batalla cuesta arriba.  Siempre habrá un formulario de papel que se pierda o tenga una mancha de café y sea difícil de leer, o que no haya pasado por la máquina de fax. Puede ser frustrante experimentar retrasos en el envío de sus RAP a Medicare porque no tiene toda su documentación junta. Recuerdo que una vez me preparé para nuestra encuesta CHAP y uno de los médicos literalmente entró y tiró una gran pila de papeleo de su bolso, con poco tiempo de sobra. Era un gran lío de papeleo, y a algunos de nosotros nos tomó media hora clasificarlo todo y organizarnos. Esa vez fue una carrera hasta la línea de meta, sin duda.

 

 

¿Cuáles son algunas de las soluciones que más ayudaron al personal a hacer frente a estos desafíos?

La agencia para la que trabajaba servía a seis condados diferentes, por lo que el personal a menudo podía conducir más de 40 millas para ver a un paciente, y su carga diaria de casos era muy pesada. Nuestro objetivo principal era mantener la continuidad de la atención desde el hospital o el consultorio médico hacía el hogar y alentamos a nuestro personal a construir una relación de confianza con los pacientes y sus familias. Sin embargo, con lo mucho que gestionan en un día, hubo muchas dificultades, como el papeleo tardío que volvía a la oficina o que el personal se quedaba sin suministros médicos.  La agencia trató de facilitar las cosas para el personal mediante la creación de oficinas satélite donde los médicos de campo tendrían un lugar para conectarse en línea, recoger el papeleo y los suministros médicos y realizar la documentación clínica. Sin embargo, su mantenimiento era costoso y tuvo que cerrar debido a los recortes presupuestarios.

La siguiente iniciativa que implementamos para ayudar a los médicos a gestionar sus días y mejorar la satisfacción de los empleados fue un canal de comunicación interna. Este sistema permitía al personal enviar solicitudes de formularios en blanco que podíamos enviar a sus hogares, o suministros médicos que enviábamos directamente al hogar del paciente. El objetivo era ahorrarles un viaje a la oficina y reducir su tiempo manejando. Esperábamos que el personal sintiera que estábamos allí “cuidándolos” mientras ellos cuidaban a los pacientes. Estos pueden parecer cambios muy pequeños, pero cuando el personal se ve abrumado, pueden tener un impacto notable en la atención al paciente, el agotamiento del personal y la calidad de la atención. Nuestro personal tuvo un poco más de tiempo en su día para concentrarse en la atención al paciente y eso marcó una gran diferencia.

Pero una de las mayores mejoras que vi provino de la digitalización de la mayor cantidad posible del proceso en papel. Tener un proceso de consentimiento totalmente electrónico eliminó la posibilidad de errores y formularios faltantes. Esto redujo el tiempo del personal, la frustración de los pacientes, los retrasos en la facturación, las preocupaciones sobre las encuestas y los gastos. Es un cambio pequeño, pero marca una gran diferencia.

Personas por encima del papeleo

Un pequeño cambio que marca una gran diferencia. Ese es un pilar de lo que People Over Paperwork significa para nosotros aquí en Interlace Health y el por qué nos dedicamos a garantizar que nuestras soluciones marquen la diferencia para todos nuestros clientes. Reserve una demostración personalizada para su agencia.

Vea cómo Interlace y otros están utilizando innovaciones tecnológicas para mejorar la atención domiciliaria.

 

 

ABOUT THE AUTHOR:

Dessiree Paoli, Director of Product Marketing & Strategy at Interlace Health

Dessiree Paoli is the Director of Product Marketing & Strategy at Interlace Health, a company that transforms workflows by providing clinicians and patients with digital healthcare solutions. She has more than 20 years of experience in driving strategic marketing initiatives, leading teams, and developing integrated campaigns, and she has worked in healthcare for more than 14 years. Connect with Dessiree on LinkedIn. 

 

 

Watch On-Demand Webinar: Home Healthcare News: The eSignature Effect

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Q&A: Expert Insight into Home Health Staff Challenges

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Interlace Health has been providing digital workflows and forms automation in healthcare for over 30 years. We want to continue to support clinicians in putting People over Paperwork, even as we see health care move outside the walls of a hospital and into the home. Our eSignature for Home Health solution was created to help make the administrative workflows for home health clinicians less cumbersome. We asked our resident home health & hospice expert, Nena Franco Baptiste to share her insight into these challenges. She came to us with 17 years’ experience in home health and hospice and now works as a project manager here at Interlace Health where she works to ensure the solutions are successfully implemented & managed for our customers.

 

What were the most common staff struggles that you saw in home health during your tenure at an agency?

They say you never really know the struggles of someone else until you walk a mile in their shoes. And that is how I uncovered the struggles that clinicians face in home health & hospice, even after I had been working in the industry for many years. That experience came for me when my father was discharged after critical surgery, and we had home care come into our personal space and into our family’s lives to help take care of him. That’s when it really hit me that the field staff are a crucial part of the healthcare journey for patients and family. They manage so much in a single day, and I saw it in a new light. Here are just a few of their daily challenges:

-Juggling their daily caseload

-Managing all the paperwork

-Traveling from each patient to the next, and often back to the office

-Fielding questions from family members

-Serving as a voice between the physician and the patient or family

-Documenting clinical care so the home-based experience is as seamless as the hospital

-Ensuring medical records has what they need to submit billing

-Providing patients with the clinical care they need

 

 

What are some of the impacts you saw specifically related to a paper-based forms process?  

There are 5 main challenges that I saw related to paper-based form processes during my time in home health:

  1. A lack of consistency in care & process due to high staff turnover.

Staff retention is an ongoing issue in home health, and the abrupt changes that occur when you have staff with physical paperwork and medical equipment in hand when they resign, can impact several people and slow down the entire process.

  1. Juggling multiple patient appointment types in a day.

Staff could have two admissions visits, a 60-day check-in and a rehospitalization visit all on the same day. Treating patients, calming & educating family members, ensuring all paperwork is completed and documenting care are just a few of the to-dos. Having to drive back to the office to scan in all the paperwork after a day like that is a sure cause of burnout.

  1. Power of attorney isn’t home.

Maybe the POA couldn’t get off work, the visit was rescheduled, or they are traveling out of state on the day of the visit. Now staff and family are coordinating how to communicate about the appointment, get the forms signed and sent back in a reasonable amount of time.

  1. Multiple language needs.

Staff may not have been informed in advance that the patient or family members don’t speak English, and they may not have access to translation services on the spot. Being confined to only the printed forms they have on hand causes patient frustration, staff frustration and delays in care and billing.

  1. Mountains of paper for medical records.

Medical records staff are the recipients of these mountains of paper forms that need to be reviewed and filed away. This takes a considerable amount of their time and there is much room for human error.

  1. The pre-survey scramble.

Preparing for a JCAHO survey, a CHAP survey, or Medicare survey is a time-consuming endeavor. Everything needs to be perfect and where it is supposed to be, and staff scrambling to ensure this is the case when paperwork is involved are facing an uphill battle.  There will always be that one paper form that gets lost or has a coffee stain on it and it’s hard to read, or it didn’t come through the fax machine. It can be frustrating to experience delays in sending your RAPs into Medicare because you don’t have all your documentation together. I remember preparing for our CHAP survey once and one of the clinicians literally just came in and dumped a huge pile of paperwork out of her bag, with little time to spare. It was a huge mess of paperwork, and it took a few of us half an hour to sort through it all and get organized. It was a race to the finish line that time for sure.

 

 

What are some of the solutions that helped staff the most to juggle these challenges?

The agency I worked for served six different counties so staff could often expect to drive 40+ miles to see one patient, and their daily caseloads were very heavy. Our primary goal was to maintain continuity of care from the hospital or physicians’ office at home and encouraged our staff to build a trusting relationship with the patients and their families. However, with so much to manage in a day, there were many struggles such as late paperwork coming back to the office or staff running out of medical supplies.  The agency tried to make things easier for staff by setting up satellite offices where field clinicians would have a place to get online, pick up paperwork and medical supplies and touchdown to do clinical documentation. However, those were expensive to maintain and had to close due to budget cuts.

The next initiative we implemented to help clinicians manage their days and to improve employee satisfaction was an internal communication channel. This system allowed staff to submit requests for blank forms that we could send out to their homes, or medical supplies we would ship directly to the patient’s home. The goal was to save them a trip to the office and reduce their daily driving time. We hoped it would let staff feel like we were there “taking care” of them while they were out taking care of patients. Those may seem like very small changes, but when staff are overwhelmed, they can have a substantial impact on patient care, staff burnout and care quality. Our staff had a little extra time in their day to focus on patient care and it made a big difference.

But one of the biggest improvements I saw came from digitizing as much of the paper process as was possible. Having a fully electronic consenting process removed the possibility of errors and missing forms. This cut down on staff time, patient frustration, billing delays, survey concerns and expenses. It is a small change, but it makes a big difference.

People Over Paperwork

A small change that makes a big difference. That is a pillar of what People Over Paperwork means to us here at Interlace Health and why we are dedicated to ensuring our solutions are making a difference for all our customers. Book a customized demo for your agency.

Watch how Interlace and others are using technology innovations to enhance home-based care.

 

 

ABOUT THE AUTHOR:

Dessiree Paoli, Director of Product Marketing & Strategy at Interlace Health

Dessiree Paoli is the Director of Product Marketing & Strategy at Interlace Health, a company that transforms workflows by providing clinicians and patients with digital healthcare solutions. She has more than 20 years of experience in driving strategic marketing initiatives, leading teams, and developing integrated campaigns, and she has worked in healthcare for more than 14 years. Connect with Dessiree on LinkedIn. 

 

 

Watch On-Demand Webinar: Home Healthcare News: The eSignature Effect

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LIVE from the MUSE Executive Institute: New Year in Newport

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One of the best parts of my job is that I get to build relationships with people. Not just people that I work, but with our customers and other vendors in the healthcare community. Earlier this month, Art Nicholas and I were able to immerse ourselves in a great community of MEDITECH EHR hospitals at the 2024 Muse Executive Institute.

The Executive Institute is a smaller event, with IT executives from about 20 hospitals who come together for educational sessions and reverse tradeshows with HIT vendors like Interlace Health.

This year’s theme was “Solving Workforce Challenges” and the executives in attendance also served as the session leaders. This provides invaluable insight into “how the other guys are doing it” for the CIOs, VPs of Information Systems and Medical Directors of Informatics who are in the audience. Hospital executives are facing similar workforce challenges across the country, and this event allowed them to share their solutions with each other. Some of the questions answered in the presentations were:

• How do you do more with less?
• How do you manage staffing issues?
• How do you measure productivity?
• Do you innovate, automate, or find AI solutions?

 

The session that I felt most creatively addressed these questions was titled “Personality & Productivity – Staffing the Seats on the Bus” by Kingman Regional Medical Center leaders Brett Mello, CIO and Dr. William Gustin, Director of Medical Informatics. Mr. Mello and Dr. Gustin led the group in an insightful session that focused on evaluating the alignment of staff personality with role expectations for each position in the department. Demands on IT departments are unrelenting, and many hospitals are facing increased project requests with reduced staff and budgets. The personality & productivity exercise was geared at maximizing department productivity, one individual at a time. This approach allows leaders to identify and reconcile misplaced personalities that are having a negative impact on IT workflow and culture.

One of my favorite lines from Mr. Mello’s presentation was “Culture eats strategy for breakfast”. It’s an adage we have all heard before, but it really resonated with me as I am working with my organization to determine the best strategies to meet our goals for the year. Taking the time to ensure you have the right people in the right positions to influence the cultural shift towards the change and success you desire is just as important as the strategy itself, maybe even more so.

Over the two days, there are many opportunities talk with and get to know each other better. These conversations provided insight into the challenges hospital IT leaders are facing in the year ahead, which helps me work with my organization to try and find ways to support them. A few common themes I heard were

  • Preparing for cyber security attacks. It’s not a matter of “if” it’s a matter of “when” and you need to be prepared when it happens.
  • Prioritizing digital technologies to improve the patient experience, enhance data collection and automate workflows for overwhelmed staff.
  • Patient portal improvements and adjustments. Patients are still slow to adopt the portal, but what are the other options to digitize the administrative process for staff?
  • Getting creative with the technology that you have in place today to solve other problems when budgets are tight.

My favorite part of the trip was spending time with our customers and hearing what they like most about working with Interlace Health, check out some videos below we captured.

What our Customers are saying at the MUSE Executive Institute

Tito Perez, Corporate Director of Enterprise Applications at Emanate Health

 

 

 

 

 

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Eric Gasser, VP/CIO at Wooster Community Hospital

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Kelly Lippold, Director of Health Informatics at NMC Health

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Jeff Goad, CIO at Williamson Medical Center

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The Muse Executive Institute is a wonderful opportunity to connect with the MEDITECH community, learn more about their successes and challenges, and discover new ways Interlace Health can continue to enhance MEDITECH for our customers. I look forward to next year!

 

ABOUT THE AUTHOR:

Dessiree Paoli, Director of Product Marketing & Strategy at Interlace Health

Dessiree Paoli is the Director of Product Marketing & Strategy at Interlace Health, a company that transforms workflows by providing clinicians and patients with digital healthcare solutions. She has more than 20 years of experience in driving strategic marketing initiatives, leading teams, and developing integrated campaigns, and she has worked in healthcare for more than 14 years. Connect with Dessiree on LinkedIn. 

 

 

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