This pilot project was developed in large part based upon input and feedback of five focus groups with caregivers of frail elders with dementia. Program planning began in July 1998. Community health workers (CHWs) were trained during January of 1999, and an evaluation of the pilot project was completed in December 1999. A total of fifty-five patients with dementia received greater than 650 home visits by the CHWs. The work accomplished and lessons learned during the pilot phase will be taken into account to fine tune, and expand and fully evaluate a demonstration project to begin July 2000.
The pilot project has been successful in defining a model of care coordination that includes licensed social worker care coordinators, CHWs and volunteers; a training schedule; delineating roles and responsibilities; and initiating a data collection and analyses process for project activities, caregiver and provider satisfaction, caregiver burden, and health utilization.
The pilot project utilized four CHWs for 20 hours per week to provide home- and community-based services to dementia patients and their caregivers in two service areas of Kaiser Permanente San Diego.
The presenter will provide a project overview and report on two areas of evaluation. The first area is the quantitative outcomes, which includes analyses of community health worker activities, and utilization studies. The second area is the qualitative information which includes satisfaction surveys, an analysis of CHW chart notes, and program learnings and recommendations.
Learning Objectives: Describe a model of care coordination for frail elders with dementia within a managed care setting that includes LCSW care coordinators, community health workers, and volunteers. List 8 main roles of community health workers and the percentage of time devoted to each role. Articulate key lessons and recommendations for program development including, training, procedures for home visits, and recruitment and retention of community health workers. Describe provider and caregiver satisfaction with the pilot program. Describe an initial evaluation which compares emergency room visits, outpatient visits, and inpatient visits. List lessons learned for evaluation tools and processes and steps for implementing a full-scale evaluation for a demonstration project
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Kaiser Permanente San Diego, California
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.