Harvard Pilot Study Examines the Importance of the In-Home Care Checklist

Posted on Monday, August 22, 2016 7:24 PM

The Harvard Medical School initiated a pilot study over a six-month period that has already shown success in reducing hospital readmissions among home care patients. The results concluded that caregivers who use a short checklist about their patients’ conditions were able to report a number of changes that could result in more serious care interventions if left untreated.

The study observed at 22 offices with Right at Home (RAH), a home care company with more than 310 offices in 45 states.

Caregivers were required to clock-in and clock-out of a web-based platform by ClearCare that functions for the following:
• Visit scheduling
• Integrated telephony for point-of-care reporting
• Two-way caregiver messaging
• Other managerial functions

The checklist asked several questions, such as,” Does the client seem different than usual? Has there been a change in mobility, eating or drinking, toileting, skin condition or increase in swelling?”

A caregiver must note if there are any changes to the patient. If the patient shows sign of change, then the caregiver is required to submit a task on the system dashboard of the office’s care manager. The care manager uses that task to determine if additional actions are required for the patient.

“Most interviewees suggested that changes in condition would not have been reported without the in-home checklist,” the study reads. “They also reported relatively few ‘false positives’ in that they felt that most of the tasks warranted attention.”

During the course of the study, the following results were found:
• Caregivers throughout the 22 RAH offices that participated reported condition changes after 2% of all shifts
• There were 402 hospitalizations during the study

Caregivers explained that the changes would not have been tracked without the checklist. However, care managers had varying views on the system.

“Certain care managers expressed concern that they already had systems in place to track changes in condition and hospitalizations and questioned the need for the In-Home intervention,” the study reads. “One care manager explained that, before the In-Home pilot, caregivers would call the office to report a change in an individual’s condition. thus, she felt that the In-Home program was somewhat redundant.”

Fortunately, caregivers stated that the checklist had a positive effect and felt “enthusiastic about the intervention,” according to the study.

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