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Evaluations of the home care program at Women and Infants Hospital in Providence, RI, show that patients were highly satisfied with the service, says Carol Dabek, MS, RNC, IBCLC, director of home care. "The patients just thrive on this one-on-one attention," she says.
If you want to start your own home care program, Dabek offers the following advice, based on her own experiences:
• Look at needs in your area with focus groups and patient surveys.
• Negotiate with third-party payers to determine what they’ll reimburse before you get started.
• Ask your legal department to make sure your facility is licensed to provide home care.
• Approach your experienced nursing staff to determine who is interested in providing home care. Dabek has two full-time nurses who can visit up to four women per day and a "pool staff" of 12 nurses who can fill in on certain days.
• Recruit LPNs to work on the floor and monitor who is going home and what insurance they have. These nurses can find out if the mother wants the home care option. Women whose insurance carrier won’t pay for the home care visit can self-pay for the service.
• The LPNs also can check on each woman by phone the day after discharge and remind her of the home visit scheduled for the following day.
Women and Infants Hospital deliver more than 9,000 babies annually, with an average combined mother/baby daily discharge of between 40 and 70. A little over half of women covered for home care by insurance opt for the home visit, Dabek says.