Home Health Procedure

A home health nurse contacted me about designing a process to improve her efficiency in her work. This particular nurse is highly educated, loads of credentials and years of industrial nursing experience, but new to Home Health Nursing; I'm honored that she chose me to assist her.

Here were the problems:

1. A big, backpack size, heavy bag of supplies and small equipment only some of which are to be used at every visit, the others must be readily available.

2. The forms; numerous forms for different situations; opening a case, closing a case, referral for other services, basic visits; some forms are used at every visit. There is also Mrs. C's Daily Activity Log; mileage between patients, the date, patient's name and time & length of visit.

3. Where to put a small number of office supplies: pens, post-it notes, paperclips, small stapler, staples, tape, etc.

4. Mrs. C also requested a form designed to leave with the patients that lists all of their medications and when to take them so the patient can reference it as she sees a need to help the older patients remember the proper times and dosages of their medication.

5. Notes were being taken on the back of a form and then later entered in the appropriate one, in an effort to save time.

6. Client files containing medical information, information which by law (HIPPA) has to be safeguared, but Mrs. C needs accessible if she needs to refer to something.


Here are the solutions we came up with:

1. We got a small, zippered, clear make-up bag for the supplies that are used at every visit and can be kept inside the bigger bag; after every visit Mrs. C re-stocks the small bag to have ready for the next patient.

2. We picked up a clip board, file folders, labels and a plastic 'milk-crate' that we made sure the file folders would fit in. We labeled a folder each patient's name and Mrs. C put the forms in the order she knew was necessary. The forms each got their own labeled folder and all folders were put in the crate, alphabetically with the patient files behind the forms' folders. There are some forms to be used at every visit, so we paper clipped one set for every patient she was scheduled to visit the following week and put them into their own folder at the very front of the crate, all she has to do is reach in and grab one set before she gets out of her car. We also put one set on the clipboard and used dental floss to attach an extra pen. The Daily Activity Log is kept on top of the clipboard (it hides the medical forms below it) and is filled out immediately upon arrival at the patient's home and immediately before leaving the patient's home.

3. We bought a small, hard plastic 'pencil-case' to store all the office supplies and it sits inside the crate.

4. Using Word we designed a form to leave with the patient; the form has their name, a list of all medications being taken, the date and time of the visit and who to contact if the patient has questions about their medication. This took about an hour.

5. Instead of taking notes on the back of another form, we added that form to the paper clipped forms used at every visit, therefore Mrs. C is only writing the notes once. She has since told me it sure saves her a lot of time!

6. We solved most of this issue when we handled the forms, each patient has their own folder, labeled with last, first name only and they are stored behind the forms' folders. At the end of the day, Mrs. C takes the crate into her house for safe storage. She also spends 15 minutes double checking her supplies and forms to be ready for the next day. Mrs. C has remote start on her car so the heat or air can stay on for a while during the visits to help keep the temperature fairly even to protect the medical supplies.

This procedure, including the shopping trip & designing a Medication Form, took us 4 hours at a cost of $100. Mrs. C has since contacted me and said it is saving her approximately 1 hour a day, that she no longer feels like she forgot something and the investment of $100 for my time actually saves her $250 per week for the time she used to spend!