Three best practices for caregiver management success
By Linda Donev
In today’s competitive health care environment, there’s increasing demand for high-quality caregivers to serve Medicare, Medicaid, and private-duty clients. According to the U.S. Department of Labor Bureau of Labor Statistics (BLS), employment of home health aides is projected to grow 48 percent from 2012 to 2022.1 BLS data also reveals employment of LPNs and licensed vocational nurses is projected to grow 25 percent in the same span of time.
As the baby boomer population ages, the overall need for health care services is expected to increase too — especially in residential care facilities and home health environments. This means that attracting and retaining the best clinicians and home health aides must be a top priority for home health agencies (HHAs), something that’s easier said than done. While the need for home health is growing, the pool of available and qualified caregivers is not growing fast enough.
A few key practices can help HHAs handle the challenges of finding, managing, and retaining the best caregivers. HHAs that put these practices to work will increase their caregivers’ work satisfaction and improve the quality of care they provide.
The challenges of managing caregivers
Caregiver burnout is a significant industry problem. High rates of annual staff turnover—more than 70 percent in nursing homes and between 40 and 60 percent in home care agencies, according to research by the Paraprofessional Healthcare Institute—have led to an estimated $5 billion in turnover costs each year.2
A primary source of frustration for caregivers is feeling overworked and overloaded with documentation responsibilities. CMS’ OASIS documentation requirements, not to mention quality-improvement initiatives, can be substantial, and many HHAs haven’t transitioned from paper to electronic systems. As a result, caregivers can spend more time manually documenting with paper than caring for clients.
Another issue is that caregivers are occasionally paired with clients who are ill-suited to them and therefore difficult to manage. For example, a nurse who is allergic to cats may not be able to attend to a client who has animals in the home. Such a mismatch would negatively affect the relationship with the client, and could harm both the caregiver’s morale and health.
Going forward, HHAs need to leverage technology and processes to address these and other challenges so they may attract and retain the best talent — despite financial pressures such as increasing overhead costs and projected Medicare cuts.
Best practices for managing caregivers
Increasing employee satisfaction will improve an HHA’s staff-retention rates, quality of care, and bottom line. With that in mind, the following are three best practices to consider when managing caregivers:
Strive for client-caregiver compatibility. Matching well-suited caregivers and clients is the first step in ensuring a successful relationship. This is especially important in private duty, where a caregiver is in a client’s home for six to 12 hours a day. Whether it is language requirements, similar interests, or knowing that a client responds well to a caregiver’s personality, an agency should aim to find as many similarities between caregivers and clients as possible. Obtaining as much information as possible — pets, likes, dislikes, allergies, food preferences, personality type, and so on — on the front end is key.
HHAs manage client-caregiver compatibility internally on the front end. They can also improve these relationships by providing better access to information through web portals. These online “hubs,” or systems, allow agencies to manage operations and store important client information so it is accessible to caregivers. When caregivers have access to their schedules and other pertinent information as soon as it is available, they can better plan their visits, make better use of demographic information on their clients, make their workdays more efficient, and provide clients with better care.
Use Point-of-Care, GPS and EVV technology. While caregivers may not mind using paper during their home-care assessments, having to complete hours of paperwork after the visit is not time well spent. But that work process is typical for most paper-based agencies. Even clinicians who bring devices, such as laptops, to clients’ homes aren’t always equipped with wireless access to send data or may lack a convenient space to type notes. In this case, it’s often easier to take a paper assessment and then enter the data later, but that process does not improve efficiencies for caregivers. Fortunately, electronic tablets simplify charting while standing or sitting. By loading tablets with the appropriate home-assessment programs and creating a policy that requires onsite documentation, you can let caregivers complete their assessments at the point of care, which eliminates the need to rely only on their memory, handwritten notes, and manually syncing later. Granted, there is an initial learning curve when some clinicians begin using tablets. But most of them would not revert back to paper if given the choice.
In addition, this technology can often eliminate paper timesheets altogether. Smart phones with GPS allow caregivers to easily navigate, check in and out of visits, as well as capture tasks performed. Alternatively, electronic visit verification (EVV) systems allow caregivers to do many of these same tasks using clients’ home phones. Both methods reduce back-office work for payroll and billing and alleviate the burden of documentation for caregivers.
Partner with vendors that understand your needs. The health care industry has attracted hundreds of technology vendors that have tools designed to improve communication, work flow, documentation, data capture and business intelligence. Other vendors are new to home care and are still learning. But whatever vendors you choose, make sure they understand the industry, its regulations, and the day-to-day lives of those working both in the back office and in the home. Before seeking any solution, be sure to identify and document the needed functional requirements so you are not sold by just bells and whistles. That requirements list will grow as you see new features offered by various vendors, so it is important to request extensive demonstrations, customer references, and site visits.
Providing excellent home care as an integral member of the health care continuum begins with successfully managing caregivers and clients. By striving for client-caregiver compatibility, leveraging point-of-care technology and selecting an experienced software partner, home care organizations can improve client care, caregiver satisfaction, and, ultimately, financial outcomes.
About the Author: Linda Donev is vice president of Home Health at AOD Software. Linda Donev started her career in home care with Kelley Assisted Living Services in 1985. She transformed an under-performing location in South Florida into one of the most profitable in the country. Linda was later promoted to Regional Manager responsible for 22 offices. In 1988 she started FirstChoice Health Care Services and with her partners grew that business to $12 million in annual revenues before its sale in 1994. Over the next two years Linda consulted for start-up and growing home care businesses. She joined Stratis in 1999 and now leads Sales and Business Development activities. Linda earned a Bachelor of Health Sciences at Florida Atlantic University.