Developing Next Step in Care

In many ways, United Hospital Fund has been working towards the creation of Next Step in Care since it first formally recognized the importance of the family caregiver as a member of the health care team in 1996 [see Chronology].

In 2006 the Fund created a national working group and charged it with developing a strategy for a major initiative to help family caregivers. The working group’s consensus was to identify a strategy to enable health care providers and family caregivers to plan safe and smooth transitions.   That consensus was based on both the understanding of the critical need for change and the practical consideration that transitions had become a major focus of medical attention. The working group also developed the “Seven Cs”— communication, cultural competence, consideration, courtesy, collaboration, coordination, and continuity—values that should be the foundation of health care providers’ interactions with family caregivers and the people they care for.

With a focus on hospitals, rehab units in nursing homes, and home care agencies, the Fund reviewed more than 150 transition protocols, finding that only a few mentioned family caregivers specifically. An expert panel was created to review existing materials for family caregivers and identify gaps and needs and to consult on other issues. Expert panel members included:

Steven Albert, PhD, MSPH
University of Pittsburgh
Graduate School of Public Health

Eric Coleman, MD, MPH
University of Colorado
School of Medicine

Myra Glajchen, DSW
Beth Israel Pain and
Palliative Care

Mary Naylor, RN, PhD
University of Pennsylvania
School of Nursing

Helen Osborne MEd, OTR/L
Health Literacy Expert

Carol Rodat
New York Policy Director
PHI (formerly, the Paraprofessional Healthcare Institute)

Ann Wyatt, MSW
Nursing home consultant

To further inform the process, participating hospitals, rehab units in nursing homes, and home care agencies in New York City conducted self- assessment surveys focusing on current practices and protocols involving family caregivers. Using this information, Fund staff and consultants created a series of guides and checklists for family caregivers, designed to inform them about what to expect, how to work better with health care providers, and how to plan safe and smooth transitions. The materials were reviewed by a health literacy expert and pilot-tested at 10 New York City hospitals, nursing homes, and home care agencies. Additional materials were created for health care providers to help them work more effectively with family caregivers.

This website was also developed to create easy access to these free materials, as well as to encourage the participation of health care providers.

Next Step in Care differs from other efforts to improve transitions because it:
•    Provides tools that address the most common concerns of both providers and family caregivers
•    Focuses on the role of family caregivers
•    Stimulates change across health care sectors: hospitals, rehabilitation units in nursing homes, and home care

Through involvement of providers and community-based organizations, the Next Step in Care campaign is currently working toward further integration of family caregivers into transition protocols, utilization of the materials in routine practice, development  of additional tools and materials, and identification of additional partners and funders that will support the campaign’s goals and ongoing work.

Campaign Goals
Defining the Issue
Collaboratives
United Hospital Fund Family Caregiving Chronology
Staff and Funders