Michelle Sieveke, Director of Home Care & Hospice for Monument Health, thinks the best part of working in home health is the ability to care for patients holistically. Home-care professionals such as nurses and therapy providers get a unique glimpse into their patients’ home environments, meaning they learn more about family support, available resources and other factors that may affect their health.
“It’s one of the great things about home health – you really do get to know the patient and their family,” Michelle said. But because home-health caregivers are so mobile, ensuring they are following the same processes and have the same quality and productivity goals can be difficult. Home-health clinicians also need to integrate duties such as drive time, documentation, meetings and education into their work week, so structure is very important.
In 2017, Michelle and others on her team partnered with Kacey Rikala, Business Innovation Director for Home+, to create a model that would not only outline quality and productivity standards for Home Care caregivers but give them more support. Kacey reviewed data from organizations such as the National Association for Home Care & Hospice to develop the model. It was piloted with a small group in the spring of 2017, and after several tweaks was rolled out to the whole team in Fall 2017.
The model has helped the team maintain high productivity (number of visits) while also assuring quality standards are met. Caregivers who meet or exceed their goals receive a bonus. The model also helps create a level playing field in terms of caseload. Additionally, a case manager position was created to support caregivers who have questions or need assistance during visits. Case managers also track quality data and report out monthly.
Michelle said part of the reason the model has been so successful is that data regarding patient satisfaction scores and outcomes is shared with caregivers, and there is constant communication within the team regarding how they can improve. “It’s really about being transparent,” she said. “Caregivers like seeing where they’re at and how they can do better.”
The model is a constant work in progress and will be reviewed quarterly based on patients’ needs. “This is a continuous improvement process,” said Kacey, who attributes the project’s success to the partnership between clinical and business caregivers. “I think Home+ has been so successful because we’ve identified the need to pair a business leader with a clinical leader. I’m not a clinician, and Michelle might not be good on the business side, but together we can do something really special.”
When all is said and done, the overall success of the model is owed to the more than 100 Home Care caregivers in Rapid City and Spearfish. “It’s an art to be able to talk to the patient while also doing an assessment and to connect with them but also make sure you complete your documentation,” said Michelle.
“These caregivers are out there alone,” said Kacey. “A plethora of things can happen while they are there, and they have to be able to handle those situations on their own. They’re amazing.”