A recent report by Deloitte Consulting suggests that the Commonwealth of Kentucky will be short nearly 3800 physicians as a result of expanding the state Medicaid program to meet the demands of the Patient Protection and Affordable Care Act. The state is about to add 300,000 new Medicaid beneficiaries to the 800,000 already covered. Already, there is a shortage of physicians willing to care for Medicaid patients.
What are you seeing in other areas of the country? What impact will the ACA have on physician availability in your state or local area?
This should be of significant concern for home health agencies who serve Medicaid patients, as it will be more difficult to find physicians willing to certify patients, conduct face to face encounters, and provide care plan oversight.
What's your take on this issue?
Strategies and Insights for CEOs and Executives of Certified Home Health Agencies and Hospices
Tuesday, May 28, 2013
Thursday, May 23, 2013
Safety in Home Health Care
By Steve Bills
When people talk about
safety in the health care field, many people
immediately think about hospital
safety, but there is another facet of health care to consider—home health care.
Home health workers provide hands-on, long-term care and personal assistance to
people with disabilities or other chronic conditions in the clients’
homes.
These health
professionals include personal aides, nursing assistants or home health nurses,
who either work directly for their clients or for an agency or business that
sets up appointments and visits. Because of the varied work environments in
clients’ homes, there are multiple workplace hazards to which home health care
workers may be exposed.
As the number of home
health workers increases, the chances of injury also increase. In November 2011,
the U.S. Department of Labor's Bureau of Labor Statistics released data showing
that nonfatal occupational injuries and illnesses for health care support
workers increased 6 percent, which is almost two and a half times the rate for
all private and public sector workers.
Exposure to Unsafe
Conditions
Because these health
care professionals work in their clients’ homes, their work environments will
vary. Home health workers may encounter homes without water or with extreme
temperatures, as well as unsanitary conditions and hostile pets, which are all
unsafe conditions.
Unsanitary conditions
may cause the presence of rodents or other pests. Those conditions may also
cause the contamination of medical supplies and help spread disease and
infection. Hostile pets carry the risk of a home health care worker being
bitten, feeling threatened or otherwise injured.
It’s important for
home health workers to understand what conditions are acceptable for a work
environment, as well as when they should remove themselves from such conditions.
Home health care workers should be encouraged to talk with supervisors about any
unsafe conditions in their clients’ homes, and they should be educated on the
process to report such conditions.
Bloodborne
Pathogens
The hazard of
bloodborne pathogens is not unique to the health care industry, but the
potential for a more serious injury is greater. Home health care workers provide
support for their clients who are disabled or ill. Those clients often require
some medication, which may be in the form of injection. The key is to reduce an
employee’s risk of exposure.
Hepatitis B, Hepatitis
C and HIV are just some of the more common bloodborne pathogens that home health
workers can be exposed to. Exposure may occur through needles, sharp injuries,
mucus membranes and skin exposures.
Personal protective
equipment, such as gloves or goggles, can help reduce the risk, and should be
worn at all times. When home health care workers handle blood or other body
fluids, certain protocols should be followed to ensure there is no direct
exposure to them. Containers should be completely sealed, and proper medical
procedures should be followed.
The Occupational
Safety and Health Administration (OSHA) recommends that health care workers are
educated on an exposure control plan with details on employee protection
measures.
Violence on the
Job
A home
health care fact card created by the Centers for Disease Control and Prevention
notes that these workers are vulnerable because they face changing and
unpredictable environments when they go into someone’s home each time. The
violence can range from verbal abuse, threats of violence, physical abuse to
homicide.
It is
important to maintain a zero-tolerance policy for any instance of workplace
violence. Any such cases should also be reported
immediately.
Home
health care workers should know how to identify a potentially dangerous
situation, and they should be trained in how to manage hostile and violent
situations. If they feel uncomfortable at any time, they should remove
themselves from the environment.
Client Lifting and
Moving
Due to client lifting
and moving, home health care workers may experience work-related musculoskeletal
disorders, such as low back pain or rotator cuff injuries. These can be caused
by excessive force to the back when lifting a client, the repetition of the
movement if it is repeated on a regular basis, or assuming an awkward position
when performing these tasks and placing stress on the
body.
When moving or
assisting clients in movement, several factors should be considered to help
determine the proper method in moving the patient:
· The level of
assistance the patient requires
· The size and weight of
the patient
· The ability of the
patient to understand and cooperate
· Any medical conditions
that the patient may have
The ultimate solution
is to minimize or eliminate the manual lifting of patients when
possible.
Motor Vehicle
Accidents
An often-overlooked
hazard that home health care workers face every day is the travel to and from
various patient locations. With most jobs, driving is limited to getting to and
from work once a day. For home health care workers, driving can be the most
frequent activity they perform each day. Every worker that is required to drive
on the job needs to be alert and drive defensively. Vehicles need to be
maintained and serviced regularly. Weather and traffic patterns can greatly
impact driving safety, and driving practices should be adjusted to the
conditions of the roadways.
The more home health
care workers are prepared to protect themselves against these hazards, the more
productive and safe the environment will be for them and their
clients.
About the Author: Steve Bills is Senior
Manager of Loss Prevention for Texas Mutual Insurance Company.
Austin-based Texas Mutual Insurance
Company is the leading
provider of workers’ compensation insurance in Texas.
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