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I want to return to home care but not sure. Have a queston.

Posted

I worked at Home Care agency prn for 3 years. I liked it and even was planning to go to home care full time. But last year I quit because our agency switched to computer charting. In fact, many nurses quit because did not want to deal with computers. It used to take me 10-15 minutes to document a routine visit on paper. Now it takes at least 1 hr. (That's what I was told by nurses who still stay in home care.) I also heard that some companies have better computer programs and charting takes less time. My question is: how much time you used to spend to document a routine visit on paper in the past and how much time you spend now? When you know computer program very well is it possible to spend on documentation of one routine visit 15 minutes or less?

I would ask about documentation when you apply to each agency. An acquaintance who worked with computerized charting told me she was very upset with it because the system was always going down when she was in the middle of something. She always lost her own time due to this. So far I have managed to avoid computerized charting and am just fine without it. Do not look forward to changing over from paper charting.

Our agency does computer charting. We do our charting during our visit and inform the patient that we will be doing this so " everyone has the most up-to-date information " it does take him about 60- 65 minutes to complete her charting and longer if the patient has issues along with phone calls to doctors. I have been with homecare for approximately eighteen years and only three of those did we not do use a computer it is just something to get used to but it does work well . Everyone is able to see what is going on with the patient and it makes for better communication and it looks older even the paper charting was faster and took about half an hour. I think you should go back to home care. Computer charting is not the worst

I think it depends on the program and how fast you can type.

My visits are at least 30 minutes long and I start the charting in the house - vitalsigns and check off the boxes for the routine visit notes or hospice notes. The actual note where you have to write free text I do in the car because I need to focus so I type faster. I am a fast typer and also use a mouse in the car - which helps a lot. The complete charting for one pat visit routine or hospice does not take me more than max 20-30 minutes. Often even faster if most things can get checked off in boxes.

Now the harder parts : All Oasis like SOC,ROC, D/C - I need to focus and I do the complete note in the office or from home because I have to focus on those notes big time and a long admission can easily mean 1-2 hours of computer work if it also includes putting in 20 or more medications, care plans, outline of care and so on and forth.

Lesson here is that if you work extra visit or per visit you are usually changed short because it is more work than let's say a routine visit.

I think 15 minutes may be possible if there is nothing going on but when you have the electronic health record you also have to update medications, create alerts for INR, update this and that ....

I wonder if you could spend some visits with a nurse and see the documentation they are using to get a better idea?

I think it depends on the program and how fast you can type.

My visits are at least 30 minutes long and I start the charting in the house - vitalsigns and check off the boxes for the routine visit notes or hospice notes. The actual note where you have to write free text I do in the car because I need to focus so I type faster. I am a fast typer and also use a mouse in the car - which helps a lot. The complete charting for one pat visit routine or hospice does not take me more than max 20-30 minutes. Often even faster if most things can get checked off in boxes.

Now the harder parts : All Oasis like SOC,ROC, D/C - I need to focus and I do the complete note in the office or from home because I have to focus on those notes big time and a long admission can easily mean 1-2 hours of computer work if it also includes putting in 20 or more medications, care plans, outline of care and so on and forth.

Lesson here is that if you work extra visit or per visit you are usually changed short because it is more work than let's say a routine visit.

I think 15 minutes may be possible if there is nothing going on but when you have the electronic health record you also have to update medications, create alerts for INR, update this and that ....

I wonder if you could spend some visits with a nurse and see the documentation they are using to get a better idea?

That's a great idea, a ride along to see how long the documentation takes them.

I can complete a routine visit note uninterrupted on paper in 5 min, can't imagine it taking up to 15 min unless I had an addl TO, med addendum, infection report.

On our recent EMR a visit note with TO/med addendum took 30 minutes. Over an hour to do a simple SOC and up to 2 hrs on a complex one. That was pretty rough when you add in everything else on top of 6 visits/day. That program is being replaced.

Other changes in the past year have been OASIS-C update and upcoming ICD-10 update.

I'd go with the ridealong idea to see what I could at least work up to. Or down to depending on how you look at it :-).

At least your old company is already up and running on EMR and you got to skip the big transition.