From the Weill Cornell Medicine, New York, NY (MRS, JBR, PG, LMK); University of Pennsylvania School of Nursing, Philadelphia (BR, KHB); Johns Hopkins University School of Medicine, Baltimore, MD (AIA); Center for Home Care Policy & Research at VNS Health, New York, NY (KHB, MVM).
J Am Board Fam Med. 2023 Apr 3;36(2):369-375. doi: 10.3122/jabfm.2022.220204R2. Epub 2023 Mar 22.
Despite providing frequent care to heart failure (HF) patients, home health care workers (HHWs) are generally considered neither part of the health care team nor the family, and their clinical observations are often overlooked. To better understand this workforce's involvement in care, we quantified HHWs' scope of interactions with clinicians, health systems, and family caregivers.
Community-partnered cross-sectional survey of English- and Spanish-speaking HHWs who cared for a HF patient in the last year. The survey included 6 open-ended questions about aspects of care coordination, alongside demographic and employment characteristics. Descriptive statistics were performed.
Three hundred ninety-one HHWs employed by 56 unique home care agencies completed the survey. HHWs took HF patients to a median of 3 doctor appointments in the last year with 21.9% of them taking patients to ≥ 7 doctor appointments. Nearly a quarter of HHWs reported that these appointments were in ≥ 3 different health systems. A third of HHWs organized care for their HF patient with ≥ 2 family caregivers.
HHWs' scope of health-related interactions is large, indicating that there may be novel opportunities to leverage HHWs' experiences to improve health care delivery and patient care in HF.
尽管家庭保健员(HHWs)经常为心力衰竭(HF)患者提供护理,但他们通常既不属于医疗保健团队的一员,也不属于患者家庭的一员,其临床观察结果往往被忽视。为了更好地了解这一劳动力在护理中的参与情况,我们量化了 HHWs 与临床医生、卫生系统和家庭照护者互动的范围。
对过去一年照顾 HF 患者的讲英语和西班牙语的 HHWs 进行社区合作的横断面调查。该调查包括 6 个关于护理协调方面的开放性问题,以及人口统计学和就业特征。进行了描述性统计。
56 个独特的家庭保健机构雇用的 391 名 HHWs 完成了调查。HHWs 在过去一年中平均带 HF 患者去看了 3 次医生,其中 21.9%的患者去看了≥7 次医生。近四分之一的 HHWs 报告说这些预约涉及≥3 个不同的卫生系统。三分之一的 HHWs 与≥2 名家庭照护者一起为 HF 患者组织护理。
HHWs 与健康相关的互动范围很广,这表明可能有新的机会利用 HHWs 的经验来改善 HF 患者的医疗服务提供和护理。