United Hospital Fund Announces Guides for Family Caregivers and Health Care Providers to Improve Patient Care | Archived

Free Guides, Available On a New “Next Step in Care” Website, Are Designed to Ensure Safer Transitions between Care Settings

Release Date: 01.13.2009
Contact: rdeluna@uhfnyc.org
Contact Phone: 212-494-0733

To improve the working relationship between family caregivers and health care providers, the United Hospital Fund has launched the Next Step in Care website: www.nextstepincare.org. The website offers a range of guides and checklists—most intended for family caregivers of persons with serious illness, with some specifically for health care providers—designed to make patients' transitions between care settings smoother and safer.

The website is the first stage of a larger campaign, called Next Step in Care, which will engage hospitals, nursing home rehabilitation facilities, and home health agencies, as well as patient advocacy groups and other family caregiver-focused organizations, in addressing a range of transition-related challenges. Many studies have shown that miscommunication and lack of coordination in transitions lead to errors, particularly around medication changes. The tools are expected to reduce confusion and anxiety for family caregivers—family members or friends who provide or manage care—as well as improve patient outcomes and reduce unnecessary rehospitalizations.

“Family caregivers are the invisible workforce in health care,” said Carol Levine, director of the Families and Health Care Project at United Hospital Fund. “They are usually responsible for coordination of care after a stay in a hospital, nursing home, or after home care services end. Yet they are rarely trained, supported, or included in transition planning. These guides are intended to give them basic information to navigate an increasingly complex system.”

An estimated 34 million Americans, or one in five adults, are family caregivers—defined as relatives, partners, friends, or neighbors who provide or manage full- or part-time care to a chronically ill or disabled person. Family caregivers are an essential part of the health care workforce, providing 80 percent of chronic and long-term care in the U.S., and pressures on them are growing. Shorter hospital stays and increased use of outpatient procedures—changes that have increased the effectiveness of medical care in many ways—have shifted responsibility from paid to unpaid providers of care, increasing burdens on family caregivers.

Coordinating care during transitions is particularly challenging in today's health care system, in which chronically ill patients visit many physicians during any given year and may take a dozen prescription medications daily. When frail elderly or chronically ill patients move from one facility to another, each transition brings new challenges, new providers, and new financial concerns, as well as changes in medication and treatment. The responsibility for many of these changes often falls primarily on the family caregiver.

Next Step in Care aims to help family caregivers better manage transitions in care, in part by helping providers and family caregivers to work more effectively together. Created and tested by the United Hospital Fund, its tools can guide family caregivers in determining what issues to consider, how to seek assistance, how to manage medications, and how to better communicate with physicians and other health care professionals. For example, one guide (“What Do I Need as a Family Caregiver?”) asks a number of basic questions (e.g., “Can you lift the patient?” and “Can you give an injection?”) to help providers and family caregivers assess how well prepared the family caregiver is, what training and support, if any, he or she may need, and what tasks the caregiver cannot manage alone.

“Ultimately, we hope Next Step in Care can change provider practice so that family caregivers are routinely included in transition planning,” said David Gould, senior vice president of United Hospital Fund. “Smoother transitions mean fewer medication and other errors, better patient outcomes, and greater satisfaction among family caregivers and health care providers.”

In addition to the new website, the Next Step in Care campaign will include quality improvement activities, some to be developed as collaboratives, in which teams from different health care providers work together to identify, implement, and share best practices.

The guides and checklists available on the Next Step in Care website were developed and tested by a team of current and former family caregivers, long-term care experts, and health care providers from hospitals, rehabilitation units in nursing homes, and home care agencies. In English and Spanish, these tools can be downloaded for free at www.nextstepincare.org. A list of all guides and checklists currently available is below; more will be added in the future.

Funds to support the development of the Next Step in Care campaign were provided by Altman Foundation, The Jacob and Valeria Langeloth Foundation, Baisley Powell Elebash Fund, Eisenberg Family Trust, Aetna Foundation, The Bloomingdale's Fund, and The New York Community Trust, as well as the United Hospital Fund.

About the United Hospital Fund: The United Hospital Fund is a health services research and philanthropic organization whose mission is to shape positive change in health care for the people of New York.


Guides and Checklists
For Family Caregivers

HIPAA: Questions and Answers for Family Caregivers
Your Family Member's Personal Health Record
Medication Management Form
Advance Directives
A Family Caregiver's Planner for Care at Home
Planning for Discharge
Medication Management
What Do I Need as a Family Caregiver?
Hospital-to-Home Discharge Guide
Going Home after Rehab

Medication Management Form
Going Home: What You Need to Know
What Do I Need as a Family Caregiver?
When Home Care Ends

Next Steps
Emergency Room (ER) Visits
A Brief Guide to Home Care
Home Care: A Family Caregiver's Guide [detailed version]
Planning for Inpatient Rehabilitation (Rehab) Services
Admission to Inpatient Rehabilitation (Rehab) Services

For Health Care Providers
Medication Management
Assessing Family Caregivers' Needs


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    Family Caregiving

    Resources for family caregivers and health care providers are available at our Next Step in Care website.

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