Nurse
burnout has long been a challenge for home health care companies, as care
delivery in the home comes with certain expectations and requirements that may
not be typical of other care settings. But in many ways, the COVID-19 crisis
that began in early 2020 made in-home care even more challenging for nurses and
other care providers whose top priority was maintaining safety of patients
while ensuring continuity of care.

“In
a hospital, the environment is set up to support the clinician. It’s designed
for efficiency of the workforce. In the home, the situation is different every
day, and the clinician has to constantly conform to a new environment,” says
Michael Johnson, practice president, home health for BAYADA Home Health Care,
who has worked in both hospital and in-home settings.

This
uncertain environment is one stressor that can lead to nurse burnout, he says,
along with other factors such as the lack of proximity to colleagues when a
question or patient issue arises. Nurses in the home support patients not just
physically, but emotionally, and they typically find themselves involved in
family and personal dynamics, all while being responsible for documentation of
the visit.

“In
home health you get the meaningful connection….However [also] when you are in
patients’ homes the documentation required is extremely onerous,” Johnson says.
“The thing that stresses clinicians is the amount of work that is not directly
related to taking care of patients.”

“Our
growth is going to depend on our ability to make the experience for clinicians
at BAYADA superior to any other place,” Johnson says. “Technology and processes
can help us do that. It’s our primary strategic objective as a practice this
year because we are really seeing the impact of burnout.”

Johnson
identifies three critical factors to reduce nurse burnout in 2021.

Improving communication

The
time spent on work not directly related to patient care can be frustrating,
particularly in light of the challenges due to lack of support for home health
nurses who typically are working independently. And much of the onus is on the
nurse when it comes to communicating with family, the primary physician, and
other participants in the care process such as DME providers.

“People can be great clinicians, but they may not
have the best communication tools available to them,” says Rob Stoltz, VP of
business development for Citus Health, a digital care coordination platform
serving the in-home care industry. “Many times the nurse leaves the home health
visit and has to coordinate with the DME provider. Then a family member calls
with a question about equipment. Everyone is making phone calls on a one to one
basis, which is inefficient.”

Citus
Health offers a platform to facilitate communication between family members,
care providers and the patient, enabling real-time updates as they take place.
This can be key to preventing the nurse from being the center of
patient-related communications and allowing him or her to focus more on patient
care.

Easing documentation access

An
electronic health record (EHR) is a critical part of any plan of care, as it
documents the patient’s journey. Making the information accessible, however, is
another way to ease the burden on nurses in the home.

“EHRs
are good at collecting data, but not serving it up quickly to provide insights
on next steps and communicating easily to colleagues,” Johnson says.

Further,
documentation that needs to be signed by physicians to ensure CMS timelines are
being met can be difficult to access and deliver in a timely manner.

Technology
platforms like Citus Health enable electronic forms and signatures from home
health physicians and other parties who need to sign patient-related documents.
This can be done wherever they are, rather than having to be in person. It also
reduces the burden of the nurse or caregiver who is coordinating those
documents in the home.

Citus
Health recently released its “App-less” eSignature feature which speeds up the
process capturing these critical signatures because it does not require the
signer to log into a portal or an app.

Coordinating care

Among
the key frustrations of home health nurses is the lack of coordination between
those involved in the care plan — from physicians to therapists, pharmacists
and others. A single hub for the information can reduce the frustration and
lead to a better experience for the patient, family, and importantly, the care
provider.

“[In
the home] you as the nurse primarily serve as the case manager… you are
coordinating the home-based care plan with others,” Johnson says. “In the
hospital, you could read the [physical therapist’s] note, or the OT’s and run
over to the OT department. In the home-based care setting, that person might be
on the other side of town. This is definitely a place where technology could
make things better in terms of reducing the burden on the clinician.”

A
care coordination platform can also save precious time for nurses so they can
focus on what matters most — the patient. In turn, this improves the experience
for the clinician to serve his or her purpose in providing care. And, when the
care coordination platform easily integrates into the organization’s EHR, as
the Citus Health platform does, it means any data captured on the platform can
be automatically added to the patient record.

It
can also serve as a competitive advantage, as in the case of BAYADA home
health.

“Health
care is a team sport if it’s done well,” Johnson says. “Technology can make
sure every player is in the right place at the right time and achieving their
full potential.”

To
learn more about how Citus Health can help your organization improve
communication and collaboration to reduce nurse burnout, visit CitusHealth.com.