Time saving tips for HH nurse

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I've been a HH nurse for a little over a year now. My old office was not well organized at all and as a result I usually worked from the time I got up to the time I went to bed 7 days a week. I was on the verge of quitting, then moved to a new area (transferred to a different office within the same company) this office is MUCH better organized and I starting thinking I finally got a point I could see myself sticking with home health. However, last couple weeks have been especially busy (as it tends to get) and I've started working more and more hours again. Nowhere near as bad as it was before, but still I'm determined to get down to a 40 hour week. What are some of your time saving tips? Here's what I already do

I try to do as much charting in the home as possible (unless the patient is SUPER chatty, in which case I just get what I need and try to get out ASAP)

I try to schedule my next visit while still in the home to prevent from having to call up patient and schedule visits (just started this plan last week so it hasn't yielded all the benefits it will yet)

I wake up at about 5am and chart (I'm a morning person and can focus much better this way then when I try to chart after a long day) which usually allows for about 2.5 hours of charting before i have to get ready and go

I keep a notebook with all my patients info and goals and try to cross off goals as i meet them to keep up with it (even though I usually forget to do this and end up having to go back through my notes and cross things off that way)

any additional ideas? it would be incredibly helpful!

I use mapquest route planner to try to minimize drive time. I also wrote a macro that fills out the computerized assessment form according to the last visit so that not only do I get a report of sorts going through the screens but I only have to change what is different. This saves me about 10 minutes a visit but took many hours to write, as it is over 5000 lines of code. I used autohotkey to write it. I'm payed by the visit per diem so it is in my best interest to be as efficient as possible. I just started doing start of cares (only been doing this about 6 months) and although with regular visits I usually have my documentation locked and complete with charging and notes and all, I'm going to experiment this week with using an oasis cheat sheet I made for SOC so I can reduce my time in the home since it seems there are so many steps that utilize the assessment info that it would be easier to see it all in one place for reference rather than coming in and out of the screens in our program (McKesson). I've got all the info and steps I need with checkboxes for tasks completed or things documented on one half of a sheet of paper with fall risk assessment and Braden on the back. And even though it was a pain the first time, I think a macro that prefills the oasis for what a healthy patient would look like so I don't have to waste time filling millions of wdl boxes and can chart by exception will save boatloads of time. I also make the lab draw kits like the previous poster. I like to write an order draft and note draft the night before so I can just add or take away as needed according to assessment and I outline the teaching in my note that I'd like to do so it functions as a to do list of things to discuss with the patient. This also allows me to call the md pretty close to the end of my visit to give for a verbal ok on my order to give them the max amount of time to call me back so I'm not waiting on calls into the next day when I'm not working. I'd love to hear other peoples tricks!

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Specializes in Cardiac/Telemetry, Hospice, Home Health.

My biggest time saver is I use voice dictation for the narrative parts of my documentation on my ipad or iphone in between visits.

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Specializes in Nursing home and Home Health.

wow, that seems really high. Are you field only? Even then that seems high. I have been in HH 2 1/2 years and my average day is 2-OASIS and 2-SN/SUP visits. If I have more than that there is no time left to case manage (follow up phone calls, equipment, f/u orders etc.).

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Don't you just love it when you are down to the last phone contact to set up visit when that LAST patient has one thing or another reason to have to back and redo the whole day.... How do you all deal with this?

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Don't you just love it when you are down to the last phone contact to set up visit when that LAST patient has one thing or another reason to have to back and redo the whole day.... How do you all deal with this?

That happens, especially when you think your whole day is planned perfectly. Maybe try to adjust the patients where you would only have to change the visit time for one patient and maybe just adjust things by 30min. Most patients are flexible when they can be seen since they are 'homebound' unless their caregiver or DPOA needs to be present and they have a limited time to meet. We like to give an hour window of when we will be there to give us time in case things come up.

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I only set up my first of the morning visits the night before. everything after noon, I start calling on that morning between clients. I have alot of routine, longer term clients, so they are usually a quick visit, go over meds, I know them back and front, ask about new appointments etc, but I do have a rule and I NEVER bring my work home, unless I am working the weekend and/or on call. Having time for your family is important as well.

as for time saving tips.. those clients you know well, I have have template in my head and just fill in the client specific information. When I worked for long term care, I had an EXCELLENT DON, who had a system that I have brought forward into this job. Head to toe, EVERY SINGLE TIME. it keeps things from being missed and I do my charting on these clients in the home and fully complete the visit at that time. Those visits I can get down to 40 mins or so. On these clients, I also give them a calendar, especially if they are older or mark on their's what day and aprox time I would try to be there, and tell them I will call them to confirm the day before. Then they look forward to my visit, they know when I will be there, and it works. they will even schedule everything else around MY time. If they have favorite shows, know that, and either make a mental note or even put it in the chart, and read up on them the day before quickly just to refresh your memory. I find it helps alot if you do that, and you dont feel like you are trying to read up on them while there, and waste visit time.

I also prepare lab req's early, and put everything I need in bags ready to go. but I also have a soft "tackle box" that I use to put in needles, syringes, blood collection tubes, and anything else I would need for lab draws. if I dont have it prepared, I just grab the bag and its all there for me. I also carry extra supplies, as we are very rural with our clients, and you never know what you will need. I actually have 2 car boxes. one with dressings, supplies of that such, unna boots, kerlex, coflex, and things of that nature and the other has collection hats, caths, foley kits and the bigger items that may be needed while out in the field and no way to "run" back to the office to get it.

I am very anal retentive though, so I try to have anything I would need ahead of time... and should the world end? well.. I have supplies for that as well, lol. Joking on the last one. but I do find it takes off alot of pressure if you plan for Armageddon, but only have to deal with a simple boo boo.

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I want to add: there are some clients who are just difficult to work with, especially with scheduling, and most of the time it is because they want to feel in control of something. Sometimes I have to be stern and tell them right up front that if they want HH, they need to work with us and we will try our best. I also will tell them at times, that I just cannot accommodate them at the time or day that they want due to other scheduled clients such as wound care that has to be done on certain days, labs, etc. on those occasions, I will offer them a choice, and it usually satisfies them and makes them want to work with you. Also, if you say you will be there.. say at 10am, be prompt. if something holds you up, call them and tell them. it really renews their faith in you and keeps them open to HH and working well with the team. by doing this with my clients, I have some who wont work with anyone else but me because I do communicate with them well. these are the clients who tell me everything, and trust that I will follow through.

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Hi Atownshend,

I am very impressed that you wrote a macro code to speed up the charting process. I will be beginning home health at the end of this month and wanted to find good time saving techniques which led me to this post. We will be using Kinnser as our EMR. Would it be possible for you to share your code or give advice on how you went about creating it. I would really appreciate your help.

Thanks in advance :)

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Hi Atownshend,

I am very impressed that you wrote a macro code to speed up the charting process. I will be beginning home health at the end of this month and wanted to find good time saving techniques which led me to this post. We will be using Kinnser as our EMR. Would it be possible for you to share your code or give advice on how you went about creating it. I would really appreciate your help.

Thanks in advance :)

Yes, I would like to know as well. I've been with my company for 2 1/2 years and we use Kinnser.

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