Objective: To determine if there is agreement—between a systematic literature review and home care social worker interviews—that current low utilization of Medicare home health social work services has an adverse impacts impact on patient care. Methods: This is a qualitative study based on in-person interviews of a convenience sample of 36 home care social workers from 6 different home health agencies in New York City between April 9, 2026, and May 29, 2026. It is a follow-up to a similar study on home care nurses view in this Journal, published online in June 2026. Results: Four major themes emerged, with social workers feeling, like nurses: (1) the Medicare Advantage prior authorization process denials are frequent and adversely impact patient care; (2) Medicare Advantage Plans use of home health decreases the amount of home health visits; (3) decreased Medicare Advantage home health visits disproportionately affect social work, which is the lowest volume service in traditional Medicare home health and (4) decreased Medicare Advantage home health visits per patient increase the likelihood of patients developing further psychosocial and medical complications. Conclusions: The current study reinforces the need for: (a) government sponsored robust research to have a more valid and reliable idea of where relevant policy changes should be made, and (b) statutory and regulatory action to address the low utilization of Medicare home health social work services and its adverse impacts on patient care.
Introduction: Sustaining long-term home-based caregiving for individuals with amyotrophic lateral sclerosis (ALS) presents significant challenges for family caregivers. While peer support is frequently recommended, the cognitive processes by which caregivers interpret their experiences and engage with peer support over prolonged caregiving trajectories remain unclear. In this study, we aimed to explore such processes within the Japanese context, where long-term, high-burden home care is common. Methods: Semi-structured interviews were conducted with 9 primary family caregivers affiliated with the Japan ALS Association. Participants had provided home-based care for 3 to 18 years. The interviews focused on caregiving challenges, coping experiences, and engagement with peer support. Data were thematically analyzed to examine patterns in caregivers’ cognitive interpretations and meaning-making processes over time. Results: Caregivers described positive cognition not as a fixed attitude but as a dynamic, non-linear process comprising 3 interrelated themes: (1) gaining experiential knowledge and emotional reassurance through peer connections, (2) proactive engagement with caregiving challenges accompanied by self-affirmation, and (3) sharing caregiving experiences with others. Sustained caregiving contexts and ongoing engagement with peer networks shaped these processes. Conclusions: Peer support may influence how some family caregivers cognitively interpret and sustain long-term ALS caregiving by providing experiential reference points, emotional normalization, and opportunities for reflection. However, these trajectories are context-dependent and should not be interpreted as normative or expected. Therefore, home care systems should offer peer support flexibly, respecting the diverse realities of caregivers and avoiding prescriptive expectations surrounding growth, positivity, or contribution.
Background: The acute hospital-to-home transition is a period of profound clinical vulnerability. While systems track readmission metrics, the communicative and environmental friction points burdening nursing practice remain fragmented in the literature. Current models frequently treat discharge as an idealized administrative task, overlooking the complex realities of the “discharge danger zone” that impede effective patient education. Objective: This systematic review synthesizes international empirical evidence to identify the pervasive communication failures, inter-professional workflow constraints, and cognitive-environmental barriers disrupting the clinical provider-to-home handoff. Methods: Designed as a mixed-methods systematic review (PROSPERO: CRD420261435583) guided by JBI methodology, a search of 6 databases identified 30 peer-reviewed empirical studies published between 2020 and 2026. Methodological quality was appraised using the Mixed Methods Appraisal Tool (MMAT). Data were synthesized using a convergent integrated mixed-methods approach. Results: Four macro-themes mapping transition breakdowns emerged: (1) Cognitive, Psychosocial, and Health Literacy Barriers; (2) Systemic and Workflow Friction Points (e.g., rushed timelines, fragmented coordination); (3) Environmental, Socioeconomic, and Structural Home Barriers; and (4) Communication Quality and Information Processing Breakdowns (e.g., medical jargon, lack of comprehension verification). These intersecting forces routinely sabotage patient education, cultivating a perilous “illusion of comprehension.” Conclusion: The hospital-to-home transition is a complex inter-professional communication event, not merely a medical transaction. To enhance patient safety, nursing leadership must advocate for systemic workflow redesigns that decouple transition education from the rushed point of exit, mandate structured comprehension verification, and implement interventions accommodating patient cognitive load and diverse social environments.
Purpose: Home-based hospice and palliative care services depend on coordinated clinical assessment, medication access, caregiver support, and communication systems that can be disrupted by disasters and public health emergencies. This review synthesized evidence on how hospice and home-based palliative care nurses contribute to disaster preparedness, response, and continuity of end-of-life care. Methods: A systematic review was conducted using PubMed/MEDLINE, CINAHL, Scopus, Web of Science, Cochrane Library, Google Scholar, and citation searching. Eligible sources addressed hospice, home-based palliative care, community palliative care, or end-of-life care in disaster, emergency preparedness, evacuation, pandemic, public health emergency, or large-scale service disruption contexts and included nursing-relevant findings. Heterogeneous evidence was synthesized narratively. Results: Thirty sources were included. Nurses contributed to patient risk stratification, emergency planning, communication redundancy, visit prioritization, medication and equipment continuity, caregiver teaching, telehealth triage, ethical decision-making, evacuation support, and workforce safety. Nursing roles were often embedded within organizational or interdisciplinary descriptions rather than specified as distinct management responsibilities. Conclusions: Disaster preparedness in home-based end-of-life care should be treated as a routine component of care management, not only as regulatory compliance. Home health and hospice organizations should use nurse-informed risk stratification, caregiver-centered emergency plans, explicit ethical guidance, communication backups, medication and equipment contingency planning, and staff safety protocols to preserve comfort and continuity during emergencies.
Introduction: This study aimed to investigate whether family functioning is independently associated with caregiver burden among parents caring for children with medical complexity (CMC) at home and to identify factors most strongly associated with higher burden. Method: A cross-sectional survey was conducted from January to November 2024 among parents of CMC in Japan. Caregiver burden was evaluated using the 8-item Japanese version of the Zarit Burden Interview (J-ZBI-8), and family functioning was measured using the Family Adaptability and Cohesion Evaluation Scale III (FACES III). Sociodemographic characteristics and caregiving-related variables were also collected. Logistic regression analyses were conducted to explore associations between caregiver burden and potential predictors. Results: Of 112 respondents, 95 were included in the final analysis after excluding incomplete responses. In the multivariate model, caregivers who reported adequate rest had significantly lower odds of experiencing higher caregiver burden. Conversely, family functioning was not significantly associated with caregiver burden after adjusting for covariates. The medical complexity score of the child was also not a significant predictor. The overall model demonstrated acceptable goodness of fit. Conclusions: Adequate rest may serve as a modifiable protective factor in reducing caregiver burden among parents of CMC receiving home-based care. Although this study examined the independent contribution of family functioning, caregiver-level factors—particularly adequate rest—revealed stronger associations with burden. These findings suggest that interventions targeting caregiver recovery and respite may be more effective than those focusing solely on family functioning.
Background: Shifting demographics and shortages of care staff place increasing pressure on healthcare systems and highlight the need for sustainable informal care. Although informal care alleviates pressure on healthcare systems, it comes with significant burden, primarily for caregivers. Minimizing burden through adequate support systems is essential. This review maps the evidence landscape on (a) educational, (b) social/emotional, (c) practical, (d) financial, and (e) legal support interventions for informal caregivers. Methods: A scoping review of literature published between 2019 and 2025 and indexed in medline, Web of Science, and CINAHL. Screening was conducted in duplicate. Data extraction was conducted using elicit and quality checked manually. Synthesis followed a 4-step, iterative, and thematic approach. Results: About 2665 articles were screened and 67 included. The most common support types were educational (n = 63) and social or emotional (n = 45), often combined. Educational support improved caregivers’ knowledge, skills, preparedness, and self-efficacy, often linked to improved burden and quality of life. Social and emotional support was linked to lower isolation, anxiety, and depression while enhancing well-being, and emotional connections. Overall, studies reported improved caregiver burden, self-efficacy, preparedness, quality of life, as well as mental and physical health. Financial and legal interventions were marginally addressed. We identified (1) caregiver-related, (2) intervention-related, and (3) system-level barriers and facilitators. Conclusions: The literature primarily focuses on educational and social-emotional interventions with reported benefits across caregiver outcomes, including caregiver burden and overall well-being. Financial and legal support remain inadequately addressed despite broader evidence that financial burden is a key driver of caregiver burden.
Background: Patients’ homes are increasingly recognized as the preferred setting for palliative care (PC). As frontline providers, home care nurses face complex clinical and systemic challenges that demand high levels of knowledge and confidence. Thus, this review aimed to critically appraised and synthesized the literature on home care nurses’ perceived competence and self-efficacy in PC delivery, along with factors that influence both constructs. Methods: This integrative review employed Whittemore and Knafl’s framework and was guided by Bandura’s self-efficacy theory. The search was conducted in November 2024 using 9 databases: MEDLINE, Cochrane Central Register of Controlled Trials, Emcare, Cochrane Database of Systematic Reviews, CINAHL, ProQuest Nursing & Allied Health, ProQuest Dissertations & Theses Global, PsycINFO, and Scopus. Results: The search yielded 13 articles. Findings were categorized into 2 overarching themes: (1) structural and relational challenges and (2) educational and training gaps in PC. Time constraints resulted in task-oriented visits, while late PC referrals strained relationships by introducing nurses late in patients’ illness trajectories. Home care nurses often function in isolation with limited access to supervision and support. Persistent gaps were identified in knowledge and skills related to pediatric care, end-of-life discussions, symptom management, and psychosocial support. Conclusion: The findings suggest that nurses’ perceived competence and self-efficacy are shaped by individual, organizational, and systemic factors, highlighting areas for targeted training, organizational change, and policy development to support holistic PC. The review contributes to Bandura’s work by explaining self-efficacy and competence within the context of home-based PC.
Aim: This scoping review aims to determine the factors affecting the effective implementation of HMR. Data Sources: The PRISMA Extension for Scoping Reviews (PRISMA-ScR) and Arksey and O’Malley’s method act as the groundwork in guiding this scoping review. Three electronic databases (PubMed, Scopus, Web of Science) were systematically searched from inception to 31 March 2025 to identify relevant articles. Search terms included combinations of keywords related to “Home Medication Review,” “Home Medicine Review,” and “Home Care Pharmacy Service” using Boolean operators “OR.” Study Selection and Data Extraction: Studies were included if they examined factors influencing the implementation of HMR services. Only articles published in English with accessible full texts were included. Extracted data were analyzed thematically, and a concept map was developed to summarize these factors. Data synthesis: A total of 261 articles were identified, and after removing duplicates, 227 were screened for eligibility. 42 studies met the inclusion criteria. Nine key themes were identified and mapped to the WHO health system building blocks. Policy and program structure, as well as patient awareness and engagement being the most frequently reported. Most included studies were conducted in Australia. Conclusion: In conclusion, identifying and addressing these interrelated factors can guide policymaking as well as strategy development to enhance the effectiveness, accessibility, and sustainability of HMR programs.
Objectives: Limited research has examined spousal and adult-child differences with dementia caregiver burden. To address this gap, objectives of this scoping review were to: (1) synthesize differences in caregiver burden between spouse and adult-child dementia caregivers, and (2) determine whether a relationship status group consistently experienced more caregiver burden. Methods: A literature search was conducted in October 2024, using PubMed, Ovid, and Scopus databases. Articles written in English published between January 1991 and June 2024 were included if they: (1) examined impacts of caregiving for an individual with any form of dementia; (2) reported kinship distribution and/or stratified results by relationship status; and (3) examined caregiver burden as a separate variable. Studies were excluded if they: (1) described a condition without a dementia diagnosis; (2) included caregivers not stratified by kinship; or (3) examined a caregiver tool like a physical assistive device as a moderator. Results: A total of 15 studies met review criteria and were divided into quantitative (N = 14) and qualitative interview (N = 1) studies. Six found adult-children caregivers experienced more caregiver burden than spousal caregivers. Four studies found spouses experienced more burden. One study showed live-in adult-children reported the most burden, followed by spouses, and then non-live-in adult-children. Three studies found no difference. Lastly, one qualitative interview study documented profound differences by caregiver type. Conclusion: Results of this scoping review were mixed as to which group consistently felt more total burden. Future longitudinal investigations should further examine these associations, especially given an increasingly aging world.
Purpose: This review examines the potential of social media-based support networks in reducing caregiver burnout within home health care settings. As home-based caregiving continues to increase due to population ageing and the growing prevalence of chronic illnesses, informal caregivers often face emotional strain, social isolation, and caregiving burden that may contribute to burnout. Methodology: A systematic literature review was conducted following PRISMA guidelines. Twenty-eight empirical studies published between 2010 and 2024 were identified and analysed through narrative synthesis to explore the relationship between online support engagement and caregiver well-being. Findings: The reviewed studies suggest that social media platforms, including online communities and peer-support forums, offer various forms of support, such as emotional reassurance, informational guidance, and shared caregiving experiences. Although only a limited number of studies directly assessed caregiver burnout using validated instruments, many reported improvements in coping ability, perceived social support, and psychological well-being among caregivers participating in online support networks. The evidence further indicates that digital support is most effective when combined with existing offline support systems. Research Limitations: The findings should be interpreted with caution due to variations in research design, reliance on self-reported data, and the limited number of longitudinal studies. The lack of standardised burnout measures across studies also restricts direct comparison of outcomes. Practical Implications: Social media-based support networks may serve as an accessible and cost-effective resource for supporting informal caregivers in home health care contexts. Integrating digital peer-support mechanisms into caregiver assistance programmes could help strengthen caregiver resilience and improve overall well-being. Originality/Value: This review contributes to the emerging discussion on digital caregiving support by consolidating recent evidence on how online social support networks may help address challenges associated with caregiver burnout in home health care environments.
Background: The provision of in-home health and social care is increasingly important in the context of supporting an aging population, chronic disease management, and individual autonomy in daily life situations. Home-based practice has been a context for interprofessional education (IPE) to prepare health professional students with the communication, collaboration, and clinical skills to meet the needs of individuals in the home environment. Methods: A scoping review was conducted to identify how IPE has been implemented in experiences designed to prepare students for home-based practice. A search strategy was implemented in 4 databases, and articles were reviewed by 2 independent reviewers. The review is reported in accordance with the preferred reporting items for systematic reviews and meta-analyses scoping review (PRISMA-ScR) guidelines. Results: Fifty-five articles met inclusion criteria. Interprofessional home visits, instructional sessions, and simulation were the most common educational approaches used to develop students’ abilities for home-based practice. Most educational experiences were in the context of older adults or chronic health conditions. Instructional content predominantly focused on interprofessional teamwork, health management for older adults, communication skills, and considerations when conducting home assessments. Twenty-four studies reported significant findings relating to educational, interprofessional, and clinical outcomes. Conclusion: IPE has provided rich educational experiences for students to develop the skills for home-based practice. While further research is needed to evaluate the effectiveness of various educational approaches on home-based and interprofessional practice competencies, there is nascent and growing evidence that home visiting in interprofessional student teams has a positive impact on interprofessional learning outcomes.
Objective: This study assessed the perceived feasibility of the Wiser in Home Care reflection instrument among Dutch home care professionals, as well as correlations between perceived feasibility and profession, work experience and prior exposure to the instrument. Design: Quantitative cross-sectional study. Setting: This study took place in the work setting of home care professionals. Participating partners came from in and around the metropolitan area of Rotterdam, the Netherlands. Methods: A cross-sectional survey using a 16-item questionnaire, based on the measurement instrument for Determinants of Innovation (MIDI), was completed by 63 home care professionals and students in the Netherlands. Data were analyzed using descriptive statistics and Fisher’s exact test. An open-ended question explored qualitative feedback on the tool. Results: Most participants evaluated wiser in home care positively. Over 90% agreed the instrument’s steps were clearly described and the language was understandable. Eighty-three percent reported improved ability to manage complex care situations better, while 78% believed it supported the appropriate use of quality standards. Compatibility with existing workflows received slightly lower agreement (69%). Significant differences were found by professional role and experience, with more experienced or higher-qualified staff expressing greater confidence in using the tool. Conclusion: Wiser in Home Care appears feasible as a reflection-based support tool for promoting reflective use of quality standards. Findings reflect perceived feasibility, not actual behavioral uptake. The integration of the instrument with quality standards in home care can be improved.
Remote patient monitoring (RPM) technologies are increasingly integrated into chronic disease management and home healthcare systems. However, evidence regarding their clinical and organizational impact in transitional healthcare systems remains limited. This study examined the association between RPM-supported home healthcare, hospitalization outcomes, and nursing workflow transformation among patients with chronic diseases in Georgia. A sequential explanatory mixed-methods study was conducted between 2025 and 2026. The quantitative phase utilized a quasi-experimental comparative design involving 300 patients receiving either RPM-supported home healthcare (n = 150) or standard home healthcare services (n = 150). Clinical outcomes included hospitalization, emergency department utilization, readmission rates, medication adherence, and disease-specific indicators. Workflow-related experiences were assessed among 110 nurses and caregivers. Multiple regression analyses were performed to identify predictors of hospitalization and workflow efficiency. The qualitative phase included 25 semi-structured interviews with healthcare professionals, analyzed using thematic analysis. Patients receiving RPM-supported care demonstrated lower hospitalization rates, fewer emergency department visits, and reduced 30-day readmission compared with patients receiving standard care. RPM utilization was independently associated with lower hospitalization risk (OR = 0.71, 95% CI: 0.51-0.98, P = .039). Healthcare professionals reported improved care coordination, communication efficiency, and earlier identification of clinical deterioration. However, participants also described increased documentation burden, cognitive workload, and alert fatigue associated with digital monitoring systems. RPM-supported home healthcare may contribute to modest improvements in chronic disease management and continuity of care in Georgia. However, successful digital health implementation requires organizational readiness, workforce adaptation, and alignment between digital technologies and clinical workflow.
Communication failures cause most serious medical errors, with non-acute care environments being particularly vulnerable. While situation-background-assessment-recommendation (SBAR) is proven in acute settings, its safety impact in non-acute clinical settings remains unclear. This systematic review followed PRISMA 2020 guidelines and a pre-registered protocol (PROSPERO CRD420251139601). We searched PubMed, CINAHL, Cochrane Library, and Ichushi-Web through September 2025. Studies evaluating SBAR interventions for healthcare professionals in non-acute settings were eligible. Two reviewers independently performed selection, extraction, and risk-of-bias assessment (RoB 2, ROBINS-I). Evidence certainty was evaluated using GRADE. Eleven studies (1 RCT, 10 quasi-experimental) were included. SBAR implementation improved structured communication adherence (43.6%-91.0% in long-term care; 4.0%-79.0% in psychiatry). One hemodialysis study reported reduced incidents (36-9 events), but an RCT found no reduction in adverse events despite improved INR control. Staff satisfaction generally improved (87.5% nurses reporting utility). Evidence for patient-centered outcomes was very limited. GRADE certainty was very low. Successful implementation required leadership support, clinical champions, context-specific adaptation, and iterative PDSA cycles; barriers included time constraints and hierarchical culture. SBAR is feasible for standardizing communication in non-acute settings; however, robust evidence of clinical effectiveness is lacking. Successful adoption requires active, context-sensitive strategies guided by implementation science frameworks.
Background: Homecare rehabilitation providers serve clients at home and in the community. Like homecare providers of other disciplines, they were required to use facial protective equipment (FPE) during the SARS-CoV-2 pandemic. Increased FPE usage may also be required during future respiratory disease outbreaks, epidemics, and pandemics. With no known studies exploring homecare rehabilitation providers’ FPE adherence, this pilot study explored factors influencing their adherence to respiratory and eye protection. Methods: Cross-sectional online surveys were completed by rehabilitation providers from 2 large not-for-profit homecare agencies in Ontario, Canada, in January 2023. Factors influencing respiratory and eye protection adherence were examined separately using descriptive, bivariate, and logistic regression techniques. Conventional content analysis was used to explore open-text responses. Results: Rehabilitation providers (n = 124) reported adherence rates of 77% and 53% to respiratory and eye protection, respectively. Higher respiratory protection adherence was associated with previous exposure while lower adherence was associated with negative mental health effects due to past exposure. Eye protection adherence varied by provider occupation. Higher adherence to eye protection was associated with working 35 hours or less and with using face shields. Qualitative findings emphasized training and FPE accessibility to support adherence. Discussion: This pilot study revealed initial opportunities to support homecare rehabilitation providers’ adherence to FPE. Early insights suggest mental health support, easy FPE availability, and training opportunities may increase adherence. Hours worked, eye protection choice, and occupation may also be important factors. Future research is needed to deepen our understanding of the insights observed in this pilot study.
The Home Health Value Based Purchasing (HHVBP) Model program was introduced in 2016 as a pilot through the Centers for Medicare and Medicaid Services (CMS). The program devised a formula to incentivize Medicare-Certified home health agencies in the United States (U.S) to improve patient care quality, reduce hospitalizations, and improve patient experiences. The original model was piloted in 9 states (Massachusetts, Maryland, North Carolina, Florida, Washington, Arizona, Iowa, Nebraska, and Tennessee) from 2016 to 2021. These states represented geographical areas across the nation where Medicare-certified “payment was tied to quality performance.” Participating agencies’ performances were evaluated using the Outcome and Assessment Information Set (OASIS) instrument to extract data related to patient outcome measures and claim-based measures. Data extraction of patient experiences came from HHCAHPS surveys. Conclusions drawn from the first 3 years denoted modest improvements in OASIS-based quality measures in patients in HHVBP participating agencies versus non-participating agencies. Nationwide expansion of HHVBP began in 2022, with the first full performance year starting January 1, 2023. This quality improvement project examines a Michigan-based home health care organization’s implementation of a focused OASIS-based measures process to improve patient outcomes impacting their HHVBP Model TPS scores within their designated cohort. Analysis of the executed plan revealed strategic implementation of measures to improve OASIS-based measures had a positive impact on clinician engagement with patients to facilitate improved patient outcomes. Improvement outcomes positioned the agency to be rewarded with a positive payment adjustment incentive in 2026 based on their CY 2025 performance.
Background: Although timely communication between visiting nurses and primary care physicians is a key component of care coordination in home healthcare, few studies have examined how communication methods contribute to the timeliness of information-sharing. This study examined the association between the communication methods used by these professionals and physicians’ perceived timeliness of information-sharing in Japanese home healthcare. Methods: We conducted a multicenter cross-sectional study in 2024 involving patients receiving home visits from physicians. Patient-related data were collected using questionnaires completed by physicians. The outcome was physician-reported perceived timeliness of information-sharing for each patient, measured on a seven-point Likert scale (1 = not at all timely, 7 = extremely timely). Because communication methods were not mutually exclusive, they were entered simultaneously into a multivariable linear mixed-effects model with facility- and physician-level random intercepts. Results: Overall, 363 patients were included in the analysis. The mean timeliness score was 5.4 (standard deviation 1.2). In multivariable linear mixed-effects models, using an information and communication technology (ICT)-based system was significantly associated with higher timeliness scores compared with non-use (adjusted mean difference 0.95, 95% confidence interval [CI]: 0.69-1.20). Face-to-face interaction and telephone communication were also independently associated with significantly higher scores (0.61 [95% CI: 0.39-0.83] and 0.49 [95% CI: 0.28-0.71], respectively). Conclusions: Physicians reported higher timeliness of information-sharing when ICT-based systems, face-to-face interaction, or telephone communication were used, compared with non-use. Although confidence intervals overlapped, ICT-based systems showed the largest point estimate, highlighting their potential contribution to timely collaboration alongside traditional communication methods.
Introduction: The Medicare Payment Advisory Commission (MedPAC) has documented a significant increase in the number of Medicare beneficiaries opting for Medicare Advantage, also referred to as Medicare (Part C) plans. As a result, there also has been an increase in Medicare home health beneficiaries receiving their home health through Medicare Advantage Plans. A literature review indicates there is only one quantitative study and no qualitative studies on the impact of this shift on home health on patient care, and none on home care nurses’ views on the impact on patient care. Methods: The current study is a qualitative study based on in-person interviews of a convenience sample of 48 home care nurses from 9 different home health agencies in New York City between January 15, 2026 and March 25, 2026. Results and Conclusions: Five major themes emerged, with nurses perceiving: (1) the Medicare Advantage prior authorization process denials are frequent and adversely impact patient care; (2) Medicare Advantage plans use of home health decreases the amount of home health visits; (3) decreased Medicare Advantage home health visits per patient adversely affects nurses’ ability to deliver appropriate care; (4) decreased Medicare Advantage home health visits per patient increases the likelihood of health care readmissions; and (5) decreased Medicare Advantage home health visits per patient increase the likelihood of patients developing further medical complications. Recommendations are made for further government actions based on the study findings.
Background: Growing pressure to reduce hospital length of stay has made Medicare-certified home health agencies (HHAs) essential for preventing readmissions. Despite record demand, high clinician turnover remains a critical barrier to care delivery. Aim: To explore the perspectives of Registered Nurses (RNs), Licensed Practical Nurses (LPNs), Physical Therapists (PTs), Physical Therapy Assistants (PTAs), Occupational Therapists (OTs), Certified Occupational Therapy Assistants (COTAs), and Speech-Language Pathologists (SLPs; n = 372) on key operational aspects of home health practice and examine how satisfaction with these factors correlates with overall job satisfaction. Methods: A cross-sectional online survey was disseminated nationally via professional association forums and social media between March 11 and April 15, 2025. The survey assessed 5 components: scheduling, traveling, environment, documentation, and overall job satisfaction using a 5-point Likert scale, along with questions on discipline, work location, OASIS completion, and documentation mode. Reliability was assessed using McDonald's omega (omega = 0.754). Spearman's rho correlation analysis examined associations between operational components and job satisfaction. Results: Of 372 responses (179 PTs/PTAs, 78 OTs/COTAs, 71 RNs/LPNs, 44 SLPs), scheduling received the highest satisfaction ratings while documentation received the highest dissatisfaction. All 4 operational components correlated significantly with job satisfaction (df = 370): documentation (rho = 0.575, P < .001), scheduling (rho = 0.490, P < .001), traveling (rho = 0.481, P < .001), and environment (rho = 0.305, P < .001). Conclusion: Documentation burden, scheduling autonomy, and travel demands are the strongest operational drivers of home health clinician job satisfaction. Targeted improvements in these areas may meaningfully support workforce retention in Medicare-certified HHAs.
Background: Individuals with mental health conditions experience significant health disparities, including elevated rates of chronic illnesses and reduced life expectancy. These disparities are often exacerbated by healthcare providers’ challenges in addressing physical health needs when mental health symptoms are present. Methods: Professional development staff from a large home health organization spanning 2 states and 6 counties in the greater Philadelphia, Pennsylvania area created a training to enhance clinicians’ ability to care for individuals with mental health conditions. To accommodate diverse learning styles and geographic distribution, the training was delivered in a virtual, synchronous format, ensuring accessibility and real-time engagement across the organization. The program was grounded in Universal Design for Learning principles and employed multimodal instructional strategies to support varied learner needs. Training content focused on understanding mental health diagnoses, recognizing symptoms, applying trauma-informed care, and effective communication techniques. Results: A total of 974 clinicians completed the program, reporting increased confidence and competence in managing mental health conditions in the home setting. Participants noted a deeper understanding of mental health issues and felt better equipped to provide holistic care. Conclusions: These results suggest that targeted education can better prepare clinicians to integrate mental and physical health care in the home setting. Such approaches may represent an important strategy for reducing health disparities and promoting more holistic, person-centered care for individuals with mental health conditions.
