Your physician may order a “Start of Care” with Home Health Care, to provide care after a change in your health.
Many illnesses and surgeries are notorious for re-hospitalization, and home health care can reduce that possibility (Healthleaders, 2018). In order to keep you home and out of the hospital, your home care nurse or therapist will need to perform a lengthy evaluation. Your first visit, called a “Start of Care”, can be detailed…please know your nurse or therapist is required to ask and assess many different things to ensure we address all areas that could contribute to interfering with your healing process. They want to ensure that you recovery is timely and thorough!
Tips for clinicians to help with a great “Start of Care” :
Here are 9 tips for an Oasis-like OASIS.
1. Phone call prep: Always clarify address and back up number, and make sure insurance cards, medications, and hospital paperwork (especially if there are new precautions) are laid out and ready for assessing. **IF the visit is cancelled or the patient information is incorrect, take a minute to notify your team! They will love you for it 🙂
2. Begin at a table, where you can lay out the booklet and paper work, collect signatures, and perform vitals.
3. Clarify prior status and patient goals. This will help you prioritize what you need to assess. Double check past medical history, as pertinent information may be missing in documentation- it may change what or how you assess.
4. Be up front about the activities you wish to observe, and find out how they feel about completing them: not only are they prepared, but then they can let you know if they have any concerns. They may suggest a different activity they feel unsure doing, thus presenting you with a way to assess and educate them (and gather your Oasis information) at the same time. (For example: you may want to do a 2 minute walk test, but they may prefer to practise a car transfer for their follow up visit the next day).
5) Get creative and incorporate measurement tests within functional activity, as so often their endurance is limited. (For example, 2 Minute Walk Test and end in bedroom for bed mobility and skin check). Or a Tug assessment ending in the bathroom for toileting safety and skin check).
6) Have a small checklist or cheat sheet with reminders of the things you cannot call to check on afterwards: Vitals, skin assessment, equipment check, medication, signatures… You can always call back to ask about the flu shot, but certain things cannot be assessed or attained once you have left the home!
Check out this cute home care notebook for staying organized with patient care! (affiliate link)
7) Leave a calendar with your information and next visit documented. Write down Dr visits, dates for bandage changes, or any other scheduled assessment. See my Premium Resources page for a free printable monthly calendar!
8) Call the physicians office as soon as you can (bribe yourself with a coffee if you must:)). Don’t put it off unless you are waiting on information. You will thank yourself at 4:30 when you remember, and then the call line is off for the night!!
9) Don’t undervalue safety and technique verses ‘ability’. Too often I have seen at discharge that someone was rated “supervision” or “Mod I”, when they should have been “Contact Guard”. As I tell my teenagers all the time “just because you can, doesn’t mean you should”. Many of these “Mod I” designations were performed unsafely with poor technique. These measurements affect reimbursement and ratings. When we assess correctly we help demonstrate our (and the patient’s) hard work and achievements.
Resources to assist with a great “Start of Care”:
Here is a freebie you can print out and use for patient care!
Click this link for a quick overview of the Oasis Assessment.
And of course Medbridge has an amazing course on Oasis documentation!
There are even U tube videos with sample assessments if you are new to Home Health Care and want to learn more!!
I would love know what you think! What is the most difficult part of the assessment for you? Do you have any tips to share? Subscribe to the blog for weekly tips and information!