 |
Next Step in Care
In 2006, the United Hospital Fund began laying the groundwork for a campaign that brings its prior work on family caregiving to a new and broader level. Recognizing that transitions in care settings are critical points for family caregivers, patients, and providers alike, the Fund started work on Next Step in Care: Family Caregivers and Health Care Professionals Working Together, a multi-year, multi-dimensional campaign to change practice so that family caregivers are routinely involved in planning, decision making, and coordinating care, particularly around transitions in care settings.
Next Step in Care has its own website (launched January 13, 2009)--www.nextstepincare.org--featuring free information, guides, and other tools.
Through the routine inclusion of family caregivers in transition planning, implementation, and follow-up, the campaign aims to make transitions in care smoother and more efficient, which will benefit patients, family caregivers, and health care providers. To better enable family caregivers to manage transitions in cooperation with professionals, a series of guides and checklists have been created, and framing information has been developed.
Next Step in Care is seeking the active participation of health care leaders and other professionals—from hospitals, rehabilitation units in nursing homes, and home health agencies—to implement changes that meet the campaign’s goals. Next Step in Care is also seeking the active participation of caregiver organizations and social service agencies that come in contact with family caregivers.
Next Step in Care differs from other efforts to improve transitions because it
• Focuses on the role of family caregivers
• Stimulates change across health care sectors (hospitals, rehabilitation units in nursing homes, and home care)
• Provides specific tools that address the most common concerns of both providers and family caregivers
What the Next Step in Care Website Offers
Free, downloadable materials are available from the Next Step in Care website: www.nextstepincare.org. Guides and checklists for family caregivers include:
• HIPAA: Questions and Answers
• Your Family Member’s Personal Health Record
• Family Caregiver’s Guide to Medication Management (including easy-to-fill-out form)
• Family Caregiver’s Guide to Advance Directives
• The Next Step in Care: What Do I Need as a Family Caregiver?
• Hospital-to-home Discharge Guide
• Going Home: What You Need to Know
• A Guide to the ER
• When the Next Step in Home Care: A Family Caregiver’s Guide
• When the Next Step is Rehab: A Family Caregiver’s Guide
Guides for health care providers will include:
• Guide to HIPAA
• Guide to Caregiver Needs Assessment
• Medication Management Guide
How Next Step in Care Was Developed
All were developed by the United Hospital Fund with feedback from content experts, a health literacy expert, health care professionals (from hospitals, nursing homes, and home health agencies), and family caregivers. During summer 2008, these material were pilot-tested at 10 New York sites—four hospitals, four rehabilitation units in skilled nursing facilities, and two home health agencies (in two units each). With the endorsement of senior administrators at each pilot test site, physicians, nurses, social workers, case managers, therapists, and nursing aides on the selected units were briefed and provided binders with all the materials and additional resources. They were also provided with packets of materials (the Family Caregiver Bundle) to give to family caregivers at the start of the episode of care to serve as resources throughout the stay and in preparation for the transitions. In all, over 300 staff members were briefed, and 700 copies of the Family Caregiver Bundle were provided.
Through surveys and debriefing sessions, Fund staff assessed the experiences of these participants. A number of family caregivers were also asked to complete surveys. The response to the content was overwhelming positive. Typical comments from staff:
“I learned a lot from the material.”
“Everyone on staff should have this.”
“The family caregivers were grateful to get this information.”
Integrating the materials into routine practice—admittedly a challenge for busy providers and overwhelmed caregivers—will be the next focus of Next Step in Care, and additional tools will also be developed. Materials have already been translated into Spanish and will also be translated into Chinese and Russian.
The United Hospital Fund’s focus on transitions in care as a critical challenge for family caregivers dates back to 1998—and in fact was the subject of the Fund’s first family caregiver-focused publication, “Rough Crossings: Family Caregivers’ Odysseys through the Health Care System.” This report dealt with the problem of transitions and the poor communication and training that often accompanied hospital-to-home discharges. Since then the problem has, if anything, become worse as chronically ill patients move frequently, and often precipitously, from hospital to rehab units to home, with rehospitalizations and medication errors unfortunate and costly consequences.
The Fund’s early recognition of the importance of family caregiving was reinforced by a May 2008 report from the Institute of Medicine, Retooling for an Aging America: Building the Health Care Workforce. The report confirms what family caregivers know and experience every day: “In assuming specific tasks and responsibilities, [family] caregivers become part of the health care delivery team and contribute directly to medical outcomes….”
|
|
