private duty nursing

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OUR SERVICES - PEDIATRIC & ADULT
PRIVATE DUTY NURSING

What is PDN?

Pediatric and Adult Private Duty Nursing is one of the most important services offered by Together Homecare. Providing clinical services to medically complex patients in the home presents a number of wonderful opportunities to serve these patients and their families.

Private duty nursing recipients have numerous clinical and functional needs that are typically marked by chronic health conditions, extensive care needs, significant functional limitations and specialized support needs.

At Together, the keys to managing the care of homecare patients with complex medical needs center around:

  • effective interdisciplinary communication between the patient, family members, nursing and therapy staff, physician, hospital and payer
  • proactive care planning and assessments
  • elimination of gaps in care
  • effective use of medical device and clinical software technology
  • maximizing functional abilities of the patient
  • minimizing avoidable hospitalizations

Our Role in Coordinating Care

The majority of PDN recipients are being seen by multiple physicians focused on individual specialty care, and critical medical treatment plans must be coordinated among the entire physician care team. The home health team at Together is in a unique role to ensure that care planning decisions are coordinated among all members of the care team.

The pediatric and adult PDN patient have unique needs that require the creation of effective and proactive care plans that address the comprehensive medical treatment plan and addressing future health concerns before they occur. The timely and integrated review of clinical documentation and flow-sheets to the care plan is an important key to optimizing outcomes by minimizing hospital episodes.

There are opportunities for home health agencies to positively affect unnecessary inpatient utilization for PDN patients:

  • Managing co-morbidities
  • Focus on ambulatory care sensitive conditions such as asthma
  • Proactive surveillance of medical devices i.e. tracheostomy tubes, G Tubes, shunts etc.
  • Improved coordination with home medical equipment, nutrition and pharmacy providers
  • Clinical assessment, treatment protocol and care guidance to field nursing and therapy staff

In addition to providing the clinical tools that support effective patient management, Together Homecare also provides:

  • Robust clinical scheduling and recruitment onboarding of pediatric and adult care staff
  • Innovative Point of Care documentation systems tailored for hourly/shift care delivery
  • Medicaid and Medicaid MCO integrated claims submission teams with tools to facilitate patient account management and authorizations
  • Built in compliance assistance including automated OIG checks
  • Integrated CRM tool to assist hospital liaisons and case managers with PDN referral source communication
  • EVV and/or Telephony interface automation
  • Physician, Field Staff, and Family Portals to drive effective communication
  • Data aggregation to support PDN best practices

 

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