Story Behind Fundamentals of Home Health!

Hello & Welcome to our blog!

For the first blog, I want to share why I decided to build a standardized education and orientation platform for home care agencies…..

During my post as the Director of Quality, Education & Program Development in the area’s biggest Home Health Agency, the agency was under constant pressure to grow!  Growth meant capacity management, and in order to grow capacity we needed a solid recruitment and retention strategy. 

Our program had the following barriers:  

1. Hiring full time educators was not an option (initially!) We were part of a major corporation and getting FTEs approved would have meant giving up our first born or at a minimum a limb!  Also, it would have taken closer to a year just to get approval and finally hire an educator!
   1. So all of us in management were tagged for teaching part of orientation! Our clinical management, Utilization Review and Quality Consultant all had to dedicate 2-4 hours per week to teaching orientation.  This meant that orientation will take them away from the task they were hired to do! 
   2. This added work had a trickle down effect on our clinical processes and operations.  We experienced a drop in quality and patient satisfaction due to
      1. A large influx of new hires (with and without home care experience) in short period of time
      2. Poor retention rate!
         1. Those we were hiring were not getting the proper support and training before they were sent out in field to conduct independent visits.  
      3. Time taken away from clinical management, utilization review and quality staff to train and educate new hires 
      4. Field clinicians acting as preceptors felt burned out as they constantly had to train new hires and manage their own patient load.  The mentors also had a low moral as they saw those they trained leave agency within 90 days of hiring!
      5. Utilization of traveling clinicians to help manage capacity. 

I was very much aware that in order to build a recruitment and retention strategy, I must have a reliable, standardized education and orientation platform for our current clinicians and those we were on boarding. 

The following were the “must haves” for the ideal orientation and education program:

1. The program must be able to accommodate a new orientation class every week to assist with the influx of new hires and their start date preference
2. Condense orientation from current 6-8 weeks to 4 weeks, while keeping the critical content and ensuring that the new clinician’s experience is positive
3. Build a customized orientation structure based on incoming clinician’s experience.  
4. Should feature continuously updated content that is in-line with the latest regulations and EBP 
5. Reduce new hire’s training burden on Clinical Management, Field Clinicians, Utilization Review/Quality Assurance staff (Nurses helping QA the charts). 
6. Build a Mentorship program within the Orientation program.  

In summary, we I had a monumental challenge to overcome!  Failure meant closure or sale of our agency!  In my next blog, I will expand on how I overcame some of the barriers listed while others were too big for us to overcome!