Ohio’s Hospice speeds response to after hours and urgent calls

About Ohio’s Hospice

Ohio’s Hospice is a partnership of mission-driven, not-for-profit hospices in Ohio committed to strengthening and preserving community-based hospices. The organizations and its affiliate members have been serving patients and their families throughout Ohio since 1978. Headquartered in Dayton, Ohio, Ohio’s Hospice serves 55 counties through its affiliates and supports patients in their homes, at extended care and assistance facilities, and at its Hospice House and inpatient care centers in Dayton, Middletown, Troy, Columbus, Newark and Wooster, Ohio.

The challenge

After hours and crisis calls are difficult – for patients and their families waiting for help to arrive, as well as the hospice care providers doing their utmost to reach them as quickly as possible. Ohio’s Hospice recognized this as a key issue and took action to address it.

According to Ashley Puchalski, director of clinical care at Ohio’s Hospice, the impetus to address the need for faster response to calls came from leadership.

“Kent Anderson, our CEO, had a vision to increase availability,” she explained. “He wanted to focus on speed to care, especially for issues such as uncontrolled pain and breathing issues.”

Overcoming the barriers to fast response

“When a crisis call came in, we didn’t always easily know who was available or who could respond the fastest,” Puchalski said. “We also didn’t know the status of available providers. So even if we did know who was closest, we didn’t want to interrupt if they were with another patient.”

Ohio’s Hospice came up with a technology concept to identify patient needs in relationship to staff availability. After creating an initial version of the solution, the organization partnered with Netsmart to continue developing the technology that would improve metrics and reporting to support superior care and services to patients and families. The result was CareRouter.

With CareRouter, Ohio’s Hospice can provide quicker responses to care for crisis calls and those that come in after hours or on weekends. When a call is received, the care coordinator selects the patient and address and immediately identifies the nearest available provider, looking at licenses, disciplines based on the patient need. Care Coordinators can select to notify the patient via text or email when the provider is enroute to the visit.

Adding needed information to crisis calls

The care coordinator then selects the reason for the call, e.g., extreme pain or shortness of breath, and can include additional information in the notes section, such as what prescribed medication has been taken. The care coordinator can then select the nearest available provider who receives notification of the patient need inclusive of notes from Care Coordinator to communicate real time.

Putting information at the fingertips of our providers absolutely has a positive effect. They don’t have to look up the patient’s address or records. They know immediately what the problem is and can be on their way quickly.

Ashley Puchalski, Director of Clinical Care, Ohio’s Hospice

“Our goal is to have the provider on the road within 15 minutes of receiving the request. We’ve now been able to monitor this goal and increase this to close to 90% since implementing CareRouter.”

Collecting data to improve operations

The solution also offers Ohio’s Hospice the ability to collect additional data to further enhance their operations.

“We cover a large area – more than 55 Ohio counties. The information from CareRouter helps us identify heavy usage in specific areas and staff appropriately,” Puchalski said. “We are able to prioritize patient needs based on urgency and monitor volume of visits based on priority and day.”

The information also lets the organization know when non-clinical staff should get involved. For example, if a patient has been seen after hours for uncontrolled pain multiple times, it might indicate the need for a social worker to become involved and initiate proactive care to reduce or avoid similar calls in the future.

Measuring success

Prior to implementing CareRouter, Ohio’s Hospice didn’t have the means to benchmark and monitor speed to care. Now the organization is able to set metrics and goals to improve patient care outcomes after hours.

The organization also has gained insights into the productivity of care providers, with a complete picture of travel time and how long they’re in a visit.

“Our care providers were a little reluctant at first. The initial concern was being tracked,” Puchalski said. “But that changed quickly when they recognized how much CareRouter benefits them and their patients.”

The organization’s care providers work 12-hour days, not including travel time. CareRouter reduces the length of their day by routing them to patients with shorter travel times. She noted that the agency had paid out $8,000 less in mileage expenses during the previous month alone.

Care providers also appreciate the additional information they receive with after-hours and crisis calls.

“They go into patient visits better prepared for what they’ll encounter,” she noted. “It’s just better all around – for our providers and our patients.”

Puchalski observed that the agency has received many expressions of appreciation from patients and their caregivers for the fast response.

“It is very difficult to wait for help while you or someone you love is in extreme pain or having trouble breathing,” she said. “Knowing we’ve eased some of that anxiety is a good feeling.”