Harvard study: Provider phone checklists help detect clinical changes in home care patients

Using phone-based checklists could be a viable tool for providers to help avoid unnecessary hospital admissions for elderly adults who receive home care services, according to new research from Harvard Medical School.

Researchers analyzed data from 22 home care agencies over a six-month period and found that clinical status changes for elderly individuals receiving care at home are relatively common. Even for patients not receiving medical care at home, unnoticed changes in clinical status can result in the need for medical care or hospitalization. Fourteen percent of elderly individuals included in the study indeed ended up being hospitalized over the course of the research.

This finding highlights the importance of monitoring systems to avert complications before they arise, the authors concluded. Caregivers from the agencies included in the study were prompted with a phone reminder before clocking out at the end of their shifts to report any health status changes they observed to the home care agency.

"By using a telephone-based checklist, caregivers in the In-Home pilot identified changes in condition in a number of domains, which can potentially be managed in the home to prevent costly hospitalizations," the authors concluded. "As a possible limitation, the program could lead to higher medical costs such as more 911 calls or physician visits."

Another trial is underway to determine whether this pilot program has an impact on care outcomes. The results are published in the Journal of the American Geriatrics Society.

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