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Biosecurity BriefingAHRQ Releases Report on Home Healthcare During a Pandemic By Crystal Franco, July 11, 2008 On July 8, 2008, the Department of Health and Human Services (HHS) Agency for Healthcare, Research and Quality (AHRQ) released a report on the issues and resources associated with Home Healthcare During a Pandemic. The report offers insight on how the home healthcare sector may engage in community pandemic planning processes; the categories of supplies and resources that may be key for home healthcare in a pandemic; and potential barriers to home healthcare participation. The report was generated with input from a panel of subject matter experts from home healthcare and emergency/disaster preparedness and is meant to serve as the basis for ongoing discussion and pandemic planning in the home healthcare sector, not as official federal guidance to stakeholders.1 The report was produced with funding from the Office of the Assistant Secretary for Preparedness and Response (ASPR) and in coordination with the Centers for Disease Control and Prevention (CDC). The report provides an overview of the stakeholders that are included in the home healthcare community. According to AHRQ, there are nearly 18,000 different home healthcare organizations operating in the U.S., ranging from home healthcare agencies to hospice facilities—most of which are non-governmental and non-profit institutions.1 In a pandemic, the home healthcare sector is expected to be called upon to help care for patients who have been discharged from the hospitals to make room for flu patients but who still require some level of care as well as those patients who are sick (due to flu or other illness) but do not meet triage criteria for hospitalization. In order to prepare for their role in a pandemic, the report urges home healthcare entities to engage in planning with their local preparedness community. This type of collaborative planning process can help overcome some barriers to home healthcare participation in a pandemic response such as legal and ethical issues and confusion over reimbursement policies.1 The report identifies staffing and maintaining a strong home healthcare workforce as a major challenge in meeting patient surge. According to AHRQ, the home healthcare sector already faces workforce shortages due to difficulties in staff recruitment and retention. Additionally, the report indicates that staffing may be limited in a pandemic by staff illness and inability or unwillingness of workers to report for work. The report suggests that pandemic flu-specific training for home healthcare workers may be necessary both before and during a pandemic.1 In addition to patient surge during a pandemic, the kinds of patients that home healthcare providers care for will dramatically change. Patients being cared for at home will likely require a greater level of care than home healthcare workers typically provide, and workers will need to be prepared for a wide range of medical issues. Patients will also likely be looking to home healthcare providers as reliable sources for a variety of medical information.1 The report concludes that the home healthcare sector will be critical in a pandemic response and should be integrated into community planning efforts. However, it is expected that the patient surge in a severe pandemic would greatly strain the resources of the home healthcare community. Thus, AHRQ recommends that additional research be done on existing home healthcare surge capacity, training needed to augment home healthcare preparedness, and legal and ethical issues surrounding patient care and sharing of supplies during a pandemic.1 References
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