In this final article of my three-part series on achieving client satisfaction with home care, I will explain how collaboration between our office administrative staff and our nurse supervisors is so critical throughout the entire span of a client’s relationship with Ready Hands.
Here’s a typical process that many companies employ for enrolling new clients for in home care assistance: A licensed practical nurse or perhaps a registered nurse, paid by piecework, visits a prospective client to perform an assessment. The nurse then completes an intake form and hands it off to a clerical employee at the agency’s office, whose job it is to find a home care worker(s) to assist the client. If the clerical person is unsuccessful, he or she may turn to another administrative employee and ask that a suitable home care worker be recruited for the job. If problems arise, they are generally handled by office personnel. The nurse is not necessarily available, and actual onsite visits are rare. I’ll call this kind of system the “traditional approach.”
Here are the problems with this traditional approach:
- The individuals responsible for assigning home care workers have never met the client or family, and may not know the key factors upon which success depends.
- The nurse, being a costly expense for the agency, is used sparingly, yet she is the only person who knows the client and family first hand.
- Office staff are often incentivized to get new clients at all costs and may promise more than can be delivered.
- Assigned home care workers may be unsuitable, because a good “match” can only occur if someone with first-hand knowledge of a client’s situation is actively involved in selecting the right caregiver (see part 1 of this series).
- The agency’s office personnel occupy job silos with separate duties, thereby reducing collaboration and coopration.
- Little ongoing monitoring takes place. Clients can become thoroughly unhappy before problems are addressed.
At Ready Hands, the system that has evolved over time is uniquely ours and differs in almost every respect from that described above. It may help that the owners, including a physician and registered nurse, have been seeing clients in their homes since the day our company opened its doors. They know from long experience that the representative of our company who actually sits down with clients and families is the person who is most important to achieving a successful experience with in home care assistance.
Our nurse supervisors are full-time, seasoned registered nurses whose job it is to learn clients’ needs and expectations first hand, then participate actively in all stages of assigning and supervising our Home Care Aides. Our nurses are not paid by the visit but are salaried. They can invest the time it takes to get to know and respond to the unique circumstances that every client brings to the table. When they complete an initial assessment, they confer with office administrative personnel collaboratively to identify the best Home Care Aide for the client. Then, they monitor the case closely as it gets underway, making whatever proactive adjustments are needed so that the client’s needs and expectations are met.
Our office staff do not have mutually exclusive job descriptions, but rather work as a team. All are cross-trained in key job duties, so that they are familiar with staffing, recruitment and scheduling functions. And, they coordinate all decisions about a particular client with the registered nurse assigned to oversee that client’s services.
Here are a couple of real-world examples of how each of the two systems described above can have major implications for client satisfaction:
Mrs. T. needs an aide from 8:30 a.m. to 1:30 p.m. Monday through Friday to assist with morning personal care activities, help with meals and occasionally drive her to appointments. Mrs. T. has a cat in the home that she adores.
Traditional approach: an aide arrives the first day 20 minutes late, but otherwise is eager and helpful. However, late arrivals continue, and when Mrs. T’s doctor’s appointment is due, she learns that the aide has been taking the bus every day and does not have a driver’s license. Then it turns out that the aide has to put her six-year-old on the bus to elementary school just before 8:00 o’clock, so an 8:30 start time was never going to work. Finally, the aide’s continuous sneezing the first week makes it clear she has an allergy to cats.
Ready Hands approach: before assigning a Home Care Aide for Mrs. T., the nurse supervisor and office staff review all the choices, checking for obstacles like scheduling conflicts, pet allergies, lack of a driver’s license or a poor driving record. When they agree upon the best candidate, the nurse brings the aide to Mrs. T.’s home for a preliminary interview. If all parties agree at that point that the aide will be a good fit, then things are likely to work out well.
Dr. G., who lives in Fairfax Station, needs a full-time day aide from 8:00 a.m. to 7:00 p.m. seven days a week. He has impaired mobility and requires someone to assist with transfers from bed to chair. He has had negative experiences with home care in the past.
Traditional approach: A bright, professional aide arrives and Dr. G. feels immediately relieved. However, the aide states that the commute from her Maryland home to Fairfax Station took two hours and she simply can’t keep that up. She also notes that a chronic back problem prevents her from doing any significant lifting. She says her agency never informed her of the long commute or the necessity for assisting with transfers.
Ready Hands approach: The commute distance and necessity for lifting would have been forefront in governing the selection process for the right Home Care Aide.