[Nursing News]

Home-health providers penalized
Arizona Daily Star, AZ -

Nurses' failure to communicate with doctors contributed to the deaths of two Tucson patients and led to substandard care of at least 30 others, state investigators found.

Each of the patients received care from one of four Tucson home health-care agencies: Dependable Home Health Inc., fined $6,000 for violations of Arizona Department of Health Services rules; University Medical Center Home Health, fined $3,000; Heritage Home Healthcare of Arizona, also fined $3,000; and Interim Healthcare, fined $1,400....
...
"If there is a No. 1 problem in health care, it's errors in communication," said Greg Pivirotto, president and CEO of University Medical Center and its home-health agency...

....In one case last year, a nurse tried eight times from Nov. 19 to Dec. 9 to arrange a home visit to check on a sick 3-month-old who was born prematurely. The baby was the fourth for the 20-year-old mother, the state says.
On the nurse's first attempt, the mother put the nurse off until the following week. After that, the mother did not return calls, the report shows.

In January of this year, the baby ended up in Tucson Medical Center, where staffers reported the case to Child Protective Services. The baby was discharged to Casa de los Niños nursery for abused or neglected children — evidence of a dysfunctional family with whom the nurse never tried to get a social worker involved. .....

...Patient noncompliance is "certainly a problem," said Kathryn McCanna, who heads the state's office of medical facilities licensure. "But it's not a license to throw up your hands and say, 'Oh well.' " ...

AZ State taking a hard stance on this issue.....

In my experience best practice standard with mom baby cases: at least 2 drive by's done along with phone calls to parents & emergency contact documented.
Communicate with referring physician AND referral source unable to contact patient. Department of youth and child services also notified if case was referred to them by hospital staff.

I'm seeing an increase in # of not home/not found cases at my agency. Reinforce with my staff need to obtain emergency contact tele# from referral sources and DOCUMENT all calls.

Lack of documentation re communication is what will get you in trouble with regulators, patient and families!!!!!....something our QA audits have found and staff working hard to correct issue now.

[DutchgirlRN]

That was very interesting. Thanks for sharing.

[Mijourney]

When I was in home health these scenarios never happened to me, but I wonder what the supervisor and/or manager was thinking during all of this if the no contacts were reported.

[teejayrn]

This is a very interesting situation and I can say, I have come across the same instances many, many times. My suggestion is the get that monkey off your back! When I try repeatedly to get in touch with a patient or new referral, not only do I let the MD office know, I call the initial referral person, even if it is hospital personnel, as well as my supervisor and even the person who does the scheduling. I document everyone who I call. After the third driveby, at which I leave my card or a note everytime, We call the referral source and discharge the patient do to not being able to contact or locate.