Quality of Hospital Communication and Patient Preparation for Home Health Care: Results From a Statewide Survey of Home Health Care Nurses and Staff.

Jones CD1, Jones J2, Bowles KH3, Flynn L4, Masoudi FA5, Coleman EA6, Levy C7, Boxer RS8.

Author information

1: Division of Hospital Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO. Electronic address: christine.jones@ucdenver.edu.
2: College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO.
3: School of Nursing, University of Pennsylvania, Philadelphia, PA; Visiting Nurse Service of New York, New York, NY.
4: Rutgers School of Nursing, Newark, NJ.
5: Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO.
6: Division of Health Care Policy and Research, University of Colorado Anschutz Medical Campus, Aurora, CO.
7: Rocky Mountain Regional Veterans Affairs Medical Center, Denver, CO.
8: Rocky Mountain Regional Veterans Affairs Medical Center, Denver, CO; Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO.

Abstract

OBJECTIVES:

To evaluate the quality of communication between hospitals and home health care (HHC) clinicians and patient preparedness to receive HHC in a statewide sample of HHC nurses and staff.

DESIGN:

A web-based 48-question cross-sectional survey of HHC nurses and staff in Colorado to describe the quality of communication after hospital discharge and patient preparedness to receive HHC from the perspective of HHC nurses and staff. Questions were on a Likert scale, with optional free-text questions.

SETTING AND PARTICIPANTS:

Between January and June 2017, we sent a web-based survey to individuals from the 56 HHC agencies in the Home Care Association of Colorado that indicated willingness to participate.

RESULTS:

We received responses from 50 of 122 individuals (41% individual response rate) representing 14 of 56 HHC agencies (25% agency response rate). Half of the respondents were HHC nurses, the remainder were managers, administrators, or quality assurance clinicians. Among respondents, 60% (n = 30) reported receiving insufficient information to guide patient management in HHC and 44% (n = 22) reported encountering problems related to inadequate patient information. Additional tests recommended by hospital clinicians was the communication domain most frequently identified as insufficient (58%). More than half of respondents (52%) indicated that patient preparation to receive HHC was inadequate, with patient expectations frequently including extended-hours caregiving, housekeeping, and transportation, which are beyond the scope of HHC. Respondents with electronic health record (EHR) access for referring providers were less likely to encounter problems related to a lack of information (27% vs 57% without EHR access, P = .04). Respondents with EHR access were also more likely to have sufficient information about medications and contact isolation.

CONCLUSIONS/IMPLICATIONS:

Communication between hospitals and HHC is suboptimal, and patients are often not prepared to receive HHC. Providing EHR access for HHC clinicians is a promising solution to improve the quality of communication.