false
Catalog
HCCIntelligence™ Webinar Recording: Lunch & Learn: ...
Webinar Recording
Webinar Recording
Back to course
[Please upgrade your browser to play this video content]
Video Transcription
Hello and welcome to today's HCC Intelligence webinar, COVID-19 and home-based care, what have we learned? Today we will be talking to several panelists out in the expert world here that will give us some great feedback on what they've learned from COVID-19 and what we can do going forward. A couple of housekeeping items before today we get started. As a reminder, all participants are muted during the call. If you have any questions or comments, feel free to put those into the Q&A box at the bottom. We will also be recording today's Lunch and Learn and placing it out on our HCC Intelligence webpage. Joining us today is Amanda Tufano, Chief Executive Officer of Genevieve and Tammy Browning, President of Grace at Home, and Brianna Plinstener, Senior Consultant and Manager of Home Centered Care Institute. I have had the pleasure of working with these individuals for a couple of years and I know you will find a lot of great discussions and learnings out of today. With that, I am going to turn this over with our first question to get our conversation going to Tammy. Tammy, as you are owner, president, as well as a provider of care in your program, talk to us a little bit about what are those big pieces or challenges that you have experienced? Well, I don't think any of us ever anticipated having to deal with what we have survived in the last year in this global pandemic. From learning how to quickly adapt to be able to offer telemedicine and telehealth services to just being able to evaluate our patients' needs and care for them in a completely different environment, acquiring PPE, supplies when everything is short, really assessing the patient's needs and how they were changing related to the pandemic, it was shocking and overwhelming and I think everybody on the call can probably relate to all those emotions. So you had so many different things going on from trying to figure out how to deliver care to the patients to how to take care of your staff and your team that were experiencing all these emotions as well. Isolation with patients and caregivers, increased depression. So it's really hard to start and be able to encompass everything that we have learned. I think there's a lot we've learned and the biggest thing for me is that you have to be on the ready at any moment and constantly be running through scenarios with your team to prepare for the unknown. Because even if we prepare for what we already know now in the last year for a global pandemic, the next thing may be completely different. But there are disasters in some form or fashion every day. Yeah, I think about that as well as, you know, we have this the global pandemic, but, you know, we also have natural disasters. You know, we have systemic disasters. So I think even though this was specific to a PHE, I think it does help us kind of remind us that there are other things that can happen. And we need to be prepared for those. And I think that's really what we want to do today. And I think all of us out here are trying to do is learn so we can adapt and be ready for the next crisis because we know that it's probably going to be here. So Amanda, I know your role as an executive leader, you span a pretty good part of your organization from the top down. And that's a lot of responsibility. And as you think about the past year, and let's say you would have had a crystal ball to know what was going to happen. What were some of those things that you encountered that you think, oh man, I wish I would have known that and I would have done this a little bit differently? I, you know, I think it's a really hard question because I have these mixed emotions around, you know, when I look back, I think, oh, you did everything right and you did everything wrong at the same time. So, you know, I'm in COVID still here. And so and there's still a lot we're navigating and I think even the navigation into how do we step into the future and what is kind of a future world look like and, and people have deemed this kind of the new normal. You know, I think I'm still a little close to it to probably give you the very best answer to the question. But, you know, one thing that I wasn't really prepared for was how many decisions I was going to have to make without enough information. And in, in my position, often that is the case where I won't have all the information, but it's not, it's not every decision I have no information or every decision I have very little information or speculation. And, and days and weeks and months on end of making those decisions without enough information at all times really took a toll on me. And I think, you know, one of the things I could have done differently, I haven't exactly parsed out how to do this, but I think they're, you know, I'm not sure I was, I had the mental resilience for that, because it just was, you know, as I look back, it's, it's been really exhausting that that day in day out piece, you know, but I did learn a lot through that, you know, I really learned to, you know, have trusted advisors trust their advice. I had a gunnery sergeant in high school who said, you know, you have to make a decision, you know, even if it's the wrong decision which you obviously won't know at the time but even if it's the wrong decision you have to move forward and and make a decision and that statement was something I really tested. You know, in the last 14 months, you know, a couple of surface thoughts about that is I probably I wish I would have moved faster. I remember I have, you know, one of my, my best friends grew up in China and saw his family in China, and, you know, for three months prior to America recognizing that we're going to have a global pandemic on our hands publicly was really, you know, alerting everybody that this is going to be a big deal and I just was kind of like, now, you know, no, that's not us and I don't, I don't mean it in a xenophobic way but I just didn't really understand the, the global impact of these public health events because we haven't really had one in the last hundred years but I wish I would have moved faster. And I definitely wish we would have had more PP on hand. We had enough PP for, we had enough in 95 for every employee that we had, except probably because I wasn't moving very quickly all of our field nurses came in and cleaned it out one night, and so I went we didn't know that we didn't have any and 95 until And there was in one week they were all gone. And so it's maybe it's slightly humorous now but it was certainly terrifying at that moment. So, yeah. Some really good points there I know, you know, to piggyback on that, take the partners route. I know for me it was important to recognize that those that were either on my team or other leaders in our organization. space or create a space to just be able to say, this is tough. This is hard. And, and recognizing that in someone else, you know, as small as that gesture seems just to acknowledge and say yeah, it is and we're, we're here, how can we do this together I know there was days that I would reach out to to my partners out and be like, look, today's not a great day can can you kind of help me through the day can you give me your insight because your point, we're moving so fast we have so many decisions to make. And, you know, I found myself more and more tapping those trusted advisors that I can both from a mental standpoint to do a mental check of, yep, I'm not feeling this just by myself, everyone else is kind of feeling it, and that's okay. And also to your point you're exhausted you're tired, having that other person or persons was very important at least for me in making those decisions. We all know we didn't all make the right decisions. But I think we've all learned from those. And, you know, we'll, we'll try to kind of change things going, going forward. Brianna I know that, you know, as a consultant for HCCI and in prior practice manager with your depth of knowledge. I know that you field, a plethora of questions, everything from processes to billing and coding to you name it, it all geographic and it all kind of comes across your desk. As you kind of look back on what were some of those commonalities that that you found on in your, in your consulting role and what were some of those pieces of nuggets of information that would probably be useful for others who maybe weren't in touch with you. Yeah, it's a great question I think everyone was in the same boat right everyone had questions, and it was all and to Amanda's point there wasn't always information you know especially, you know, from a coding and auditing perspective I'm used to being able to go look online or go find a source and say okay this is the answer or this is the guidance and we just didn't have that with coven which, you know, for me one of the things that was most eye opening was just how behind from a federal legislation and policy of telehealth coverage and access was under the Medicare fee for service program. And to their credit, I mean, CMS acted incredibly quickly you know we got all of these 1135 waivers that promoted access to telehealth regardless of setting or location of the patient that but they they changed it you know in the first three months we had three different interim final rules and you know it takes an expert like that just looking at that to even try and divulge all that information, understand what it is and then it changed. So I think just trying you know the biggest challenge I heard from people is trying to stay up to date on what is the telehealth policy How can I build for virtual services now obviously patient care is way more important, and, you know, those kinds of things but people were struggling with even knowing. Okay, I still have a business that I need to keep the doors open and be able to, you know, stay here to provide care for these patients so what does that look like from a regulatory perspective, and how am I going to manage to keep up on that so I think that was one of the things that HCC I really prioritized is. Okay, we need to synthesize this we need to have resources we need to have information available so these providers can focus on just caring for their patients and not having to navigate the constantly changing guidelines from a from a telehealth perspective. And then my final comment is though I think on a positive side it was quite remarkable to see how quickly healthcare and providers and organizations were able to adapt, like many of us had never used telehealth and or any virtual and didn't want to in our And then they had no choice and they just did what was best for their patients because they had no other option. So I think on a positive note, it was really remarkable to see how quickly, all of these providers and healthcare organizations were able to adapt and just meet the needs of their patients the best they could. Yeah. You know, as you pointed out telehealth became more and more of the forefront. Some people had dabbled in it. Some people were like, Nope, don't know anything about it and they quickly had to kind of get up to speed. I think, and additionally, you know, our patients and our caregivers had to up their game and technology. I know I spoke to my parents last night, who are older. And, you know, all we had to do is FaceTime and it took me eight minutes just to get them on the phone, just to say, Hey, how's it going, what are you guys up to so, um, you know, I know that's that has been a challenge it's an ongoing challenge. So, with that said, what are some things that you put in place for your providers or or your caregivers and patients that you think we will stay going forward as you use telehealth, that might be, you know, in, you know, might be important or something that we're sharing with this group would be a good, good thing to know. I'll take that. So, you know, prior to covert 19, we didn't initially on intake for new patients assess their ability for telehealth assess their support for electronic communications. We've made that a standard part of our intake questionnaire and process. In the geriatric population that we serve. Most of them aren't real comfortable with using a patient portal may not, you know, even want to give us an email address. It's, it's a mandatory part now of our practice and so when we intake a person we are very understanding of the fact that, you know, if you don't communicate but does your daughter does your power of attorney does your son you know your granddaughter or whoever is there someone who lives in the house or visits with you frequently. That's all part of the intake process now and we screen them, and we talked to them about telemedicine. From the beginning. And then, you know, adding services like remote patient monitoring. The more I think current we can help our patients become with technology, the better it is to keep our patients healthy and at home, as well as enabling us in times of challenge to still communicate with them. Yeah, you touched a little bit on on RPM. How do you see these models being integrated into a home based primary care practices. And what are your, your goals your outcomes that you're looking for in using that type of model. So, ultimately, I think with home based primary care what we're all looking for is to keep the patient at home to keep them healthy out of the emergency room out of the hospital. And so I think with remote patient monitoring, that is a very useful tool to enable that with congestive heart failure monitoring weights. So many times when you say to the patient, you need to measure your weights daily and if you're increasing by you know two or more pounds you need to call the office. they're compliant, some of the time, or they had a bad day they ate something yesterday they shouldn't have eaten and so they know better and they don't get on the scale. And then by the time they're calling you. They're acutely ill and really bordering on needing to be sent out to the emergency room anyway and so I feel like with remote patient monitoring, if you can get that into the home. And really, it gives you the feedback you need on a daily basis to help better manage those patients. It is certainly decreasing er visits, and that is obviously the goal I hope that answered and I'll defer to Amanda and Brianna. I would just add one thing I hope something that sticks around is the ability to use multiple platforms for reaching patients, you know, one of the nice things about not having invested and you know and I just best I say this I guess into telemedicine is unlike some groups who were like well we bought the system you have to use the system we just haven't. And we had some were like we just haven't rolled it out yet or we've rolled it out and we have very low utilization. We were kind of like well, we haven't really rolled anything out and so when they when they put the waiver in place and it opened up all these other options that some people Dana to your point may may use on a more frequent basis with their family members but they were never thinking about using some of these platforms for healthcare, it allowed us to say, okay, let's just add those to iPads and now we can move again in a rocket ship. And so I am really hopeful, you know, Brianna would know the most about if something like that would happen, but I'm hopeful that Medicare continues to look at other vehicles for speed for telehealth and it allows us to be a little bit more flexible and in a cost structure that's a little bit more flexible for us as well, versus again, buying an entire system when in reality, we just need a way to interact with, to see the patient, we just need to interact. So, yeah. You know, Brianna, this is a love of yours, I'll let you kind of... I don't know if it's a love necessarily, but no, I mean, I think that's a great point. I think that was really one of the things I was so happy to see was the immediate flexibility that we got, like, okay, you know, HIPAA is out the window, you want to use, you know, Apple FaceTime or, you know, something like that, you know, it just get connected with your patients. I don't know that the HIPAA relaxations will stay, I'm very skeptical on that. You know, none of us really have a crystal ball on what's going to help happen with telehealth policy when the public health emergency is, you know, officially declared over. I don't see any way of us going back to how it was before. I mean, there is telehealth bill after telehealth bill and different things being introduced. You know, right now, the CONNECT Act is the most recent one I've heard of. It stands for Creating Opportunities Now for Necessary and Effective Care Technologies. So I think, you know, what we need, though, and a lot of people don't realize is all of these waivers and these flexibilities from a Medicare standpoint on why we can, you know, provide virtual services and be paid for them for our patients are because we're in a public health emergency. Those 1135 telehealth waivers go away unless we have legislative change. So right now, those are done in 90-day periods, although, you know, a lot of kind of experts in the field predict that the public health emergency will keep getting extended until the end of 2021. We don't know. The Health and Human Services Department secretary has to declare those every 90 days. It was just extended recently. Again, they predict that to continue through the end of 2021. But what I would like to see organizations and providers think about is what worked well? Like what kind of technology or other kind of use cases benefited your patients? You know, I know we need policy and payment and reimbursement, but take that out of the equation for a minute. What's best for your patients, your caregivers, and your practice? You know, even from an efficiency standpoint, I know a lot of programs that have, you know, rather than adding that patient physically on your schedule and adding another route for your providers, you're able to make a virtual visit, kind of assess an acute need, and then you save travel time. And maybe you're able to treat the patient and wait until the provider's back in that area. Or even anxiety and depression patients, you know, frequent check-ins and things like that, that even if it's just a telephone call. So I would like to see us learn from what worked well and what's really best for our patients and our caregivers, and then think about what, you know, regardless of what happens with, you know, policy and payment, what do you want to integrate into your model? No one's saying that face-to-face care is going to be diminished. That's always going to be the gold standard. There's things that you need to be in the home or with the patient in the assisted living setting to do. That's never going to, you know, go away. That's always going to be, you know, first and primary. But where can you use those technologies to better the care? Yeah, I think, you know, one of the threads in that statement there is, you know, taking us to that emotional place for our patient. You know, they already have, you know, chronic illnesses. They already have all of these in play. And now, and I know, Tammy, you alluded to it as well, now we have this emotional care that the patients need. There's depression. There's anxiety. There is other components that were either there before and exaggerated more or, you know, aggravated more or their new onsets. Tammy, as a provider, how did you kind of navigate that? What maybe you have done different or will do different in the future to kind of focus on that mental aspect of our patients? It's so hard to really address those needs adequately because people are just so lonely and isolated during, or have been so lonely and isolated during this time. And, you know, whether they're in a private home or even in an assisted living facility that I have had patients who really have had such significant decline in their mental wellbeing. You know, how to address that and help them navigate through has been very, very difficult. I'd love to tell you that I have all the right answers. I can tell you what we've done and it's not the best, but it's what we had at the time. And that was just to really reach out into the community and explore all the mental health resources that you can get from social workers with home health agencies to, we are very fortunate here locally to have some licensed clinical social workers and psychologists and psychiatrists, a group. And so they quickly implemented telemedicine as well. And I apologize for the background noise, uncontrollable. They're mowing outside my window. So I apologize if you can hear that. But using that as resources, helping them with telemedicine visits. And some of the other things that we did is with patients who were in assisted living facilities and their families couldn't come in and visit with them, we would do a telemedicine visit with their family member while I'm in the facility with them, just to kind of make it seem more inclusive. I'm already communicating with the family member to tell them what's going on and updating them. But for the son or daughter, who's the assisted living facility patient and resident, who's missing their loved one terribly and can't figure out how to do FaceTime or any kind of telecommunication with that family member themselves, just to have them there and visually be able to see them, I saw tears, hugs of joy, just thank you so much for helping me through this. You know, and I'm all in my PPE full garb, but to be able to give that kind of just connection with the patients and the families, that was really incredible, helpful to them, to me, truthfully, to see that value. So I would just encourage everyone who's listening is just always be prepared to think outside the box and do the right thing for the patients. That's kind of my personal motto is just, you know, do the right thing for the patient first, think outside the box second, and then, you know, we'll figure it out on the tail end. Great mottos to live by. You know, we talked a little bit about the patient. How are you guys, or how have you, you know, checked in, this is going to be a twofold question, you know, checked in on your staff? I mean, they're, you know, they've got their own, you know, they've got their own personal challenges as they're adjusting personally to COVID. But then, you know, their professional obligations, and we know in this world, more than other professions, we were, you know, head first into all of this. And, you know, you're now having your staff is balancing personal impacts with professional impacts. And they're looking for stability, leadership, someone to tell them it's okay. Tell me a little bit about what you guys did to stay connected, to keep or try to keep your staff as mentally healthy as possible. Well, I can. Okay, well, go ahead, Tammy. No, go ahead, please. Um, you know, so what Genevieve did is, you know, as soon as we, you know, I think we all went home, maybe the 16th was our first day from home. And I want to say within a couple of days, we organized an all company call. So every morning between eight and 9am, the entire company got on a phone every day. So five hours a week, just to being together to talking about what we know. And we did that for months. And so and we're just at the tail end of that, but you know, it was five days for the first six months, you know, then it was four days, it was three days, and now we're at the point where we've moved monthly. And we'll probably just start putting in a regular workflow. But so I'll kind of answer it, maybe it's a two part. So what do we do at the time was we really tried to stay connected. And what we found, being an evidence based organization is we connected through the science of what was going on, what could we, what did we know? How did we identify what we didn't know, and early on, those were disproportionate buckets of information, right? It was 5% of what we knew and 95% of what we didn't know. And probably two, three months in, we realized that we had some experiential learning that hadn't really caught up yet. And that was really interesting to start disseminating some expert learning, because we've been connecting so much, we were able to pull some themes out. And so I think that that was really great. There were from an employer standpoint, there were many things from personal standpoints that we really couldn't touch. And we really tried to, you know, we really tried to touch and understand when someone's spouses got laid off, or when a loved one had COVID. I mean, we had a number of parents die from COVID during that time. And there were just, you know, and so we attempted to do everything we could, and we always pushed the limits of what can an employer do to really be there and support you. So then kind of transition to, I think, what's next? And how do we kind of check in? You know, I agree. I don't, I don't think in many ways, Genevieve has really processed, I don't think it's the ending of something, but it certainly is the transition point of what we're feeling now. And I think the work ahead of us is how do we transition out of, you know, this like very specific mindset that we've been in for the last year, year plus 14 months, and how do we then say, okay, well, we kind of have to get back to what our work was. And in many ways, we held that work, you know, like the pandemic stopped the other innovative things that we were doing, and all the train that was moving. And the hard part is like, you know, and I'm looking forward, like I, my kind of my general thought is I'm preparing for tomorrow, because I've prepared my people for today. So they're handling today. And as I look forward, I keep thinking to myself, our group's not really ready until we get them really ready for, for this transition out of that. And I and so that's, I think the work in front of us is how do you how do you really say to everybody? Yeah, I mean, I use that train example. Yeah, the train you're moving on that was going very quickly before there was a global pandemic. Unfortunately, you got off that train, you got on another train that was going even faster. And sometimes it felt like it was running into walls. But now I need you to get back on this train and like, get with the program when their lives are forever changed, especially our clinicians. So we're a we are a we're a we're the largest geriatric medical practice in Minnesota. We have over 4000 patients and SNFs, assisted living, independent living, home based care, transitional care, and our biggest areas are assisted living and our SNFs. So do but do quite a bit of, you know, home based medicine in that. And of all of our entire patient panel, we've seen over 550 people die in the last 14 months just from COVID. And so, you know, of 60 providers, everybody's been greatly impacted by this. So yeah, I'm not sure we're totally ready. But we have to do something we have to keep talking about how we move forward and set that vision. Yeah. It's a lot, for sure. Which also leads me to a phrase or a, you know, a word that's often used, I know, Amanda, you use it and teach it for us, but the self care, I mean, you're now, you know, you are potentially a provider who's got patients and caregivers to support. You've got your own staff that may be looking for leadership. But then it's like, where do you fit into that? When is that time where you say, I remember when I wrote was on a plane with my, my child the first time it was like, you know, everybody knows, put on your mask before you put on your child's mask. That's very hard to do, because your natural instinct is to start fixing things. And I'll take the backseat, let me help everyone else. I think in this, in this profession, we see that a lot, obviously, but I think there is that point where you say, okay, when do I tap out and say, I have to take care of myself, whether it's a day, an hour, and how do you guys help others recognize that and give them space and advice on that very important piece of self care, as in, we got to put on our own oxygen mask before we kind of put on others. So up to whoever wants to address that one. Well, I may not be the expert, but I've very often had those exact conversations. So kind of to pick up where on what Amanda was talking about, and then transition into what you just asked Dana is, we did very similar things with routine meetings, we subscribe to Microsoft products. So we have teams, and we very quickly went to having daily, and then bi weekly, and then weekly, so on and so forth. Teams meetings, just to keep each other abreast of changes, everything was changing so quickly. And what are we doing? What's working? What's not working? But then a lot of things, we had a marketer or have a marketer who could no longer be in the field, could no longer go call on referral sources to market. So her path kind of changed, and she was kind of that pulse checker for our organization, had routine calls with providers, with our support staff that's on the phone with patients, how are you doing? What's going on? And then she would keep me leadership advised, and I've had to have those direct conversations and say, you know, you need to take a day or two off, you need to take some time and step away, because self care is so important. And if you're not healthy mentally, then you can't be what you need to be for our patients. Those are hard conversations, but I think as long as you're doing it from the right standpoint out of concern and care, they are typically very well received. And sometimes the person, the employee doesn't even realize the point to which they've gotten, and they need someone to step in and go, hold on, you have to care for yourself first. As caregivers, we are so accustomed to just give, give, give. And it is hard to give yourself permission to say, okay, I have to do this for me first so that I can be a better me for the people I'm caring for. Yeah, and I think it is definitely something that many of us share. And it is a tough conversation to have. It's a tough thing to hold up the mirror and be like, wait, it's my turn to self care. But I think, you know, as I tried to practice it, I used the word try, you know, it was important for me to put up boundaries, being as if I'm going to take the day, I don't pick up my telephone and look at email. I, you know, I say to my team, if you need me, and it's an emergency, text me, do something, but I'm not looking at email today, I'm truly going to disconnect. And I think that is something that has been helpful for me. I have had some guilt that goes along with it. But it has been, it has allowed me, I know, to come back to myself and my team, and I think be a lot more effective. But I would love Amanda and also Brianna to kind of chime in on self care. I know you guys are our workhorses and leaders as well. Yeah, I would say a couple of thoughts. I echo everything that Tami has said and you Dana. From a how everybody needs self-care to your point, that's kind of how you have self-care. We certainly have some leaders who are maybe more prescriptive of like, just do this, do that, take a day off, go to a movie, go out with your kids, whatever those things might be. And I've really tried, especially after this pandemic, to get in the habit of being like, sitting down with leaders and with the staff and saying, you are solely responsible for defining your self-care. And I got some people who could never live like you're living, who could never take an entire day off. I got some who check in occasionally and that's their best self-care structure. And so what we're not off, like what our employers often aren't doing is saying, what is the thing you need? You tell me, and then if it's within reason, we will do that. And I think this is some pieces as we talk of kind of equity work too, of like all of it doesn't have to look the exact same as long as we're getting to a space where we're getting what we need to show up as our best and authentic selves. I also think as we were kind of talking, this just occurred to me as a thought, but if anybody's ever been the one to break up with someone, you formulate all these things in your mind first, right? You have all of these reasons, you have all these pieces, and in some ways you have to come to peace before the other person. And I think that's really the job of the CEO or the leader, the president, anything else is like, you get advanced access to information, you get advanced access to the vision and where you're going and what that's looking like. And so your job is to have worked through your stuff before you help others work through it. And it took me a long time as a leader to really understand that, because in many ways I felt excluded, like I'm not feeling this with you. We used to be peers or I used to be this and I'm not with you enough. And I would try to do things with, to try to emulate that piece. And really the biggest hand that I can lend is one that says, I'll be with you and we can definitely talk about this. And we can, and I def, but I have to work through all of my stuff. I don't get to respond back when someone says, I'm burnt out, I'm super scared. I'm so, I don't be like, yeah, I'm scared too. No, like I hear you and like, and I've worked through some of my stuff. And I really learned that lesson a lot during the pandemic too, because again, to this point of nobody had information and we're all learning at the same time, like my timeline had to be faster. To be able to keep getting up in the mornings to help. Thank you, Amanda and Tammy for your comments because I just couldn't agree more. And I think it's so important. I just wanted to comment, Tammy, you mentioned support staff. And I think one of the surprises that I've heard and kind of had the realization is how this has really affected the entire team and how we really need to think of that. And that's not to diminish anything of the clinicians who've had their patients die or their caregivers die and that weight and that burden. But some of the things that I've heard people come to me that they were surprised about is like the people that are answering the phone, all of a sudden they have to ask all these screening questions. The patients are freaking out. They don't know what to do. There's all these influx of calls and it's then affecting our clinical care and our operations and our workflow because they're overburdened and they are overwhelmed and there's people crying to them and telling them their story and they're not clinicians. So they don't have that reasoning and things like that. So I think not forgetting that the entire team, not just the support staff, but I would just echo not forgetting your entire team because I can tell you too, from working in an administrative role in a practice, it's amazing the connection you can form with people over the phone. And I still to this day think of so many families and patients that I would just miss talking to. So I think it's just important to realize too how it really affects your entire team and I think the surprise on the operations piece, just because that's what I'm more familiar with is how really that influx of phone calls or that added time having to ask those screening questions or go over telehealth and all of that added to teams and how workflows had to change to accommodate that. Can I just piggyback on that for a second? Absolutely. I just think there was something in this and it was everyone, every human was so interconnected in experiencing this. And one of the things that we talked a lot about is it's not just the self-care and the structure of the employee. And so often we think of the employee as kind of stop and starting their days with us, hear how many hours they work, FTE and some of those pieces. And it was so clear early on that everyone in someone's life had to be good for the employee to be good during a global pandemic. And that was rarely the case because everyone was structurally impacted one way or the other and at different times. And so what we also spent a lot of time in our task force working on is how do we also care for people's family members? And so like we, for example, for like, nobody could get masks. So we issued just a, I mean, nobody got paid for this, but we have 180 employees and we had maybe five employee or employee spouses who started making homemade masks for the whole company. And we gave within a very short period of time, a homemade mask to every employee and all of their children and anybody who lived in their household. And it was like, and some people were kind of like, why would you do that? I was like, well, they all gotta be healthy in that household to come to work. And we don't have, we're not large enough to have a backup person. Like there is no backup plan. So for every role that we have. So they're all critically important to Brianna's point of, the folks answering the phone had to keep answering the phone. We couldn't not have them. You could maybe have one for one day, but if someone went down with COVID or someone had to caregive for COVID, we're talking at least two weeks. And we're just sitting here as employers being like, when is this moment gonna hit that I'm out of staff? And so like we distributed PPE, we did vaccinations for all of our staff and family members. They were some of the earliest ones in Minnesota because of a special partnership we form just to do that work. Once we got surgical masks in 95s and they remember, what was it like last summer or kind of fall where they were like, well, homemade masks aren't good enough. Great, everybody gets any PPE we can have. We started mailing out care packages to people's households. And that's really how we thought about it is how do we care for the entire household of someone? Yeah, I think that is so important. And I know that gesture is definitely coming from let's keep everybody healthy, but also can be, it also is a gesture that others in your staff and in your team are like, wow, they really care. They're going above and beyond. And it's not, we all know on this phone that we are already looking for more and more providers and clinicians. We have a workforce right now that needs to be built up already. And we also know that the pandemic has also pushed people to either retire early or to make their own professional changes earlier. So as those things are, yes, about keeping people healthy and extremely important, it's also for me, a retention tool. We've got a lot of staff who have gone through the ringer to your very valid points. And as we look to pivot in this transitional phase, we now are gonna have to do double duty on that retention. We're gonna have to build back some people's morale and we're gonna have to kind of re-engage them and at times recommit them to what we're doing. And I think that will be one of our big goals going forward. But with that said, I would love to kind of go around really quick. I'll give you a couple of seconds to put you on the spot here. But when you think about what you know now, when you think about either one or two things that you're like, okay, I gotta get on back on track with this. What is this for you that you're thinking in your head? It's like, okay, like Amanda said, I'm getting off the train onto another, now I'm gonna get back on that train. That's a lot of transfers on the train. What are you looking at to really say, okay, these are the most important things I wanna get back on track. So we can move forward and adapt and obviously be ready for when this happens again. You can take that in any order. Yeah, that's a loaded question. There's so many things and I'll just hit on briefly that on the tail end of dealing with this crisis that's lasted over a year now that is a global pandemic. Our practice recently went through kind of another crisis related to our EHR. And I found myself for 10 days being without access to any of our patient records, no electronic health record. And it wasn't just our practice and it was through no fault of our own, but it affected many practices across the US. But to be totally working blind for 10 long days, I literally felt like I'd gone from the frying pan then into the fire. And it took me a minute, like Amanda said, I have to be okay first. I had to kind of regroup and then go, okay, how am I gonna lead my company through this? How am I gonna lead my team through this? And it is, I'm gonna say again what I said earlier, go back to what you know, take care of the patient first. And so we pull out the policy. Okay, I have a policy on this. It says paper. Do I have the forms already for paper charting? Well, I didn't, I had to create those. So look for gaps, look for holes, do some kind of a risk assessment and think worst case scenario. And then run through scenarios with your team totally transparently and say, okay, how would we react if we had this kind of a situation? You know, what if we had a power grid outage and you know, nobody had power for three days or what if we had a, you know, a natural disaster? How would we continue to provide care to the patient? And again, I think patient care needs to be the first priority. Team care needs to be the second priority. And then we'll worry about how we're gonna financially make this work. But being that kind of forward thinker that looks for gaps is something that I'm going to put in my pocket. And especially now that I've had the second kind of crisis in a row, it's really made me aware that I need to always be reflecting on what I've learned, self-assessing on how I can improve and then looking on to the next thing because it's coming. It's just a matter of time and we don't know what it will be. Sure, yeah. Great points. Amanda, bring on. I mean, I'm not sure you can quite follow. I'm not sure you can quite follow that any better. So, you know, so yes, yes, yes and yes. I think the next kind of steps for Genevieve are, I hate to say it this way, but I think Genevieve did a very nice job from a patient care partnership focus and from an employee relations standpoint. And it's hard to kind of build up some inertia during a pandemic. And yet I do think that it brought us all closer together and it continued to solidify us in the community that we were of great value. And there are a number of pieces in that, but again, both are all from the, a patient and family member perspective, a partnership perspective, and every partnerships at every level and from an employee perspective. And so I think for us, the next step is how do we leverage some of those things for growth? And what does growth really, strategic growth look like for us? We're right at the point, you know, we have total about just over 7,200 patients, 4,000 in primary care. We do quite a bit of community care management as well, over 3,000 patients in community care management where we're just starting to say, what would the next big thing look like? And in that is growth, but it's also structure and really taking a medium-sized company to a larger scale. And how do you kind of set a growth company up for decision-making and management infrastructure and communication trees for some scalability? You know, what would that look like? And then finally, from a data perspective, how do you make sure that your data, while it made sense at one size, is ready for the next level and what that size could look like? And then how do you continue that forward thinking? So I think, yeah, I mean, I couldn't echo from a COVID stand any better. I couldn't say any better from a COVID stand what to do, but for us, I think we have an interesting and unique opportunity. And one thing we also didn't do, and we didn't get a chance to talk too much about it, but we didn't lay anybody off. And so we were one of the only geriatric practices that did not lay anybody off or reduce anybody's schedule. And so, again, I think this is the time to really move fast. It's getting, you know, the question, how do you get everybody else there to go as fast as you, right, or as you want to go? So, and that's probably always stands as my challenge with change management. Yeah. The only thing I would add to that, and, you know, again, I would just echo both of Tammy and Amanda. Tammy, kind of building on your point, I would offer, you know, when you're doing that self-assessment, okay, making a list of what did we stop doing, you know, when COVID hit, you know, maybe it was a quality improvement project, maybe it was a care management approach, whatever it was, like, what did we stop doing or what's new? And then kind of, you know, doing that priority. Okay, how important is this still? You know, now that our worlds have changed so much and, you know, is this something we need to pick back up or do we need a new big idea to Amanda's point or something like that? But doing that, you know, as you're doing that self-assessment, really recognizing the things in your practice that had to be put on hold, whether it's a partnership or a project or, you know, whatever the case may be, what did you have to stop doing and is important to now pick that back up or do you need something new? All very good points. As we, I like Amanda, when you say we're in this transition phase, I know I cannot wait to get to the new phase as many of us can. So thank you guys for all those points. You know, we're going to look here to kind of close down our general discussion, you know, pose for any of you who have any questions that maybe you have not submitted during this time. We'd love to take those here while you're looking to potentially put those in your Q&A box at the bottom. I just want to remind you about our HTC Intelligence Resource Center. This is where you can find a way to connect with us via phone and email. Our hotline for questions. We do have recurring webinars and virtual office hours. You can come and bring your questions to us as well as many resources that you can download, tools and tip sheets that you will find that yes, are COVID specific, as well as others. And we encourage you to check out those resources and we're thankful that you do and that we are here to support you and our mission at HCCI. With that said, I don't see any other questions here in the box. So I am going to take the time to thank you all for being here. I want to thank the panelists, not only for joining us today, but for continuing in your roles that you have been in over a year that has definitely brought its challenges, but more importantly, brought some chances for us to learn. So I want to thank you for joining us today. Thank you. Have a nice one. Bye-bye. Bye-bye. Take care, everyone.
Video Summary
In this webinar on COVID-19 and home-based care, the panelists discuss the challenges they have faced and what they have learned from the pandemic. They highlight the need to quickly adapt to offer telehealth services, evaluate patients' needs in a different environment, and acquire PPE and supplies. The panelists also emphasize the importance of mental health and the need to prepare for the unknown. They discuss the impact of the pandemic on staff and the need for self-care, as well as the need to take care of the entire team, including support staff. The panelists also discuss the importance of staying up to date with telehealth policy and finding the best technology solutions for patient care. They note the importance of community support and partnerships in addressing the mental health needs of patients. The panelists highlight the need for self-assessment, prioritization, and planning for the future, including addressing gaps and challenges. They emphasize the importance of patient care and team care in the face of future crises. Overall, the panelists provide valuable insights on the lessons learned from the pandemic and the strategies for moving forward in the home-based care industry.
Keywords
COVID-19
home-based care
telehealth services
patient evaluation
PPE and supplies
mental health
staff impact
telehealth policy
technology solutions
©2022 Home Centered Care Institute. All rights reserved.
×
Please select your language
1
English