Home Health & Hospice Week

Home care agencies and hospices were woefully under prepared to handle the onslaught of H1N1 cases that erupted earlier this year, according to the recent "Planning for an Influenza Pandemic in the Home Health Care Sector" Web conference. While agencies' preparation for a pandemic paid off, "we ran out of gloves, masks, gowns, alcoholbased hand-washing solution," Barbara Citarella, founder and president of RBC Limited in Staatsburg, N.Y., shared in the conference, which was sponsored by the Agency for Healthcare Research and Quality.

Though "we had done a lot of preparing, we still were not as prepared as we probably needed to be or could have been," she said.

Worse: When agencies ran out of supplies and personal protective equipment, they weren't quickly able to restock. And "surge capacity became a moving target," so agencies were never sure how many staff members they needed to adequately assess and treat patients, Citarella explained.

Lesson learned: After taking so many hits in the first weeks of the H1N1 outbreak, experts have outlined two particular issues that agencies must address if they hope to better handle another potential avalanche of flu patients. They are:

1. Community involvement. Home health agencies don't operate in a vacuum -- and their patients definitely don't exist in one. When the H1N1 outbreak began, "agencies' response varied according to what their community was doing," Citarella said.

Agencies also acted according to how local and state associations responded.

Better: Agencies must be part of the solution. They shouldn't wait to see how others are handling a situation -- they should work with providers across the spectrum to set the tone for response.

How: You must learn the "emergency response language," and become familiar with state and national incident management systems, Citarella stressed. This way, agencies don't find themselves struggling to keep up -- or out of the loop when resources dry up.

2. Communication and outreach. When H1N1 pounced onto the national scene, many care providers didn't know the difference between standard and universal precautions to keep the virus from spreading. Communication breakdowns kept home health workers from knowing who their community partners were or how to access state stockpiles. For instance, no one was quite sure how to tell if a staffer was infected with H1N1 -- or how to diagnose whether a patient was.

Better: Agencies must "educate the community to be the caregivers," because hospitals will want to keep most H1N1 patients at home and out of the public space Citarella said. That will leave home health workers as key players in responding to and mitigating the virus.

How: Your staffers already know how to stay safe from the flu. Namely, they must wash their hands, wear masks, and distance themselves socially from infected persons. However, you must also train them on how to report incidences of H1N1 as the virus spreads.

Many states, including New Mexico, New Jersey, and New York are already focusing on home care education to ensure aides are able to alert state and national responders that the virus is spreading.

Next step: To effectively train your aides and prepare for another potential outbreak, you must first connect with your local emergency management office. Establish your agency as a partner in beating back the tide of flu cases, and take advantage of any training opportunities available in your community, Citarella advises.

You should also beef up on national guidelines, including those released by the Centers for Disease Control and Prevention, the Institutes of Medicine, AHRQ, and others, she adds.