Teaching staff Y2K plans can allay year-end fears

Home health agencies face special challenges

These days, when you ask people about their plans for Jan. 1, 2000, you’re less likely to hear about New Year’s Eve parties and more likely to hear about computer checks and alternate power sources.

Concerns about a year 2000 (Y2K) glitch have permeated the business world, with many com panies designing Y2K plans as a backup in case computer systems fail. Home health agencies face special challenges when preparing for the possibility of shutdowns at work and in clients’ homes. Because of the independence of workers in the field, it’s important that they understand what could go wrong and what the agency’s planned backup systems are, says Debbie Lawson, RN, BSN, director of Our Lady of the Way Home Health in Martin, KY.

Lawson created an inservice detailing the agency’s plans in case of disruptions caused by Y2K. "Each of the employees had to be informed of the processes so they would have some idea of what to expect if this had to be implemented." Including employees from the beginning also allows them to give feedback that can make the Y2K contingency plan stronger, she says.

Beat the Y2K clock

The roots of the Y2K problem go back decades, to a time when computer memory was more limited than it is today. To save space, programmers would write dates with two-digit years: "99" for 1999, for example. Now, the fear is that systems will fail when older computers read "00" as 1900 instead of 2000.

Analysts warn that the problem could affect banks, utilities, and other essential services, and programmers are racing to beat the clock to make individual companies Y2K compliant. At Our Lady of the Way Hospital, managers sat down to look at how departments, including Our Lady of the Way Home Health, might be affected by Y2K problems, Lawson says. "We got together as department managers and discussed the interdepartmental processes we had to address," she says.

As part of that process, she looked at all of the home health agency’s core processes — from supplies and fuel to power and communication — gauging how each interacted with other hospital functions and with the community.

"We’re brand new agency; we just opened in January of this year," Lawson says. "We’re all kind of new to everything, and there are a lot of core processes we haven’t had to worry about that other agencies would."

Ultimately, the plan may never be needed. Already, she says, some key dates with Y2K implications have come and gone without any problems. But a comprehensive plan ensures that nothing takes you by surprise.

Focusing on core processes

Lawson covers these areas when training employees to cope with potential Y2K problems:

1. Utilities. She says the assumption is that the home health agency will be able to work out of its offices unless a utility failure makes it impossible. "We need electricity for the lights, the phones, computers," she says. "Obviously, this is a wintertime issue. We’re in Kentucky; we’re going to have to have heat."

Lawson has accessed the Web site of her local power utility and read its assurances that it is Y2K compliant and that no widespread power interruptions are expected on Jan. 1. However, if power is lost, she has identified an alternate place out of which her office can operate — an administrative conference room in the hospital. The hospital recently purchased a new, Y2K-compliant backup generator.

Lawson says employees know that if the base of operations is changed, she will post a sign at the agency letting them know where to go. Work will be prioritized to focus on essential patient care needs.

2. Fuel. Part of meeting those essential needs requires employees to drive to patients’ homes. Because of concerns about whether gas pumps will be able to operate, Lawson is instructing her employees to fill the tanks in their own vehicles just before the New Year. She also will make sure that any company vehicles have full tanks.

"I’m contacting local service stations, asking if they’re Y2K compliant," she says. "I know there’s a gas station near where I’m living where the person isn’t addressing the issue. They don’t see it as a problem."

3.Personal communications. This doesn’t just include voice communications such as phones, but also faxes and any electronic documentation systems. Currently, the company uses manual documentation, but Lawson expects to have point-of-care devices by the end of the year; the hospital already uses them.

In some agencies, which have used point-of-care devices for some time, employees may have to be instructed how to document care manually, but Lawson doesn’t think it will be a problem for her staff because they already know how to do manual documentation.

Still, a breakdown in phone communications could wreak havoc at the agency. "We won’t have phones, faxes, maybe computers won’t work," she says. "We won’t be able to contact people. We won’t be able to obtain MD orders if we needed to or contact the staff. Staff wouldn’t be able to report safety issues in the home."

Staff are instructed that they will revert to cell phones if land lines don’t work. If cell phones won’t function, Lawson says her staff will revert to person-to person contact. "That’s where having extra gas in vehicles is going to come in handy," she says. "But also we’re going to ask staff to ride together in their vehicles. So if a safety issue comes up, you’re going to have two people together."

She says nurses can travel to most area physicians if there is a problem, and backup physicians always are available at the hospital in case of an emergency.

4. Information processes. The agency’s computer system is brand new, as is the system used by the hospital, so all are believed to be Y2K compliant. Still, employees will be ready to document everything manually if necessary.

5. Supplies. Lawson already has begun surveying durable medical equipment suppliers in her area, asking for each company’s Y2K plan. "I’ve actually had a 50% return [on her survey]," she says. "A lot of them told me, Well, we don’t have oxygen concentrators, we don’t have anything with computers in them, we don’t have to worry about that.’"

After she pointed out the potential problems, many asked for a copy of her plan. She also is dealing with the materials management department in the hospital and the pharmacy to discuss how to keep track of medications and special supply needs as Jan. 1 looms.

She tells staff to ask about supplies and equipment when they assess clients. "We recently admitted a patient with a pacemaker, and I told the nurse to make sure to ask if it is Y2K-compliant."

6. Patient education. Upon admission, each patient at Our Lady of the Way Home Health receives "Y2K: What You Should Know," a pamphlet by the American Red Cross that explains some of the potential problems. In addition, the Red Cross puts out a disaster supply kit geared for natural disasters such as tornadoes and floods.

Although Lawson says patients generally haven’t been asking about the problem, many have family members who are well aware of the issue.

Troubleshooting: Ask What if?’

Luckily for Lawson, some issues such as billing and payroll are handled through the hospital. But if they weren’t, she would have to break down each of those processes as well, looking at possible breakdowns and coming up with contingencies.

In training her staff, Lawson laid out every detail of the Y2K plan. Information brought up at employee brainstorming sessions can help refine a plan.

"I go through each little process — the assumptions, the what-if scenarios, the inter dependencies, the implementation mode, the expected resources," she says. "Your staff can give you a lot of information; they can bring up a lot of things you didn’t think of."

The training can be an outgrowth of existing training already in place for natural disasters. In deciding which areas to cover, Lawson rec ommends staying focused on an agency’s core processes.

"You can’t cover everything," she explains. "You have to focus on the actual processes that are going to enable you to continue providing patient care. Identify those, focus on them with your employees."