What is Medically Intensive Home Health Care (MIHC)?

Home health care is all about keeping families together, allowing people to live independently in the comfort of their own homes. If you're investigating home health care for a family member, you might be confused about the difference between home health care and medically intensive home health care (MIHC). There are some similarities. Both require a licensed nurse (RN, LPN), and both are performed in the home. Yet there are also differences, and it's important to understand those differences so you know what you can expect:

Home Care

• Generally does not require RNs or LPNs.
• Home care provides companionship for those in need of an extra set of hands around the house.
• Home care offers options for chores and errands for those who cannot complete the chores themselves.
• New Care does not provide home care services.

Home Health Care

• Home health care encompasses a broad spectrum of social and health services for recovering, disabled, and chronically ill persons
• Home health care provides medical and supportive care in visits usually 1 to 2 hours per day in length (for diabetic teaching, for example)
• May include Hospice Care or Palliative Care

Medically Intensive Home Health Care (MIHC)

• For medically-fragile individuals who are dependent on life-support systems
• Provides one-to-one nursing care
• MIHC provides medical care in shifts of 8, 10, or 12 hours, providing round-the-clock care if needed
• New Care does NOT provide the services of Private Duty Nursing (CNAs , home heatlh aides, etc.).  We provide continuous skilled nursing (RN or LPN) care in the home also known as Medically Intensive Home Health Care.

Please contact us to learn more about the differences in care options and how to make the best choice.

New Care has been accredited by the Joint Commission since 1991..  The following is our sentinel event policy.

SENTINEL EVENT

I. POLICY

A. New Care Concepts, Inc. thoroughly evaluates all sentinel events through performance of a root-cause analysis.

B. Whenever possible, root-cause analysis is initiated on the first working day after the occurrence.

C. New Care Concepts, Inc. educates field staff and clients/families about sentinel vent reporting.

II. DEFINITION

A. New Care Concepts, Inc. defines a sentinel event as an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof.  Serious injury specifically includes loss of limb or function, significant 2^nd or 3^rd degree burns, loss of sensory function or developmental potential.  The phrase “or the risk thereof” includes any process variation for which a recurrence would carry a significant chance of a serious adverse outcome (a “near miss”) or because they indicate the need for immediate investigation and response.  These events are called “sentinel”.  Sentinel events are unrelated to the client’s underlying illness or condition.

B. Specific sentinel events may include:

• Unanticipated death of a client
• Suicide of a client receiving round-the-clock care
• Rape, assault or other crime involving bodily harm
• Client abduction
• Client fall involving severe injury or death
• Medication errors

C. In addition to sentinel events, New Care Concepts, Inc. reviews any incidence of attempted suicide, rape or abduction occurring while the client is a patient of New Care Concepts, Inc.

III. PROCEDURE.

A. Field staff are educated during orientation to report any unusual events/occurrences to Clinical Management as soon as possible after the event, using the after-hours, on-call Clinical Director if needed.

B. Client/family is provided with sentinel event information in the client handbook.

C. Field staff complete documentation as appropriate, including the completion of a QA report for the Safety Sub-Committee.

D. Clinical Director notifies agency administrators immediately of any sentinel event or events resulting in significant injury.

E. Clinical Director communicates with the client/family/caregivers, physician, hospital emergency personnel or other external agencies as needed.

F. Clinical Management Team convenes on the next business day to initiate a review of the event, and utilizes the JCAHO “minimum scope” table when conducting a root cause analysis.

G. Review includes an interview with any involved nurse to record the details of circumstances leading to the event, actions taken during the event, and any knowledge the nurse has of outcomes of the event.

H. The analysis seeks to determine:

• Underlying cause of the event
• Possibility of preventing this occurrence
• Opportunities to avoid future incidents
• Need to amend current process/procedure
• Need to educate staff about prevention and process amendments.

I. Clinical Management Team may consult other professionals for further input on the event, such as a physician or hospital personnel.

J. The Clinical Management Team prepares a written report of all finds, procedural changes and expected outcomes to the Executive Team and PI Committee within 10-15 working days.

K. Executive Team and PI Committee review the report and determine the need for any further follow-up and/or development of an action plan.

L. A root-cause analysis and action plan is submitted to JCAHO within 45 days of the event.

M. Executive Team/agency leadership provides client family/caregiver with a report concerning the event and follow-up.

N. Information may be used by agency leadership to develop new or modified policies and procedures.

O. New Care Concepts, Inc. provides support for any involved staff depending on need.  This may range from informal discussion to referral for psychological services and support.P. Following the implementation of new processes or procedures, the PI Committee conducts periodic reviews of the effectiveness of the process to reduce risk.