Post-acute care company Compassus has built new efficiencies into its onboarding procedures for newly hired nurse practitioners in its palliative care service line, accelerating the process and reducing costs. Compassus, which provides hospice and palliative care in addition to home health, has a national footprint.
During the COVID-19 pandemic Compassus found it necessary to conduct onboarding online to comply with social distancing requirements to prevent the spread of the virus. However, in light of the results the company has achieved, plans are in development to continue the virtual program in the long term. Virtual onboarding began in May.
As the company ramped up its telehealth capabilities in response to the outbreak, they also began to leverage those same systems for internal activities.
“Our palliative care leadership team worked around the clock when COVID first hit and created and implemented telehealth protocols and procedures, as well as worked to create partnerships with long term care facilities who did not have access to palliative care,” Compassus Palliative Care Director for National Programs Karen Hyden told Hospice News. “Our providers were able, during the state of emergency, to offer telehealth visits with patients and/or family members even across state lines.”
Hospice providers have greatly expanded the scope of telehealth during the ongoing federally declared health emergency, with the U.S. Centers for Medicare & Medicaid Services (CMS) issuing 1135 waivers and other flexibilities to allow providers to continue patient care from a distance and minimize risk of COVID-19 exposure.
Prior to the pandemic, Compassus initiated new employees through the completion of training modules developed by the Center to Advance Palliative Care (CAPC), reviews of professional and medical literature and calls with National Palliative Care Director Kate Stackhouse.
Following these steps, the newly hired practitioner would travel to a Compassus location that provides community-based palliative care for 32 hours in the field with a veteran in their discipline to learn more about conducting home visits to patients, as well as complete and accurate documentation and billing.
Following the onset of COVID-19, Compassus continued with the online CAPC modules, but adjusted their process to include more intensive virtual training via case studies, role play, as well as online instruction about home visits, billing and documentation. The training also included strategies for building relationships with referral partners. Hyden spearheaded the development of the virtual training program.
While Compassus, like many other health care organizations, took a financial hit from the pandemic due to rising personal protective equipment (PPE) and technology costs, they realized significant savings from the virtual onboarding program.
“PPE for the company at large has been a huge, unplanned expense, multi-millions at this stage. Technology expenses for the organization have also increased due to more people working remotely,” said Brandy Pratt, regional vice president of palliative care at Compassus. ”Travel costs have declined dramatically, and the duration [of onboarding] has shortened. The burden for the nurse practitioner to dedicate four days to palliative care training has been reduced to one virtual day. Credentialing was virtual prior to COVID, so there were no changes in that process.”
Also during the pandemic the company established a weekly call between the nurse practitioners and Compassus palliative care leaders to review and changes related to Medicare and other factors, as well as troubleshooting for any difficulties that had arisen. Compassus also developed an internal website for clinicians with information specific to COVID-related visits and other training documents.
“The nurse practitioners enjoy the ability to do the training from home and not have to travel. We have gotten good feedback from most. Some require more follow-up and mentorship than others, but our new training program is designed to include continued training. If the nurse practitioner felt they needed to shadow a visit that was arranged in person or via a telehealth visit,” said Hyden. “At this time we do believe we will continue this platform and that it will evolve and components will be added over time in order to enhance the training experience and improve outcomes and quality of care offered.”