In the early days of the coronavirus in the United States, home health agencies and personal care providers largely explored, learned, and adapted spontaneously.
Over time, however, home care workers are increasingly gaining access to new tools, deeper insights, and best practices that are all used to map the COVID-19 landscape in more detail.
BrightSpring Health Services, based in Louisville, Kentucky, is now making an important contribution to this discovery effort.
The company released on Wednesday a detailed description of the strategy for preparing for the corona virus and the approach to damage limitation in the academic journal Home health care management & practice. The newly released piece focuses in particular on the first 100 days that BrightSpring responds to the coronavirus while caring for dozens of positively confirmed patients in their homes.
“Home health and personal home care will be really important resources for people with COVID-19 in the community,” said Dr. William Mills, senior vice president of medical affairs at BrightSpring and lead author of the magazine article, told Home Health Care News. “These services will be central to keeping people away from hospital and nursing homes who are apparently hard hit and spread by COVID-19 cases.”
Nationwide, BrightSpring and its subsidiaries operate in 49 states and serve more than 60,000 customers and patients every day. In addition to domestic health and personal care, the company’s service lines include pharmacy, hospice, neurorehabilitation, behavioral health and more.
With the support of PE giant KKR and an offshoot of Walgreens Boots Alliance Inc. (Nasdaq: WBA), BrightSprings home health and personal care operation spans 25 states.
From January 20 to April 30, BrightSpring and its subsidiaries provided 67 confirmed COVID-19 positive patients with home health and personal care services, less than 0.3% of the total census.
Of these people, only 20 were referred to BrightSpring after a hospital stay.
The fact that BrightSpring cared for fewer than two dozen COVID-19 hospital layoffs during this 100-day window is somewhat surprising as many experts believed that home care providers would be overwhelmed by a wave of patients leaving acute care settings .
“We used COVID to prepare for significant hospital discharges,” said Mills. “But what we’ve seen – and I think that’s a trend we’ve seen across the country – is that many patients who have COVID at home never end up in the hospital.” In the end, you recover spontaneously. “
With 47 of the community’s COVID-19 patients cared for by BrightSpring, the company was able to confirm its status through collaboration with local partners and health departments, although the availability of test supplies varied.
“It was a bit geographic,” said Mills. “But we could… have these people tested in any case. They were all confirmed by the nucleic acid swab test. “
Procedure and pain points
Internally, BrightSpring began daily monitoring of the global coronavirus situation in early February, relying heavily on information from Johns Hopkins University, the World Health Organization (WHO), and the United States Centers for Disease Control and Prevention (CDC).
When it became clear that the virus would spread in the United States, management formed a multidisciplinary action committee that included representatives from the areas of operations, communication, compliance, and clinical departments.
In addition, advanced infection control procedures have been implemented across all affiliates, exchanging guidelines about live and recorded web meetings, presentations, written guidelines, and guidance documents.
“We formalized the corporate infection control guidelines specifically for the mitigation of the COVID-19 pandemic,” said Mills. “Then we started meeting, both as a committee and with every single office, location in our home health and personal home care locations, to implement these guidelines.”
With regard to personal protective equipment (PPE), BrightSpring introduced a new central supply process in which employees assembled kits with masks, gloves, hand disinfectants and additional materials and then sent them to all locations.
This largely helped keep PSA under control.
“Fortunately, our procurement team did a really good job,” said Mills. “We received reliable procurement and were not affected by insufficient PPE.”
In addition to the above actions, BrightSpring has created a cloud-based web application to collect data about confirmed and possible cases in its markets. The knowledge gained from this application enabled company management to visualize coronavirus information in a “real-time situation room”.
Using digital screening tools, BrightSpring was able to monitor potentially asymptomatic caregivers.
“Every day, our home nurses, therapists, and home caregivers and staff enter their temperatures and do a symptom check,” said Mills. “That goes into a database, so we were vigilant on this page too.”
In general, Medicare beneficiaries with a higher number of chronic illnesses are the most frequently used home health services, with a quarter of the beneficiaries with six or more chronic illnesses receiving 13 or more visits during the year.
BrightSprings play-by-play in the first 100 days of COVID-19 is a somber reminder of the severity of the virus for this population.
Of the 47 COVID-19 patients identified by the company in the community, 17 had to be hospitalized. Thirteen of these hospitalized patients died of COVID-19-related illness.
“The problem is that in these cases the virus destroys the functional unit of the lungs,” said Mills. “It is really difficult to bring enough oxygen to many of these people. The vast majority died of respiratory failure.”
Looking ahead to the next 100 days, Mills expects BrightSpring to receive more referrals to hospitals, especially as the number of elective surgeries increases again.
Other areas will also stabilize, he noted.
“I think the supply chain will largely catch up with demand over the next hundred days,” said Mills. “I think we are better prepared both as a country and certainly. [BrightSpring] as a company with adequate PSA care and a solid training in infection control measures. “
Continued testing to monitor the workforce should also play an increasingly important role in home care. With this in mind, BrightSpring has started using point-of-care antibody testing as an additional precaution.
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