When Irine Devroude, RN, of the Visiting Nurse Association (VNA) takes referrals from Christiana Care’s Emergency Department, she makes a commitment to see new patients within 24 hours.
“My role as a home health nurse is to empower patients and help them be successful,” said Devroude, who works first to educate patients so they can draw on the best resources to manage their illness.
A large majority of patients coming from the Emergency Department and into the care of VNA providers are doing well with home recovery. Since October 2013, when the VNA began accepting patients directly from the ED, there have been more than 600 referrals, and 94 percent of those patients did not seek hospital readmission within seven days.
“The handoff between the ED and the VNA is proving to be a positive experience, and I am extremely pleased with how the care is working inside patient homes,” said Patty Resnik, MBA, FACHE, CPHM, CPHQ, RRT, vice president of Quality and Care Management.
Many factors went into the decision to refer patients from the ED to the VNA.
For example, surveys show that patients prefer home recovery to hospital admission, and Christiana Care providers increasingly look for ways to provide a continuum of care beyond hospital walls.
Patients who are capable of doing well at home should have the option to enroll in home health care, said Lynn C. Jones, FACHE, president, Christiana Care Home Health & Community Services Inc. and senior vice president Post-Acute Care Services.
This is an example of Christiana Care working to take care of the community in a way that’s not only cost effective but very much in line with how people want to be treated.
With the ability to make more than 310,000 home visits a year, the VNA has enormous experience in assisting patients with hospital transitions, said Jennifer Rittereiser, MPH, who serves as VNA branch director. As a way to help patients be successful after discharge, the VNA added staff to handle referrals and help with medications. They set a benchmark for nurses to see patients at home within 24 hours, understanding the need for next day follow-up to ensure patients are adhering to ED instructions. There is also a policy for patients to see primary-care physicians within 72 hours.
“We’ve had no problem having patients seen in our community within the 72-hour time frame, and that’s been an important factor in obtaining positive outcomes for our patients,” said Resnik.
In her role as a VNA nurse, Devroude said she recently treated a Wilmington man who was a newly diagnosed diabetic. Since the young man lived with his mother, father and brother, Devroude began her visits with basic education for everyone.
She pointed out that diabetes did not have to be a condemning diagnosis but could be a way for the whole family to improve their health — and feel better — with changes in diet and exercise.
“It’s enormously rewarding when someone has that “aha” moment and realizes they can take control of an illness,” Devroude said. “In this case that happened for an entire family.”