Vancouver Home Health Care Agency

Why Transition of Care from Hospital to Home

Why Transition of Care from Hospital to Home Must be Seamless

Transition of care is an important part of moving from a hospital setting to a home setting. Many times, the need for home care is not realized until hospitalization happens, so transition of care becomes essential in home care. The transition must be as seamless as possible for the comfort and best care of the patient. Vancouver Home Health Care Agency aims to make the transition seamless for not only the patient but the family as well.

Seamless care is defined as a smooth and safe transition from a hospital to a home setting. There are factors which hinder seamless care, which Vancouver strives to eliminate. Working with a home health care agency must involve the agency’s devotion to seamless care. An agency which is not interested in discussing seamless care or who does not demonstrate seamless care tactics should not be used for ongoing or temporary care.

Smooth transitions are critical regarding the patient’s post hospitalization outcomes. Patients will heal better and live happier lives if the transition is smooth, however, some issues create less than smooth transitions, and they must be handled before the patient is moved from the hospital to the home.

Communication between the patient’s doctor, the hospital administration, and the home health care worker is not always adequate. Before the patient leaves the hospital, the home health care worker must understand what happened, how care is best given to the patient, and what steps to take to make the patient the most comfortable. The issue happens when this communication is broken or never happens. If a home health care worker is brought in after the patient comes home from the hospital, the worker must talk to the primary physician about the condition. Make sure communication between worker and doctor is clear to get the best for the patient.

A second issue involves education, both for the patient and the caregivers. Patients must be educated fully on what will happen during the transition if it is to be seamless, in a matter which is understood. Some patients say they understand when they don’t, other times, the professionals fail to fully communicate the necessary education. Speak with the loved one to make sure the process is fully understood. Additionally, the education of the home health care worker is also essential. Work with a company that insists on all workers being not only educated, but re-certified consistently. Make sure the worker’s education is complete, consistent, and ongoing.

Inconsistent Continuity of Care
Creating a seamless transition can be difficult, and continuity of care is among the hardest act to maintain. Moving from a hospital scenario to the home naturally causes some inconsistency in care continuity, however, an effort must be made for care continuity. For example, a home health care worker must understand how any medical equipment works before entering the home, so the patient does not experience a break in care from the hospital to the home. There is much more involved in continuity of care, so be sure the home health care agency commits to a consistent continuity of care.

Issues in Medical Management and Accessing Necessary Services
Some patients experience a lack in necessary care or a mismanagement of the account during the transition between hospital and home. There must be someone present to make sure the medical files are transferred correctly, and that all necessary care happens to create a seamless transition. This means consistent communication with the home health care company, as well as the presence of a family member while the transition happens. Someone must be there to ensure the patient is receiving all the necessary care for his or her unique condition. The home health care agency must also be well managed, with checks and balances in place to ensure the patient is receiving the best possible care.

Lack of Accountability
This issue seriously hinders seamless transitions, because someone is accountable for care in the hospital, but sometimes, no one is placed in charge, or made accountable, after discharge. Someone must be designated as the person responsible for the transition from home to hospital. Vancouver Home Health Care Agency can help find, or even be, the accountable party for the transition.
At Vancouver Home Health Care Agency, Caring and Compassion is our business.

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