VNS Initiative Improves Work Life for Home Care Aides, ADLs for Patients

A successful effort to improve quality of life for home care workers and the people they assist is described in HHA Partnering Collaborative Evaluation: Practice/Research Brief, a publication of the U.S. Department of Health & Human Services Office of Assistant Secretary for Policy & Evaluation.

The initiative was launched in 2003 by the Visiting Nurse Service of New York. Its goal is to improve the work life of home care aides and increase support for their patients' improvement in key activities of daily living. Components include:

• Implementation of the "Five Promises" -- a set of field supervision practices designed to promote positive and effective communication among all caregivers while in the patient's home.
  
• Use of an ADL Tool to structure common goal-setting among nurses, patients, and aides in order to improve functional health.
  
• Proactive communication between patient service managers and licensed agency coordinators to cover aide supervision and service delivery issues.
  
• Increase in field support and supervision provided to aides.

In addition, it has changed the culture of health service delivery by moving from a purely professional model toward one of self-care management. In the self-care management model, patients and informal caregivers are active participants in decision-making and goal-setting, and home health aides play a key supportive role.