All aboard! Get MDs involved in home care
Getting your hospital’s doctors actively involved with your agency’s patients can be a tall order; however, it’s not impossible. Although difficulties often arise in winning physicians over to the team approach of home care, by keeping the patients’ continuity of care at the top of your list, you can win doctors over. As a hospital-based agency, you have an edge over your competition to do so.
"Contrary to independent agencies, hospital-based agencies have the opportunity to work in a true case management model that would bring the physician into the equation sooner," says Joanne Lamprey, RN, president of InterQual, a North Hampton, NH, company that provides medical appropriateness review systems, credentialing, and quality services to the health care industry. "When you’re in the hospital, the physician manages your care. If the hospital owns the home care agency, then we’re all working for the same goal, which is to get this patient back home and functional in society. You can then look at the home care agency as part of the continuum."
Peter Boling, MD, Virginia Commonwealth University-Medical College of Virginia, and president-elect of the American Academy of Home Care Physicians, recommends using the following strategies to get your hospital’s physicians to embrace the team approach:
• Leadership.
Specifically, Boling says to look for strong opinion leaders on the medical staff and enlist their help in creating a culture that supports home care.
• Peer pressure and group culture.
"By this I mean the sense that this is a good thing other respected doctors in the community are doing and therefore the doctors on staff should also," says Boling.
• Education.
"If people are reluctant to use home care or be involved in home care mostly because they don’t understand what to do, then education is a good tool," says Boling.
"I think that’s an issue in some areas, there is still a tremendous lack of knowledge about the many capabilities of home care," says Lamprey. "Patients with diabetes, cardiac and/or chronic respiratory conditions are prime candidates for exacerbation of condition and resulting hospitalization.
• Systems support.
"One reason doctors don’t like home care is because it’s really cumbersome," notes Boling. "There is lots of paperwork, and as doctors refer to it, there’s a real hassle factor. If you can create systems that make the hassle factor less, make it easier for the doctor to do their part of the beaurocracy involved in home care, then that will be a very positive thing."
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