Many factors are part of making HHA referrals
Many factors are part of making HHA referrals
Discharge planners provide important tips
Hospital-affiliated agencies have it easy. They automatically get every referral from their hospital. Right? Wrong, say hospital discharge planners interviewed by Hospital Home Health. In fact, one hospital discharge planner admits that only 30% to 40% of her referrals go to the hospital-affiliated agency.
While discharge planners usually are more familiar with and have a great deal of confidence in their hospital’s affiliated home health agency, many other factors must be considered before a referral is made, says Sandy McFolling, director of resource coordination at Rush-Presbyterian-St. Luke’s Medical Center in Chicago, whose hospital refers 70% of her home health patients to the hospital-affiliated agency. Therefore, home health agency managers cannot assume that their marketing efforts are better spent on other referral sources.
The discharge planners at Henry Ford Hospital in Detroit refer no more than 40% of patients to their hospital-affiliated agency, says Denise Allar, RN, director of case management and social work services.
The reasons for not referring to the hospital-affiliated agency are not related to quality or service, but instead to patient or physician preference for an agency with which they had previous experience, a payer’s preferred provider list, or a need for a specialized service, she says.
The best thing you can do is to make sure hospital discharge planners know what services you offer and how to reach you, says Carol O. Long, PhD, RN, home care consultant for the Capstone Group in Phoenix.
In a study conducted by Long that included a survey of hospital discharge planners in Arizona,1 she discovered that discharge planners lack information about many home health agencies in their area.
"I was surprised by the misinformation among discharge planners about the prospective payment system, financial constraints on home health agencies that could affect services, the nursing shortage within home health, and the use of telehealth in home care," she says. There also were concerns about weekend and night coverage, and some discharge planners did not know what agencies offered it, she adds.
While discharge planners do want to know what your agency offers, make sure you present the information in a way that helps the discharge planner do his or her job, Allar suggests.
"New agencies have come into our area and given us trinkets and lunches, but that doesn’t guarantee that we’ll call them with our next referral," she says. "If the patient or physician doesn’t have a choice of agency, we will refer to agencies that offer the services we need and that have a proven track record with us," she adds.
New agencies can introduce themselves to Allar’s employees through letters and with collateral materials that she distributes. "We don’t have agencies come in and make presentations because it is too time-consuming, but we do have vendor fairs once or twice a year at which agencies can display their services," she explains.
Instead of spending a lot of money on brochures for discharge planners, McFolling suggests that home care agencies produce a single page information sheet that lists specialty services provided by the agency, payer plans in which the agency is a preferred provider, geographic boundaries, a telephone number that is answered by a person at the agency (not a recorded message) seven days a week and at night, and an explanation of the type of weekend coverage provided.
Having a telephone number that is answered by a home health agency employee is important, McFolling says. "I prefer not to leave messages with an answering service." She suggests that home health agencies have a staff member on call to answer a cell phone that is for weekend or night referrals. An answering service should have the capability to connect the caller directly to the staff member on call, she adds.
Discharge planners are interested in one-stop shopping, Long says. "They want to make one telephone call and know that the patient will be seen in a timely manner and all home medical equipment needs will be arranged," she says. "A discharge planner does not want to get a call from the patient asking why the visit hasn’t occurred several days after discharge," she explains.
"Feedback is important," McFolling says. "It is nice to get a brief report that the patient was seen and that a plan has been developed and the patient is doing well."
It is important to let the hospital discharge planner know if there is a problem, she adds. "We want to know about re-hospitalizations, errors in the discharge orders, or patients who went home without medications. We need to know if the picture we painted of the patient was wrong," she says.
When you are introducing your agency to discharge planners, be sure to ask how they want to get information, McFolling suggests. "E-mail updates are a great, efficient way to let us know if an agency is adding services or changing telephone numbers or hours." Faxed notes also are another easy way to communicate, she adds.
Although most discharge planners don’t have time to hear a presentation on an agency’s services, one agency in Allar’s area provides inservice education with continuing education units (CEUs). "The topics cover infectious disease, adult protective services, and disease management," she says. The home health agency uses a meeting room in the hospital and offers the course during lunch. Because RNs must earn CEUs to maintain their license, this is a great way for an agency to demonstrate its clinical competence and help discharge planners maintain their professional licenses and stay up to date on current issues, Allar explains.
Allar can’t overemphasize the need for home health agencies hoping to get hospital referrals to offer weekend and evening service. "It is critical for my staff to be able to refer patients to home health on the weekends. We know who can and can’t accept weekend referrals, and we know which agencies will see new patients on a Sunday and deliver equipment on Sundays," she says.
"Agencies that are able to handle referrals on weekends and weekdays are more likely to get the weekday referrals because the discharge planners know they can depend on good service," Allar adds.
[For more information about working with hospital discharge planners, contact:
- Denise Allar, RN, Director, Case Management and Social Work Services, Henry Ford Hospital, 2799 W. Grand Blvd., Detroit, MI 48202. Telephone: (913) 916-1724. E-mail: [email protected].
- Sandy McFolling, Director of Resource Coordination, Rush-Presbyterian-St. Luke’s Medical Center, 1650 W. Harrison St., Chicago, IL 60612. Telephone: (312) 942-2113. E-mail: [email protected].
- Carol O. Long, PhD, RN, Consultant, Capstone Group, 3416 E. Winona St., Phoenix, AZ 85044. Telephone/Fax: (480) 893-3685. E-mail: [email protected].]
Reference
1. Long CO. Meeting Community-Based Care Needs in Arizona. Phoenix: St. Luke’s Health Initiative, School of Public Affairs, Arizona State University; 2002.
Hospital-affiliated agencies have it easy. They automatically get every referral from their hospital. Right? Wrong, say hospital discharge planners interviewed by Hospital Home Health.Subscribe Now for Access
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