The Purpose of the Quality Improvement Initiative
The predicament of the home care services sector in the U.S. is evident in a CNBC report by Woods (2019) that cited data on the gaining population of Americans. At least ten thousand baby boomers in the U.S. turn 65 years of age daily. By 2050, there will be 88 million elderly Americans. The report further states that 75% of Americans aged over 65 live with myriads of chronic health conditions (Wood, 2019). Therefore, the growth of this population segment continues to exert immense pressure on an already strained home care workforce. Quality improvement in-home care services sector is dependent on the reduction of the workload for staff by advocating for patients receiving care services and new patients to remain at home rather than nursing homes.
The purpose of the initiative to retain patients at home is to increase the involvement of family members, relatives, or hired personnel in the care of the elderly. The program is intended to address the unprecedented demand for home care services that remains unmet as the availability of staff for the roles continues to be unpromising (Smith, 2013). The support for the initiative is informed by the understanding that strategies to free up staff to attend to the ever-growing number of new and critically ill elderly patients are imperative. Successful implementation of the initiative will limit the role of qualified home care services providers to the stabilization of patients. Under the initiative, other care tasks such as cooking, bathing, and dressing will remain the prerogative of family members rather than of direct care staff.
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The Target Population
The limited number of direct care staff poses significant challenges to the wellbeing of elderly patients enrolled in home care services. Patients are unable to get their weekly or bi-weekly visits, exposing them to the risk of complications. While the working conditions of care providers remain important (Smith, 2013), the initiative attempts to find a solution by improving the functionality and efficiency of the existing and limited workforce to avoid disenfranchising the growing number of elderly patients. According to Woods (2019), the elderly population has a preference to spend the golden years in their homes rather than nursing homes, assisted-living facilities, or hospitals. The initiative is synonymous with other programs in the strained healthcare sector to keep this population out of care and nursing homes and facilities. As mentioned earlier, the elderly are frail individuals incapable of self-care. While those with families may benefit from home-based care, widows, widowers, the childless, and those whose children live in distant places often require the assistance of home care providers.
The Benefits of the Quality Improvement Initiative
The primary goal of the initiative to keep the elderly patients in their homes is to address the imbalance in the growing needs of this population that the current workforce is unable to fulfill. By reducing the workload of direct care providers in the sector, more patients would benefit from the weekly and bi-weekly visits, hence, improving their quality of life. The initiative also plays a crucial purpose in reducing the number of resources that would otherwise be required to keep the patients in care or assisted living nursing homes and facilities. These resources can be channeled to improve the efficiency of the workforce. At the individual level, in-home care for the elderly has numerous benefits. The initiative will ensure that patients maintain a sense of independence, experience peace and comfort, and maintain self-dignity. Family members can be taught to provide personalized care to facilitate quick recovery. Besides, the involvement of the family provides companionship and prevents loneliness. Patients under in-home care have the privilege of owning pets. Overall, the initiative to focus on in-home care for the elderly has substantial benefits for the patient and workforce, providing direct care.
The Inter-professional Collaboration Required to Implement the Quality Improvement Initiative
In-home care for the elderly has similarities to other home care settings such as nursing homes and facilities. A number of factors and settings that include the social environment, care processes, health systems, and health organizations define the home care contexts (Giguere et al., 2018). Stakeholders required to collaborate in the implementation of the stay-at-home quality improvement initiative are drawn from the above settings. While the primary stakeholders include care providers, the patients, and family members, inter-professional collaboration factors in policymakers, practitioners, nurses, health educators, community organizations, a representative from government agencies, and non-governmental organizations. The stakeholders engage in decision-making in relation to the needs of the patients, such as social support, social isolation, access to care, care planning, and information sharing. Stakeholders also deliberate on models of care delivery, costs, coordination, and continuity of care. Through inter-professional collaboration, the workforce would benefit from the proposed material resources, staff management, and professional development aimed at improving service delivery and quality of care and life.
The Cost or Budget Justification
Data cited by Smith (2013) on the projections of the growth of the number of Americans aged 65 and above showed that there would be at least 72 million Americans, representing 20% of the total population. The Centers for Medicare and Medicaid Services 2017 report indicated that the U.S. spent approximately $103 billion in the home care sector. Based on the projections of the population of the elderly, the budget allocation to the sector is likely to increase, creating further strain on the healthcare industry. One of the benefits of in-home care is its cost-effectiveness, implying that the initiative will address the cost challenges of maintaining patients in nursing homes or assisted care facilities.
The Basis for Evaluation of the Quality Improvement Initiative
Evaluation of the quality improvement initiative will employ periodic assessment of the changes in the performance of the workforce, and the quality of life of the patients under in-home care. Qualitative research will be conducted using questionnaires and interviews to establish opinions of direct care providers about the initiative. The efficacy of the program will be gauged from job satisfaction findings. In the same vein, interviews and questionnaires will be administered to family or care individuals tasked with monitoring the patients to determine any changes impacted by the initiative. Comparative analysis of the findings with those from nursing care homes will be used to ascertain the efficiency of the initiative.
References
Giguere, A. M., Farmanova, E., Holroyd-Leduc, J. M., Straus, S. E., Urquhart, R., Carnovale, V., & Légaré, F. (2018). Key stakeholders’ views on the quality of care and services available to frail seniors in Canada. BMC geriatrics , 18 (1), 290.
Smith, P. R. (2013). Who will care for the elderly: The future of home care. Buff. L. Rev. , 61 , 323.
Woods, B. (Apr 2019). America’s $103 billion home healthcare system is in crisis as worker shortage worsens. CNBC. Retrieved from https://www.cnbc.com/2019/04/09/us-home-healthcare-system-is-in-crisis-as-worker-shortages-worsen.html
