Physician-health service collaboration can bring quality care back home


The trouble starts at home. But with some industrial savvy and a bit of physician intervention, safety and health could easily start there as well.

With a massive generation of baby boomers barreling over the bridge toward life’s second half, the conceptualization and experience of home will also inevitably undergo its own kind of transference.

“Elderly folks are going to be sort of forced to age in their homes — which we think is the best place for them to be — especially as all these Baby Boomers come of age,” Kerry Pawl, a founder of Mission Healthcare (a home health agency) specializing in physical therapy, told PhysBizTech. “There’s not going to be enough room in the existing assisted-living facilities. People are going to want to be in their homes.”

Thus, for these aging patients, the sharper comforts of the homestead, previously withstood without much hassle, will need to be filed down. Free-flung throw rugs will need to be either fastened to the floor or done away with completely; handles will need installing in slip-susceptible locales, such as showers and other bathroom fall zones; and cords will need to be vanquished from footpaths and walkways entirely. All of this becomes more imperative as the body develops into later life — whereas a fall once meant seldom more than a bump, it could potentially mean fracture or worse as a patient settles into retirement status.

But while the above precautions seem simple and “obvious, a lot of people just fail to do them,” Pawl said.

So what’s a healthcare system to do to ensure patient safety beyond the parameters of the doctor’s office? Get physicians and home health service providers to establish more prominent relationships, Pawl suggested.

“For physicians, home health care is really the eyes and ears into a patient’s home. The more that utilize it, the more often they’re going to know what’s going on in those homes.”

Moreover, “home health services are often an under-utilized Medicare benefit that some physicians don’t know about and/or just don’t know enough about to know when it’s appropriate,” Pawl added.

Alongside basic check-ups and consults with patients, many home health organizations/companies also provide a number of services that can aid in achieving a more comprehensive level of care moving forward.

“One of the first things that we do in home health is go into a home and do an entire home safety assessment and make recommendations to the patient and/or family regarding what needs to get done,” Pawl said. “If that patient or family does not have the resources to get those things done, we make recommendations for either getting a medical social worker involved or we have a list of vendors we work with [resources who can get the job done for a certain, more reliable sum].”

Following assessments, many home health workers will report back to the patient’s physician.

“If Dr. Jones has five patients on service with me, he/she should have at least monthly, if not every-other-week, reports from me as physical therapist letting him/her know (A) physically, how is this individual doing and (B) how safe is their home, what recommendations have been made,” Pawl continued. 

Physicians should ensure that the home health servicer they choose to collaborate with is able to make these frequent and timely reports back. Pawl and Mission Healthcare also recommend physicians inform patients and/or their caregivers about the below inexpensive ways to increase home safety, categorized by room:

  • Bathrooms: Bathrooms are important to make safe because of splashing water onto the floor and an increase amount of going from a sitting to a standing position. Installing grab bars on walls around the tub and besides the toilet will help with the sitting and standing. To avoid slipping add nonskid mats to bathtubs and on floor surfaces that may get wet.
  • Kitchen: Keep commonly used items within reach. If an item is high up be sure to have a sturdy step stool. Also, make sure appliance cords are out of the way to avoid tripping.
  • Bedroom: For the bedroom, adjust the height of the bed to make it easy to get in and out of. A bedside table is important. Be sure to have a bedside light with a switch that is easy to turn on and off and also put a cordless telephone within reach.
  • Outdoors: It is important to remember there are also hazards outdoors. Be sure to repair any abrupt edges of sidewalks and driveways to avoid tripping. Installing adequate lighting by doorways and along walkways will help nighttime vision problems.

“Although you can never eliminate the risk of falls throughout the home, you can certainly minimize it,” Pawl concluded.

It’s a tall order, no doubt, but one made all the more successful through collaborative efforts between doctors in the office and off-site professionals in the home. 

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