@article{45f06a776ed74b71aa59bd8f148845b3,
title = "Skilled home healthcare clinician and staff perspectives on communication with physicians: A multisite qualitative study",
abstract = "Communication between physicians who order, and clinicians who provide skilled home healthcare (SHHC), is critical to well-coordinated care. The views of SHHC staff on communication with physicians have not been well studied. The objective of this study was to explore how SHHC staff view the communication processes with physicians who order SHHC services. Using purposive and snowball sampling, we conducted semistructured interviews with 22 SHHC staff across multiple regions of the United States. Qualitative thematic content analysis was used to analyze the data. SHHC staff experienced significant barriers to effective communication with physicians, including not being able to communicate in a timely manner when necessary for patient care, and challenges identifying the correct physician to coordinate care and sign SHHC orders. Key strategies to enhance communication focused on creating standardized processes to streamline communication, setting expectations for response times in communication, and improving the Centers for Medicare & Medicaid Services Home Health Certification and Plan of Care form (commonly referred to as the “CMS-485”/ Plan of Care). SHHC staff experience significant communication challenges with physicians who order SHHC services that can compromise care coordination and delivery. Modifications to workflows are urgently needed to improve efficiency and quality of communication, care coordination, and quality of care.",
author = "Norton, {Jonathan D.} and Amelie Nkodo and Bhavana Nangunuri and Arbaje, {Alicia I.} and Pierotti, {Danielle M.} and Kimberly Carl and Boyd, {Cynthia M.} and Bruce Leff and Sheehan, {Orla C.}",
note = "Funding Information: Jonathan D. Norton, BS, is Sr. Research Program Coordinator, Division of Geriatric Medicine and Gerontology, Department of Medicine, Center for Transformative Geriatric Research, Johns Hopkins University School of Medicine, Baltimore, Maryland. Amelie Nkodo, MS, MA, is a Research Assistant, Division of Geriatric Medicine and Gerontology, Department of Medicine, Center for Transformative Geriatric Research, Johns Hopkins University School of Medicine, Baltimore, Maryland. Bhavana Nangunuri, BS, is a Medical Student, Eastern Virginia Medical School, Norfolk, Virginia. Alicia I. Arbaje, MD, MPH, PhD, is an Associate Professor, Division of Geriatric Medicine and Gerontology, Department of Medicine/ Center for Transformative Geriatric Research, Armstrong Institute Center for Health Care Human Factors, Johns Hopkins University School of Medicine, Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland. Danielle M. Pierotti, PhD, RN, is Vice President of Patient Care Services, Visiting Nurse and Hospice for Vermont and New Hampshire, White River Junction, Vermont. Kimberly Carl, RN, is Director of Home Health Services, Johns Hopkins Home Care Group, Baltimore, Maryland. Cynthia M. Boyd, MD, MPH, is a Professor, Division of Geriatric Medicine and Gerontology, Department of Medicine, Center for Transformative Geriatric Research, Johns Hopkins University School of Medicine, Baltimore, Maryland. Bruce Leff, MD, is a Professor, Division of Geriatric Medicine and Gerontology, Department of Medicine, Center for Transformative Geriatric Research, Johns Hopkins University School of Medicine, Baltimore, Maryland. Orla C. Sheehan, MD, PhD, is an Assistant Professor, Division of Geriatric Medicine and Gerontology, Department of Medicine, Center for Transformative Geriatric Research, Johns Hopkins University School of Medicine, Baltimore, Maryland. Funds to support this project were provided by a grant from the Alliance for Home Health Quality and Innovation (AHHQI) under award number 128832. CB and JN were also supported by the National Institute on Aging (NIA) under award number K24AG056578. Investigators maintained full independence in the publication of this work. Kimberly Carl is the director of home healthcare services at Johns Hopkins Home Care Group. Bruce Leff is a member of the board of directors of AHHQI. No conflicts were declared for the remaining authors. Address for correspondence: Orla C. Sheehan, MD, PhD, Center for Transformative Geriatric Research, Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Mason F. Lord Building, Center Tower, 5200 Eastern Avenue, 7th Floor, Baltimore, MD 21224 (osheeha1@jhmi.edu). Publisher Copyright: Copyright {\textcopyright} 2021 Wolters Kluwer Health, Inc. All rights reserved.",
year = "2021",
month = may,
day = "1",
doi = "10.1097/NHH.0000000000000959",
language = "English (US)",
volume = "39",
pages = "145--153",
journal = "Home Healthcare Now",
issn = "2374-4529",
publisher = "Lippincott Williams and Wilkins",
number = "3",
}