The Shape of the Visit Susan Balfour RN

Transcription

1 The Shape of the Visit RN Conference by the Bay 1. How would you define and effective and efficient visit? 2. Four Perspectives on the Visit Clinical Staff Agency Management The primary, if not the only, interaction between the agency and the patient and family Critical for o gathering information needed to establish and carry out the plan of care o teaching o building trust Personnel costs are the largest budget line item Limited resources, almost unlimited needs Productivity must be considered Each visit is an opportunity for branding the agency Facility Partner The Patient and Family What happens during the visit embodies hospice care for the facility staff Each visit demonstrates the respect, or the lack thereof, that the hospice has for its facility partner The visit is the patient s experience and the family s memory 1

2 The Shape of the Visit Managers readily identified staff members that were very skilled at conducting visits Four consistent qualities mentioned 1. Excellent management of patient and family needs 2. Thorough and timely patient/family teaching 3. Regular involvement of other disciplines in the care 4. High visit productivity Was not related to length of time in the position 2

3 Some Key Points What Would You Add? Focus & Intention The care plan should guide care No matter how good the plan for the day, it may need to be changed Plan for the day needs to be checked with patient and family The quality of our presence has great impact on the environment A visit is not an isolated incident, it is part of a continuum Involving Other Disciplines Interdisciplinary care is a basic tenet of hospice care Patients and families are cheated if it is not provided We all need to develop our skills in Identifying cues that tell us another team member is needed Marketing our team members Getting them in the door Boundaries We are there as compassionate healthcare professionals not as friends It is all about them; introducing our own problems or personal issues is a form of abuse It is beyond our power to save people The team can be very helpful and supportive in helping identify and work with boundary issues Basic Organizational Skills Some people are born with organizational skills; others are not Being in the latter group does not excuse people from being organized; it just means they have to be more deliberate about it An organized team member increases the sense of security for patients and families An organized approach preserves sanity 3

4 The Visit Quality Continuum An isolated, unconnected event An intentionally designed interaction understood to be part of the continuum of care The Visit Stages & Cycle Post-Visit Wrap-Up Pre-Visit Preparation The Visit 4

5 The Most Common Hospice Measures Visits Easy to measure and manage Can lead to unneeded visits to get quota Misses the mark as a measurement of overall caseload management Based on the assumption that more is better Caseload Harder to measure Makes more sense given our model of care and reimbursement Must consider acuity; no validated tool available Must factor in admissions, deaths & discharges Key Performance Indicators - Visits Calls to on-call Use of GIP or continuous care ER visits & 911 calls Revocations & discharges Family satisfaction measures Complaints Overly long or short visits High or low number of visits Overtime Anything else? 5