Q: What two items are found to be the most cited?
A: The coordination of care and aides following the plan of care are two of the most challenging standards to meet without fail. Communication and coordination between all of the entities that are caring for the patient are imperative when the goal is to help the patient return to their previous lifestyle. Not only do you have to do the coordination and communication, but these activities must be documented in the medical record. Being a home health aide is one of the most difficult jobs there is in home care. As an aide, you typically see the patient in a much more intimate environment than any of the other team members. Therefore, you will “see” things that could be done for the patient that would improve their day or even their circumstances. The problem is, the aide will quite often do the “extras” for the patient even if they are not on the care plan. Because of this, the aide is not following the plan of care and this leads to a deficiency being cited on survey. Training the aides to call the nurse for a change in the plan of care and documenting that conversation is part of the difficulty. Education to both the nurse and the aide to document those conversations would help reduce the number of citations for this
issue.
(ACHC newsletter – Spring 2011)