Summary
Objectives
To help manage the risk of falls in home care, this study aimed to (i) identify home
care clinicians’ information needs and how they manage missing or inaccurate data,
(ii) identify problems that impact effectiveness and efficiency associated with retaining,
exchanging, or processing information about fall risks in existing workflows and currently
adopted health information technology (IT) solutions, and (iii) offer informatics-based
recommendations to improve fall risk management interventions.
Methods
A case study was carried out in a single not-for-profit suburban Medicare-certified
home health agency with three branches. Qualitative data were collected over a six
month period through observations, semi-structured interviews, and focus groups. The
Framework method was used for analysis. Maximum variation sampling was adopted to
recruit a diverse sample of clinicians.
Results
Overall, the information needs for fall risk management were categorized into physiological,
care delivery, educational, social, environmental, and administrative domains. Examples
include a brief fall-related patient history, weight-bearing status, medications that
affect balance, availability of caregivers at home, and the influence of patients’
cultures on fall management interventions. The unavailability and inaccuracy of critical
information related to fall risks can delay necessary therapeutic services aimed at
reducing patients’ risk for falling and thereby jeopardizing their safety. Currently
adopted IT solutions did not adequately accommodate data related to fall risk management.
Conclusion
The results highlight the essential information for fall risk management in home care.
Home care workflows and health IT solutions must effectively and efficiently retain,
exchange, and process information necessary for fall risk management. Interoperability
and integration of the various health IT solutions to make data sharing accessible
to all clinicians is critical for fall risk management. Findings from this study can
help home health agencies better understand their information needs to manage fall
risks.
Keywords
Home health agencies - health information technology - quality of care - workflow
- information management
