Consistently assigning the same nurse for home-based care visits can foster strong patient-provider relationships, reducing hospital readmission risk, especially for limited English proficiency patients. NYU Rory Meyers College of Nursing’s study advocates care continuity and enduring connections as essential, even when optimal language alignment isn’t possible. This strategy offers actionable insights for healthcare organizations dealing with nursing shortages. However, challenges in maintaining consistent care persist due to workforce issues.
Researchers have identified that assigning the same home care nurse can foster strong patient-provider relationships, leading to decreased hospital readmission rates.
Healthcare organizations aiming to curtail hospital readmissions within their limited English proficiency (LEP) patient groups receiving home-based care might find value in consistently deploying the same nurse for each visit. Recent findings from NYU Rory Meyers College of Nursing suggest that such an approach enhances care continuity and establishes enduring patient-provider connections, thus improving outcomes and mitigating certain language barriers, even when implementing optimal staffing solutions—be it a linguistically diverse nursing team or medical interpreters.
As healthcare institutions increasingly adopt value-based care agreements and prioritize patient-centered medical experiences, home-based care has gained popularity. Convalescing at home post-inpatient hospitalization is preferred by most patients, with home-based care proving effective and cost-efficient.
However, this positive trend isn’t uniform across all patient demographics, as underscored by NYU researchers. Patients with limited English proficiency face an elevated risk of hospital readmission, attributed to language barriers impeding effective patient-provider communication and thereby compromising the quality of healthcare.
Ideally, healthcare organizations would employ a diverse workforce capable of administering home-based care. Having healthcare providers proficient in multiple languages would enhance language alignment during nurse visits to LEP patients.
“While home care agencies should ideally strive to employ nurses fluent in their patients’ languages, the reality is that the demand often surpasses the supply,” remarked Allison Squires, Ph.D., RN, FAAN, lead author of the study and an associate professor at NYU Rory Meyers College of Nursing.
Given the prevailing shortage of nursing staff, Squires indicated that the study’s insights offer actionable steps for healthcare institutions. In cases where language alignment isn’t feasible within the home-based nursing team, providers can still promote positive outcomes by ensuring care continuity—ensuring that the same nurse attends to the patient during all home health visits.
The research analyzed 22,103 patients who underwent home-based nursing care following acute inpatient hospitalization. These patients primarily spoke Spanish, Korean, Chinese, or Russian.
Not surprisingly, patients who experienced consistent care and language alignment with their nurse displayed the lowest risk of hospital readmissions. Conversely, variability in nursing staff throughout the home care process correlated with a higher readmission risk.
Interestingly, having the same nurse for all home care visits, even if the nurse didn’t share the patient’s language, also correlated with a decreased risk of hospital readmissions, although the effect was slightly weaker than with language alignment.
Squires explained, “Frequent interactions between nurses and patients seem to facilitate familiarity with the patient and their family or caregivers, regardless of any language barrier.”
The study’s authors suggested that this data could offer a viable strategy for hospitals aiming to reduce readmissions but grappling with language diversity issues in their home health workforce.
“For healthcare providers referring patients to home health care services and managing these referrals, it might be worth evaluating an agency’s capability to maintain consistent skilled nursing care, as a means to decrease the likelihood of hospital readmissions,” advised Squires. “Home health care organizations should prioritize assigning providers in a way that ensures the patient’s preferred nurse remains involved throughout their treatment journey.”
Nonetheless, ensuring care continuity presents its challenges, particularly within the context of the industry’s workforce constraints. Reports indicate diminishing nursing job satisfaction and a shrinking workforce. Many organizations rely on per-diem workers, making it difficult to assign a single nurse to a patient throughout their entire home healthcare experience.
“The attainment of care continuity relies on a home care organization’s ability to recruit and retain nurses,” Squires emphasized.
