Try these quick tips for IPS changes
No education manager likes to give staff only the bad news, and with the interim payment system, it seems that all the news is bad. If you want to help staff see the bright side of this industrywide transition, here are some suggestions of what to do:
o Customize staff.
Beaumont Home Care in Sterling Heights, MI, is working on a new concept expected to help improve the agency's productivity. "I'm really looking at the concept of customization or mass customization, which marries specialization with mass production," says Deborah Kleinhomer, MSN, RNC, CNAA, CHCE, director.
"It's economically unfeasible to serve the patient population efficiently with specialization," she says. "When care used to be 30 to 40 visits a patient, then you could intersperse a specialist in that care now and then. But not with six visits."
So the agency is redesigning the nursing provision of care by designing customized programs. Nurse specialists who work in the area teach staff nurses about a particular specialty. Staff nurses must pass a test or competency-based requirement. Then they can provide that specialized care and consult with a specialist when necessary.
The "customized" nurses are more marketable to the agency's patient population, and they are more flexible. Most of the time, they will provide the same general care as would any RN. However, occasionally they will be called upon to treat a diabetic patient or someone who needs wound care, Kleinhomer explains.
o Benchmark costs and productivity.
Beaumont Home Care uses benchmarking studies to measure its agency's costs and staff productivity, Kleinhomer says. "We're looking at productivity per discipline, and we're looking at utilization per diagnosis and per discipline. There will be more standardization with operating procedures, and benchmarks will be valued."
The advantage to this approach is it gives an agency a good idea of what its peers are doing in terms of productivity and costs. The disadvantage is that it may increase staff stress, at least in the short term.
o Carefully evaluate each patient upon admission.
The Visiting Nurse and Hospice Services in Kalamazoo, MI, is putting a great deal of its focus on evaluating new patients before admission.
"We take a look at what the patient's needs are," says Jill Eldred, president and chief executive officer of the agency. "Before we admit a patient, we're taking a very close look at how many visits per year they will require."
If the patient will be a long-term case, requiring visits twice a day, the agency may decide not to accept that case, Eldred says. "We have not denied very many admissions to very many people. But all of the staff and nurses know that they need to let the family know upfront, upon admission, that our goal is to teach and train them to take care of themselves."
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