What Barbara Bush Reminds Us About Caregiving

Tom Maxwell

As I re-read the March newsletter, I find myself once again on a flight headed back West. On this trip, I am returning from the National Hospice and Palliative Care Organization’s MLC conference in Washington, D.C.

It was a well-attended conference focused on caring for America’s aging population. As I strolled through the exhibit hall, I found my mind wondering to the recent news of Barbara Bush’s passing. I found myself thinking about how much pressure it would be to care for someone as special and powerful as Mrs. Bush. I am sure, in many ways, she was just like any other patient. But, she was also the first lady of the United States — just think of the stories and memories this patient has had in her lifetime. I hated hearing she was only on hospice for such a short time — less than 24 Hours. She and her family deserved (as does everyone) the invaluable opportunity to benefit from all the amazing people and resources that only hospice can provide at the end of life.

It’s times like these that have always motivated me in my career to do the right thing and help improve our system. How can I make our amazing caregivers’ lives easier? These angels tirelessly care for the people we love and yet we continually pile them with regulatory changes, documentation requirements and other busy tasks. We must figure out how to ensure our gifted caregivers are able to spend more time taking care of patients and less time checking boxes.

My focus in this blog is clinical — how we can eliminate unnecessary or redundant documentation and requirements. It’s Maxwell Healthcare Associates’ recommendation that you create a documentation team and begin to look at each service code. It’s important to review the documentation with these questions in mind:

  1. Does this question or assessment support the clinical need of the patient?

  2. Have we asked it in the easiest way to collect the appropriate responses?

  3. Should we change it to free text or to multiple choice?

  4. Should there be a validation to help guide the caregiver and allow for checks and balances?

  5. Does this question or assessment support the regulatory requirement of the patient?

  6. Is this question in the correct portion of the assessment?

  7. Is it covered somewhere else in our clinical documentation?

Last, I think it’s important to use the Point Care Recommendation (PCR Note) coordination note. Request that caregivers complete the PCR Note anytime during the visit where they find documentation that does not make sense, has a spelling error or any other recommendation. The documentation team can then run the coordination notes report for the PCR Note types and work through the corrections and changes.

MHA has a team of trained forms experts, nurses and therapist who can assist in reviewing your documentation. We owe it to caregivers to simplify our processes and documentation to allow them more time to treat our patients.

We will continue to explore more of these themes in our coming newsletters and blogs (if you haven't subscribed to our newsletter, do so by clicking the button in the top left corner of our site). In the meantime, I would like to express my sincere appreciation for your feedback and comments on our work. I am sincerely proud of the team we have assembled. They are amazing in every way and continue to lead our industry.

Like the 41st first lady, I want to always do the right thing and be remembered for giving back to others. I’m hoping my work with MHA is a vehicle for that. (If you have not seen the video of the Texas A & M Aggies Corp lining the street for the first lady’s motorcade, find it here. )

Please call on me directly here, or reach out to any of my amazing team members. We would love to help you review your processes. Next month we will be talking about challenges faced by the clinical caregivers. Please take care of each other and remember to be kind to everyone.

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