HOME CARE Scenario
Type of Care Provided
Care in this capacity can range from short term to long term based upon the changing needs of the patient. Patient age can range from pediatric to elderly. Care can be provided in the patient’s private home, group home, or assisted living setting. Medical homes fall into this category and are a new focus of Accountable Care Organizations through the Affordable Care Act of 2010.
Standardization, process, attention to detail, and uniform adherence to policy are the most difficult con- cepts for Louis to impress on his managers. As a quality insurance director for a home health company, he continually finds errors that put the company at risk. More importantly, they put people at risk. There are three shifts and 27 managers. Most follow protocol well, but there are eight managers who have been with the organization for over 10 years who do not. When the process was revamped late last year, these eight managers rejected the changes and instructed their employees to continue charting as they had been doing in the past. This has created a great deal of confusion at shift change, as well as hostil- ity with the other managers, who feel their teams will make errors because information was not charted within the scope of the new policy. The managers who refuse to follow the new charting process admit that they understand what is expected, but they state that the new process is cumbersome, increases error, and obscures vital data. The managers that refuse to comply with the new process are also some of the best in the organization. They say they are not objecting because they want to avoid change or work. Instead, they detailed a list of problems and risks that they identified as a result of the new process and gave it to the leaders of the home health company. This put the company in a bind. They had invest- ed $750,000 in the new system and had service agreements for the next two years. However, they could not just dismiss the concerns or risks communicated by the eight managers. Louis’ job was a nightmare. Everything was at an impasse and people were at risk.