scholarly journals Provider Delivery of Emergency Preparedness Education in Home-Based Primary Care

2018 ◽  
Vol 13 (03) ◽  
pp. 547-554 ◽  
Author(s):  
Tamar Wyte-Lake ◽  
Claudia Der-Martirosian ◽  
Maria Claver ◽  
Darlene Davis ◽  
Aram Dobalian
Keyword(s):  
Primary Care ◽  
Disaster Preparedness ◽  
Assessment Tool ◽  
Risk Group ◽  
Home Health ◽  
Patient Assessment ◽  
Home Based Primary Care ◽  
Home Based ◽  
Health Agencies ◽  
Home Health Agencies

ABSTRACTIntroductionHome health agencies have been tasked to improve their patients’ disaster preparedness. Few studies have evaluated the robustness of tools to support preparedness in home health. Through evaluation of the Home-Based Primary Care (HBPC) Patient Assessment Tool, we conducted a survey to identify strengths and challenges in supporting the preparedness of patients served by home health programs such as the Veterans Health Administration’s HBPC program.MethodsPractitioners from 10 HBPC programs fielded the Patient Assessment Tool with all patients during a 3-week period. Logistic regression and bivariate analyses were used to identify patient characteristics associated with the delivery of preparedness education.ResultsA total of 754 Patient Assessment Tools were returned. The educational item most likely to be covered was how to activate 911 services (87%). The item least likely to be discussed was information on emergency shelter registration and emergency specialty transportation (44%). When compared to the low risk group, HBPC patients in the high/medium risk group were more likely to receive preparedness education materials for 6 of the 9 educational preparedness items (P values less than 0.05).DiscussionPractitioners are relaying preparedness education to their most vulnerable patients, suggesting that home health agencies can provide disaster preparedness in the home. Nonetheless, there is room for improvement. (Disaster Med Public Health Preparedness. 2019;13:547-554)

scholarly journals “You get three different hats on and try to figure it out:” home based care provision during a disaster

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sue Anne Bell ◽  
Sarah Dickey ◽  
Marie-Anne Rosemberg
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Focus Groups ◽  
Home Health ◽  
Care Provision ◽  
Care Providers ◽  
Home Based ◽  
Health Agencies ◽  
Home Health Agencies ◽  
Home Based Care

Abstract Background Home based care is a vital, and growing, part of the health care system that allows individuals to remain in their homes while still receiving health care. During a disaster, when normal health care systems are disrupted, home based care remains a vital source of support for older adults. The purpose of this paper is to qualitatively understand the barriers and facilitators of both patients and providers that influence the provision of home based care activities in two hurricane affected communities. Methods Using qualitative inquiry informed by the social ecological model, five focus groups were conducted with home based care providers (n = 25) in two settings affected by Hurricane Irma and Hurricane Harvey. An open-source database of home health agencies participating in Centers for Medicare and Medicaid Services programs was used to identify participants. Data were manually coded and larger themes were generated from recurring ideas and concepts using an abductive analysis approach. Results Twenty five participants were included in one of five focus groups. Of the 22 who responded to the demographic survey, 65 % were registered nurses, 20 % were Licensed Vocational Nurses (LVN), and 15 % were other types of health care providers. 12 % of the sample was male and 88 % was female. Five themes were identified in the analysis: barriers to implementing preparedness plans, adaptability of home based care providers, disasters exacerbate inequalities, perceived unreliability of government and corporations, and the balance between caring for self and family and caring for patients. Conclusions This study provides qualitative evidence on the factors that influence home based care provision in disaster-affected communities, including the barriers and facilitators faced by both patients and providers in preparing for, responding to and recovering from a disaster. While home based care providers faced multiple challenges to providing care during and after a disaster, the importance of community supports and holistic models of care in the immediate period after the disaster were emphasized. We recommend greater inclusion of home health agencies in the community planning process. This study informs the growing body of evidence on the value of home based care in promoting safety and well-being for older adults during a disaster.

Untapped Potential of Home Health Care Innovations to Improve Outcomes With Bundled Payment Initiatives

2016 ◽  
Vol 29 (1) ◽  
pp. 53-55
Author(s):  
Teresa Lee ◽  
Jennifer Schiller
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Home Health ◽  
Bundled Payment ◽  
Home Based ◽  
Medicare Program ◽  
Health Agencies ◽  
Home Health Agencies ◽  
Home Based Care ◽  
Payment Models

A rapidly changing health care payment system creates opportunities for optimizing home health and home-based care for patients needing cardiac rehabilitation (CR). Home health agencies are poised to play a significant role in episode payment models in the context of post–acute care for patients with cardiovascular conditions. As the Medicare program expands its episode payment models to include patients with cardiovascular conditions, hospitals and other health care stakeholders that will be engaged in these bundled payment arrangements should consider use of home health care in the delivery of CR as a bridge to outpatient therapy and patient self-management.

scholarly journals Emergency and Disaster Preparedness in Hospice and Home Health Agencies (SCI951)

2021 ◽  
Vol 61 (3) ◽  
pp. 697-698
Author(s):  
Charles Mupamombe ◽  
Janna Baker Rogers ◽  
Jennifer Vanin ◽  
Lori Constantine
Keyword(s):  
Disaster Preparedness ◽  
Home Health ◽  
Health Agencies ◽  
Home Health Agencies

Disaster Preparedness in Home-based Primary Care: Policy and Training

2015 ◽  
Vol 30 (4) ◽  
pp. 337-343 ◽  
Author(s):  
Maria L. Claver ◽  
Tamar Wyte-Lake ◽  
Aram Dobalian
Keyword(s):  
Primary Care ◽  
Disaster Preparedness ◽  
Community Dwelling ◽  
Veterans Health ◽  
Health Administration ◽  
Care Policy ◽  
Home Based Primary Care ◽  
Home Based ◽  
Increased Risk ◽  
And Training

AbstractIntroductionVeterans served by Veterans Health Administration (VHA) home-based primary care (HBPC) are an especially vulnerable population due to high rates of physical, functional, and psychological limitations. Home-bound patients tend to be an older population dealing with normal changes that accompany old age, but may not adequately be prepared for the increased risk that often occurs during disasters. Home health programs are in an advantageous position to address patient preparedness as they may be one of the few outside resources that reach community-dwelling adults.ProblemThis study further explores issues previously identified from an exploratory study of a single VHA HBPC program regarding disaster preparedness for HBPC patients, including ways in which policy and procedures support the routine assessment of disaster preparedness for patients, including patient education activities.MethodsThis project involved semi-structured interviews with 31 practitioners and leadership at five VHA HBPC programs; three urban and two rural. Transcripts of the interviews were analyzed using content analysis techniques.ResultsPractitioners reported a need for further training regarding how to assess properly patient disaster preparedness and patient willingness to prepare. Four themes emerged, validating themes identified in a prior exploratory project and identifying additional issues regarding patient disaster preparedness: (1) individual HBPC programs generally are tasked with developing their disaster preparedness policies; (2) practitioners receive limited training about HBPC program preparedness; (3) practitioners receive limited training about how to prepare their patients for a disaster; and (4) the role of HBPC programs is focused on fostering patient self-sufficiency rather than presenting practitioners as first responders. There was significant variability across the five sites in terms of which staff have responsibility for preparedness policies and training.ConclusionVariability across and within sites regarding how patient needs are addressed by preparedness policies, and in terms of preparedness training for HBPC providers, could place patients at heightened risk of morbidity or mortality following a disaster. Despite the diversity and uniqueness of HBPC programs and the communities they serve, there are basic aspects of preparedness that should be addressed by these programs. The incorporation of resources in assessment and preparedness activities, accompanied by increased communication among directors of HBPC programs across the country, may improve HBPC programs’ abilities to assist their patients and their caregivers in preparing for a disaster.ClaverML, Wyte-LakeT, DobalianA. Disaster preparedness in home-based primary care: policy and training. Prehosp Disaster Med. 2015;30(4):17.

Assessing Patients' Disaster Preparedness in Home-Based Primary Care

Gerontology ◽  
2016 ◽  
Vol 62 (3) ◽  
pp. 263-274 ◽  
Author(s):  
Tamar Wyte-Lake ◽  
Maria Claver ◽  
Aram Dobalian
Keyword(s):  
Primary Care ◽  
Disaster Preparedness ◽  
Assessment Tools ◽  
High Rate ◽  
Veterans Health ◽  
Health Administration ◽  
Caregiver Support ◽  
Medical Needs ◽  
Home Based Primary Care ◽  
Home Based

Background: Chronic conditions paired with normal aging put home-bound individuals at risk of harm during a disaster. Because of their high rate of comorbidities, veterans receiving care from the Veterans Health Administration (VHA)'s home-based primary care (HBPC) program are especially vulnerable, which may prevent them from being prepared for disaster. With intimate knowledge of their patients' home environments, medical needs, resources, and limitations, HBPC practitioners are uniquely positioned to assess and improve disaster preparedness of patients. Objective: This study explored issues regarding disaster preparedness for HBPC patients, including ways in which policy and procedures support routine assessment of disaster preparedness for patients as well as patient education activities. Methods: This project involved 32 semi-structured interviews with practitioners and leadership at 5 VHA HBPC programs - 3 urban and 2 rural. Transcripts of the interviews were analyzed using content analysis techniques. Results: Three themes emerged regarding the assessment of a patient's disaster preparedness: (1) assessment tools are rudimentary and, in some cases, individually developed by practitioners; (2) comprehension of criteria for assigning risk categories varies among practitioners, and (3) patients' cognitive impairment, limited resources, and out-of-date or inaccessible materials are the primary challenges to their preparedness. A fourth additional theme emerged as well: (4) the interdisciplinary nature of the HBPC team allows for unique innovative practices, such as a central focus on caregiver support and personal safety, as it relates to assessment and preparedness of the patient. Conclusion: Health and functional limitations may prevent home-bound patients from being adequately prepared for disasters. Standardized strategies and tools concerning disaster preparedness assessment for HBPC patients, which allow flexibility in consideration of factors such as local hazards, could assist in creating more comprehensive planning approaches and, in turn, more prepared persons. This is a work of the US Government and is not subject to copyright protection in the USA. Foreign copyrights may apply. Published by S. Karger AG, Basel

Developing a Home-Based Primary Care Disaster Preparedness Toolkit

2016 ◽  
Vol 11 (1) ◽  
pp. 56-63 ◽  
Author(s):  
Tamar Wyte-Lake ◽  
Maria Claver ◽  
Claudia Der-Martirosian ◽  
Darlene Davis ◽  
Aram Dobalian
Keyword(s):  
Primary Care ◽  
Disaster Preparedness ◽  
Online Survey ◽  
Vital Role ◽  
Clinical Expertise ◽  
Veterans Health ◽  
Health Administration ◽  
Preparedness Plan ◽  
Home Based Primary Care ◽  
Home Based

AbstractObjectiveHealth agencies working with the homebound play a vital role in bolstering a community’s resiliency by improving the preparedness of this vulnerable population. Nevertheless, this role is one for which agencies lack training and resources, which leaves many homebound at heightened risk. This study examined the utility of an evidence-based Disaster Preparedness Toolkit in Veterans Health Administration (VHA) Home-Based Primary Care (HBPC) programs.MethodsWe conducted an online survey of all VHA HBPC program managers (N=77/146; 53% response rate).ResultsRespondents with fewer years with the HBPC program rated the toolkit as being more helpful (P<0.05). Of those who implemented their program’s disaster protocol most frequently, two-thirds strongly agreed that the toolkit was relevant. Conversely, of those who implemented their disaster protocols very infrequently or never, 23% strongly agreed that the topics covered in the toolkit were relevant to their work (P<0.05).ConclusionThis toolkit helps support programs as they fulfill their preparedness requirements, especially practitioners who are new to their position in HBPC. Programs that implement disaster protocols infrequently may require additional efforts to increase understanding of the toolkit’s utility. Engaging all members of the team with their diverse clinical expertise could strengthen a patient’s personal preparedness plan. (Disaster Med Public Health Preparedness. 2017;11:56–63)

Evaluating the Quality of Home Care in China Using the Home Care Quality Assessment Tool

2020 ◽  
pp. 104365962095319
Author(s):  
Xianping Tang ◽  
Song Ge ◽  
Chenjuan Ma ◽  
Xuemei Chen ◽  
Yaolin Pei ◽  
...  
Keyword(s):  
Home Care ◽  
Rural Areas ◽  
Assessment Tool ◽  
Home Health ◽  
Care Quality ◽  
Quality Assessment Tool ◽  
Health Agencies ◽  
Home Health Agencies ◽  
Quality Of Home Care

Introduction This study aimed to evaluate the quality of home care in China using the Home Care Quality Assessment Tool (HCQuAT). Method We recruited 38 home health agencies in Shanghai, China, which included 18 in urban areas, 11 in suburban areas, and nine in rural areas. Data on quality of home care from each agency were collected by trained staff using the HCQuAT. Results On average, these home health agencies scored 74.28/100.00 ( SD = 6.80) on the HCQuAT, with an excellence rate of 39.5% and a failing rate of 23.7%. The mean scores on the structure quality module, process quality module, and outcome quality module were 71.2 ± 21.8, 86.6 ± 9.2, and 44.1 ± 37.5, respectively. Significant differences existed across geographic locations ( p = .018). Discussion Significant variations were identified in the quality of home care across quality modules and geographic locations. Outcome quality and quality in rural areas were lower than those for their counterparts.

scholarly journals Hurricanes Harvey, Irma, and Maria: Exploring the Role of Home-Based Care Programs

2020 ◽  
Vol 14 (1) ◽  
pp. 119-124 ◽  
Author(s):  
Tamar Wyte-Lake ◽  
Maria Claver ◽  
Rachel Johnson-Koenke ◽  
Darlene Davis ◽  
Aram Dobalian
Keyword(s):  
Primary Care ◽  
Disaster Preparedness ◽  
Veterans Health ◽  
Health Administration ◽  
Home Based Primary Care ◽  
Home Based ◽  
Complex Patients ◽  
Effective Program ◽  
Home Based Care

ABSTRACTObjective:The aim of this study is to determine the response of home-based primary care programs to the fall 2017 Atlantic hurricane season.Methods:This study examines the experiences of 9 Veterans Health Administration (VHA) Home-Based Primary Care (HBPC) programs in their responses to Hurricanes Harvey, Irma, and Maria. Thirty-four phone interviews with HBPC leadership and staff were conducted from April to July 2018.Results:The total census of impacted HBPC programs was 3118. No program reported loss of life due to these hurricanes. Early preparedness was key to an effective program response. Response included prompt tracking of the patients. In the most affected areas, respondents noted limited resources to support basic patient needs.Conclusions:Medically complex patients served by programs such as the VHA’s HBPC program represent a subset of the population, yet they have an outsized impact on health care resources that could be exacerbated by inadequate disaster preparedness. HBPC programs serve a unique role in supporting the “older old.” They are tasked with supporting disaster preparedness activities of patients. Understanding what is involved in actualizing their requirements shows communities how to effectively engage with these programs.

Disaster Preparedness and Pandemic Plans: A Survey of Nebraska Home Health Agencies

2013 ◽  
Vol 7 (2) ◽  
pp. 182-190 ◽  
Author(s):  
Michele D. Kassmeier ◽  
Sharon Medcalf ◽  
Keith Hansen ◽  
Philip W. Smith
Keyword(s):  
Public Health ◽  
Health Care ◽  
Pandemic Influenza ◽  
Disaster Preparedness ◽  
Home Health ◽  
Basic Information ◽  
Surge Capacity ◽  
Health Agencies ◽  
Home Health Agencies ◽  
Planning Strategies

AbstractObjectiveTo develop a tool that assesses disaster-planning strategies used by Home Health Agencies (HHAs) throughout Nebraska.MethodsA survey of HHAs in Nebraska was created, distributed, and analyzed to assess and gain information about their written disaster plans. Part 1 of this 2-part survey identified agencies with written disaster plans and collected basic information about plan and structure. Part 2 identified detailed characteristics of the HHA and their pandemic influenza plans. Also, pandemic influenza preparedness of HHAs was assessed and compared to other health care institutions.ResultsMore than 90% of the HHAs that responded to the survey reported that they have written disaster plans; almost half of the plans address strategies for surge capacity. The majority of HHAs with plans also have disaster-specific plans for pandemic influenza preparedness. Our findings suggest that Nebraska HHAs have taken substantial steps toward preparedness, although individual plans may vary considerably.ConclusionsThis survey provides a first step at evaluating HHA disaster preparedness plans. It also demonstrates that Nebraska HHAs have taken substantial steps toward being prepared, although individual plans vary widely. (Disaster Med Public Health Preparedness. 2013;0:1–9)

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