- CATEGORIES: Businesses,Data and Research,Doctors and Hospitals,News,Nurses,Press Release,Research,Research for Business,Technology,Technology for Business
- No comments
According to a 2012 report by The American Health Care Association, there are more than 15,600 nursing homes in the U.S., housing more than 1.4 million residents. (AHCA, 2012) How can we provide quality, standardized care, while also minimizing the strain on healthcare resources?
THE BURDEN ON PHYSICIANS
Currently, more than $178 billion is spent on nursing home care annually. In 2010, 35 million Americans were over the age of 65, and this number is expected to increase so that by the year 2020, 20% of Americans will be 65+, with 6.6 million people residing in nursing homes by 2050. (Gale Group, 2013) These numbers create additional stress on an already overburdened category of healthcare professionals – nursing home physicians and staff.
The American Academy of Family Physicians reports that on average, family physicians conduct 89 office encounters with patients each week, supervise 9.6 nursing home residents, and conduct 2-3 nursing home visits per week. All tasks combined, on average, family physicians spend more than 45 hours a week on nonadministrative tasks, and an additional 5-6 hours completing such tasks. (AAFP, 2011)
Instead of on-site staff physicians, more than 80% of nursing homes use community physicians to provide care. The magnitude of responsibilities they must manage ranges from regular chart and patient function reviews, to physically attending to each resident in a timely manner consistent with state and federal guidelines (visit every 30 days for the first 90 days following admission, and at least every 60 days thereafter) while making sure all appropriate tests, treatments, services, and medications are being administered. (Nanda, 2007) Additionally, physicians are frequently called when nursing home residents fall on the floor, fall out of bed, have a fever, need new orders, have abnormal labs, need a prescription, etc.
As the attending physician is responsible for the care of their residents at all times, the demand on these physicians’ schedules creates a heavy burden.
NURSING HOMES AND ED VISITS
Additionally, nursing homes are substantial users of emergency departments (EDs). The Centers for Disease Control and Prevention (CDC) reports that a National Nursing Home Survey indicated 8 percent of U.S. nursing home residents had an ED visit in the past 90 days. Of those visits, 40 percent were potentially preventable.
Over one- third of the preventable ED visits were for injuries related to falls. Among other preventable ED visits were chest pain, chest pressuring or burning, pneumonia, UTIs, GI bleeding symptoms, fever, and skin diseases. (Caffrey, 2010)
With an estimated 1.4 million Americans living in nursing homes, and an average cost of $1,349 per ED visit, nursing home patients are potentially costing the US healthcare system more than $151 million dollars annually in preventable ED visits.
PROVIDING A POWERFUL SOLUTION
A simple yet powerful solution to maximizing physician time AND reducing the number of unnecessary emergency room visits by nursing home patients is the utilization of telephone triage nursing.
Working with a nurse triage call center, whether internal or external, allows nursing homes to ensure that each patient receives quality, standardized care regardless of which personnel are working, the time of day, or the availability of the attending physician.
In a manuscript published by the National Institute of Health Public Access, a study indicated that in long-term care settings, nurse-physician communication was an impacting barrier on patient safety. Nurses taking part in the survey indicated that two of the key issues were:
- Feeling hurried by the physician
- Difficulty reaching the physician.
The study revealed that a “lack of timely call back by the physician contributed to suboptimal nurse preparedness because the nurse would be less likely to have the information on hand if they waited a long time to speak with the physician.” (Tija, 2009)
With telephone nurse triage, trained Registered Nurses working at nursing homes can easily implement Schmitt-Thompson protocols to handle patient health concerns in a timely manner. Whether a patient experiences a slip and fall or is experiencing high glucose levels, a nurse triage call solution ensures that standardized protocols and appropriate actions are used without delay.
In addition, attending physicians have the option to include custom orders as part of the nurse triage. This can help decrease the number of calls made to nursing home physicians, as specific orders can be easily followed without ever calling the doctor.
NURSE TRIAGE AND ER/ED VISITS
Utilizing call-based nurse triage is also an efficient way to reduce healthcare costs for unnecessary ER/ED visits.
With the current and increasing number of nursing home patients in the US, it is imperative that nursing homes begin implementing procedures to ensure that only patients in real need be admitted to the ER/ED.
With the right nurse triage call solution in place, patients will no longer be admitted to the ER for conditions unwarranted by standardized protocols. Instead, nursing home staff can be efficiently directed to employ proper procedures that effectively manage the situation.
NURSING HOME BENEFITS
Nurse triage call options offer extensive benefits to everyone involved in nursing home care.
- For physicians, the standardized protocols and custom orders can help reduce the amount of time spent on non-emergency phone calls with nursing home staff.
- Patients receive quality care based on their actual needs.
- Nursing home staff have immediate access to standardized protocols without delay.
Progressive, patient-centered nursing homes recognize the benefits of utilizing a call-based nurse triage to increase efficiency and quality. As the percentage of Americans aged 65+ increases, these nursing homes will be at the forefront of recognized quality.