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A Career Development Project That Improved Clinical Outcomes

The Opportunity

By maximizing the role of the home care worker, we can increase the value of home care services in improving care transitions, reducing emergency department usage, and preventing rehospitalizations.

Our Partners

PHI worked with the Independence Care System (ICS)—a nonprofit organization offering managed long-term care plans for more than 6,500 older adults and people with disabilities in New York City—to develop the Care Connections project. The first Care Connections cohort was recruited by three licensed home care service agencies within the ICS provider network: Cooperative Home Care Associates (CHCA), Jewish Association Serving the Aging (JASA), and Sunnyside Community Services.

What We Did

We developed an advanced role—Care Connections Senior Aide (CCSA)—to provide coaching and support for home care workers and family caregivers, and to serve on the Interdisciplinary Care Team. We also developed a telehealth program using customized software on mobile devices to facilitate communication about changes in a client’s condition between home care workers and clinical supervisors (as well as a timely response).

Who Was Involved

Fourteen home care workers were trained and eight of these workers were deployed as full-time CCSAs (with six “back-ups”) across three agencies. Three RNs were trained to oversee the senior aides. More than 1,400 ICS clients benefited in the first 18 months of the Care Connections project.

The Results

CCSAs received an annual salary with benefits, which increased their earnings by 60 percent compared to entry-level home care positions, and reported improvements in their job satisfaction, inclusion in the care team, relationships with clients and families, and communication with clinical managers. Furthermore, the project was associated with an 8 percent drop in emergency department visits in 2015 compared to the previous year, and caregiver strain appeared to improve for at least half the family caregivers involved.

Lessons Learned

Findings from the pilot Care Connections project demonstrate that creating an advanced role for home care workers can improve care quality and outcomes, while also benefitting the senior aides and the family members and home care workers they support.

“The real value of the job came to me when I was doing a home visit. I could see that the home care worker needed to know more about diabetes, and I was right there to connect her with the information she needed. I’m elated.” – Beverly Harriott, Care Connections Senior Aide

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