On March 27, 2012, 30 representatives from the Pennsylvania Home Care Association (PHA) joined together to discuss issues relating to home care and home health. We met with various national legislators to review key legislation regarding whether nurse practitioners and physicians assistants may order home health services, our opposition of co-pays for Medicare Home Health Services, protecting the hospice benefit and ensuring that we receive adequate reimbursement for home health services to name a few. Our contingent consisted of Sherri Hewitt-Laird, Administrator and Owner of Caring Mission, Gretchen Stewart, Assistant Administrator of TCM, Sharon Hixenbaugh, R.N., Director of Nursing for Caring Mission Home Care and Karen Curry, Director of Business Development for Caring Mission Home Care and TCM Home Health.
It was fascinating to be a part of making a difference in our industry and Caring Mission Home Care and TCM Home Health are committed to continue to bring our voices to both our national and state legislative members. In fact, we will be taking an even larger group of nurses, caregivers and company representatives to Harrisburg on May 1st and 2nd to discuss similar topics.
During our visit the Supreme Court was holding their hearings on the legality of the Accountable Care Act or "Obama Care" and we were able to witness first hand the opposition and supporters of the program outside of the Supreme Court. We look very forward to hearing the outcome of those hearings sometime this summer. It was an exciting time for health care in Washington D.C. during those few days we were lobbying to make a difference!
Come join the Better Breathers Club which provides community education and support for adults with pulmonary disease.
Meeting every 3rd Wednesday from 5:00 pm - 8:00 pm
Washington Family Doctors
37 Highland Avenue
Washington, PA 15301
Free to the Public
No Reservations Required
Home monitoring (Telehealth) helps you manage your health from where you want to be....home.
I am very satisfied and grateful to all individuals that took care of me for the last 2 years. When ever the Telehealth was introduced; it was a Peaceof Mind for my daughter that every morning I was being monitored and evaluated.
To be at HOME is the most wonderful feeling!
Diana, TCM Telehealth Patient in Washington, PA
Telehealth Monitoring reduces the number of hospital re-admissions and ER visits by monitoring and providing actionable clinical information to make better care management decisions by catching early signs of exacerbation and health declines. If you have heart disease, diabetes, high blood pressure or respiratory disease you have to make lifestyle changes to stay healthy. In addition to following your doctors' orders, watching your diet and getting physical activity, you also need your vital signs monitored on a regular basis. We can do that with telehealth. TCM Home Health has significantly cut down on hospital readmissions.
A TCM Certfied Teleheath Install Specialist will deliver everything you need and teach you how to use telehealth. The system is wireless so it won't get in your way. You take your measurements without a nurse and the results are automatically sent to our TCM nurse who monitors and checks your results daily 7 days a week 365 days a year.
Your healthcare team at TCM can track your vital signs and symptoms on a regular basis through our wireless system and you don't have to worry about traveling to the doctor's office. This routine takes just minutes a day...at your leisure in the comfort of your home.
W e can check YOUR:
You can answer questions on the monitor about how you feel and all of that will be read and monitored by our TCM Telehealth RN to help manage your condition effortlessly.
If you would like more information on how we can help you or your loved one, family or friend please contact us.
The New Approach to Health Care – Patient Centered Medical Home
The “Medical Home” concept is a new approach to effective coordination of medical care, ensuring continuity across all facets of healthcare. Traditionally, patient care has been very fragmented between providers, such as hospitals, physician practices, skilled nursing facilities, home health agencies, etc. Communication seemed to stop when a patient exited the doors of each provider and the patient was the least informed of all.
According to Gretchen Stewart, Assistant Administrator at TCM Home Health, “The key to a successful medical home model is actively involving the patient and their family as part of the healthcare team, respecting each patient’s unique needs, culture, values and preferences, while also encouraging a patient’s accountability for their health.” An active, engaging partnership between the medical care professionals and patient/family ensures the patient is provided the skills necessary to make better decisions regarding their overall health with the goal of achieving the best possible outcomes. TCM Home Health is a part of the first “Patient Centered Medical Home” or PCMH recognized by the National Committee for Quality Assurance, NCQA.
Preventative care and implementing evidenced-based management of chronic conditions also contributes to successful outcomes. TCM Home Health in partnership with the local PCMH has developed a measurable, Fall Risk Assessment, focusing on patient safety and function in their home environment. Our licensed Physical Therapists complete this comprehensive assessment and immediately share this information with the primary physician, including recommendations to ensure a patient’s safety. Throughout their involvement with TCM, the patient is re-assessed to determine if their “safety score” is improving. This simple process has successfully prevented many patients from sustaining significant injuries related to a fall, likely requiring hospitalization. We are also developing a similar program for patients at risk, or having a diagnosis of depression.
The Patient Centered Medical Home focuses on the patient as a whole, ensuring high quality, safe and coordinated care throughout all facets of the healthcare system, with the end result being a healthier, well-informed patient. The Care Manager with a local physician group stated, “TCM Home Health has helped our practice transform into a PCMH. Our partnership has helped all of our patients’ outcomes to be the best they can be.”
FOUR PERFECT QUESTIONS......When a Loved One is Faced With End-of-Life
In the Fall of 2010, Atul Gawande, surgeon at Brigham and Women’s Hospital in Boston and an associate professor at Harvard Medical School, delivered a touching speech at the October New Yorker Festival. My husband attended with a friend and, because he said it so profoundly impacted the audience, I watched it myself on video the next day. It was indeed amazing. Dr. Gawande, author and national health care presence, spoke unabashedly about his lack of skill in conducting end-of-life conversations with his patients.
How could that kind of conversation ever be easy? I remember when my father-in-law passed away nine years ago. A nervous young doctor had the uncomfortable task of telling him that nothing more could be done about his leukemia and it was perhaps time for hospice. As he stumbled through the explanation, my father-in-law let him off the hook easily by saying “Well, hell son, I didn’t think I’d live forever.” It wasn’t the doctor initiating an
end-of-life conversation, but rather the patient reassuring the doctor by simply announcing, albeit a bit theatrically, that he understood what was going on and he was ready.
In the 2010 presentation, Dr. Gawande talked about how he searched for a way to help his patients understand, accept, and know when they are ready. He spoke with several end-of-life physicians who told them how they do it every day.
Ultimately, one physician, Dr. Susan Block at Dana Farber Institute, gave a simple, straightforward, and elegant answer that resonated. She told Dr. Gawande that there are four questions she mentally carries around that guide her through the difficult but important conversations. And those conversations are not about sophisticated hard choices or last minute “epiphanies.” Instead, they are about the process of understanding hopes and fears.
Here are her four questions:
Do you understand your prognosis?
What are your fears about what is to come?
What are your goals as time runs out?
What trade-offs are you willing to make?
Four perfect questions.
After seeing the video eighteen months ago, I scribbled those four questions onto a torn scrap of paper and tossed it into a stack of things that I would, like Scarlett O’Hara, think about tomorrow. But once in a while, I unearth it unexpectedly and then pause to consider the genius of Dr. Block. Sometimes it is because I wonder if I may personally face the end-of-life choices sooner than I ever expected. At other times, what really strikes me is that the questions are also about the process of recognizing hopes and fears in everyday life. Think about the daily choices and hard decisions, especially the unexpected ones that we are faced with. …And with each one we have to ask ourselves….
What is going on?
What scares us about it?
What do we ultimately want to accomplish?
What are we willing to do or sacrifice to make it happen?
Four perfect questions.
They came to the forefront again recently when I read about a family physician, Dr. Ken Murray, who wrote a Wall Street Journal essay titled “Why Doctors Die Differently.” He observed that doctors are more likely than other people to decline end-of-life interventions that have little likelihood of benefit. It’s not something that we like to talk about, but doctors die, too. What’s unusual about them is not how much treatment they get compared with most Americans, but how little. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care that they could want. But they tend to go serenely and gently.
Dr. Murray goes on to talk about the importance of advance directives and all the other technical issues that must be addressed. But those notwithstanding, I have to wonder if doctors tend to go serenely and gently because they have spent years, by virtue of what they do and see, knowingly answering those questions for themselves.
I recently shared the questions with a friend who is close with someone facing an end-of-life situation. She was amazed by their simplicity and perfection, and I realized what a small but meaningful gift it is to help someone accept what is to come with grace and dignity. It was eye opening. It made me think about the fact that one day; we will all be faced with the end-of-life. And so, perhaps today we might promise ourselves for the sake of spouses, partners, family, and friends to make an effort to understand what can truly happen to us, to acknowledge our fears, to plan what we want to do with whatever time we have and to know what trade-offs we are willing to make.
They are indeed, four perfect questions.
Elaine Waples underwent major abdominal surgery for ovarian cancer that had metastasized to several organs. Her journey is chronicled on Care and Cost.