While the demand for home health services grows, the lack of infection prevention oversight presents a problem.
Editor's Note: This story is part one of a two part series.
When HealthLeaders previously spoke with Devin Jopp, CEO of the Association for Professionals in Infection Control and Epidemiology (APIC), about the importance of infection prevention efforts after the public health emergency for COVID-19 ended, he emphasized the role infection prevention specialists play in any healthcare setting.
As more individuals prefer to receive care in their home and older adults opt to age in place, home healthcare has seen substantial growth in the aftermath of the pandemic. HealthLeaders spoke with Jopp again, reopening the conversation around infection prevention—this time focusing on home health.
The following transcript has been edited for clarity and brevity.
HealthLeaders: How should home health have implemented or developed processes for infection prevention?
Devin Jopp: It's already hard enough to maintain infection prevention efforts in a hospital or an ambulatory care center, but when we start thinking of it in regard to home health, we start making a lot of assumptions about these environments: they're all great homes that are safe, that they're cleaned, that they have access to what they need, that they actually have capable caregivers that can deliver the same kind of care.
Particularly with these hospital-at-home models, they're increasingly using virtual components—remote patient monitoring or even telehealth visits. The provider might never step foot in the house. They might get a tablet with the physician communicating through it.
In our world of infection prevention, the issue is that pathogens aren't virtual, so there still must be certain processes that go into prevention and response, and to make sure that we are keeping all of the patients safe.
It's challenging because it's not one-size-fits-all in this space.
HL: How would you suggest home health integrate infection prevention efforts/specialists into their operations?
Jopp: There's got to be a reinvestment into building some sort of remote and mobile teams that are managing these homes. We worry about how many nurses and infection preventionists we have, but we're going to have to worry about that in the patient's homes.
We're going to need infection prevention control specialists or individuals training in infection prevention control coming to the house, making sure that things are being done on a random basis. Maybe environmental services will have to be provided. Maybe there will be some housekeeping service that's provided to come and make sure that those rooms are cleaned.
What I hope will happen is that we're not just going to say, “We're scalping savings here off of this system,” but that we're going to reinvest that into a model that's going to help support the family and really help yield better outcomes.
Otherwise, it's just shifting the burden and ultimately the caregiver and the family is the one that pays the price.
HL: Should there be more accountability for hospital-at-home models since they have access to more funding than home health agencies?
Jopp: I think the jury's out. These hospital-at-home programs aren't necessarily tied to hospitals and we're seeing in some cases they can be physician groups that are, in essence, having patients referred to them.
To me, regardless of who's doing it, whether it's a physician group or a hospital, I think there absolutely needs to be accountability. But even with the home health organizations, there's room for more accountability there, too.
Our loved ones deserve to be safe no matter what environment they're in. The reality of it is that in the home environment, while there's some real benefit to it, there's also got to be oversight.
We've got to figure out ways where we're building processes on a similar model or at least a modified version that's ensuring that patients are staying safe in their homes.
Jasmyne Ray is the revenue cycle editor at HealthLeaders.