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5 tips to increase continuity of care in home care [free care plan worksheet]

5 tips to increase continuity of care in home care

Increasing continuity of care in home care is an important step in providing quality service to your clients. It is one of the 3 ways to improve care management in home care that we covered in our blog recently. Continuity of care also allows for a better understanding of your client’s condition and needs over time, allowing for more effective treatments and improved outcomes. Other advantages include: 

  1. Consistency and reliability of care: allowing for better management of conditions and improved outcomes. 
  2. A stronger relationship between caregivers and clients: resulting in more successful treatment plans. 
  3. Greater satisfaction from clients: due to trust and communication between them.

To help you gain these advantages to improve care management for your agency, here are 5 tips on how to increase continuity of care and a free worksheet on how to make an effective care plan.  

1. Streamline home care software 

Streamlining home care software and continuity of care can provide several advantages to both clients and caregivers. Using software for scheduling and coordination, clinical documentation, billing, virtual care, and a caregiver mobile app allows for increased efficiency and accuracy in the delivery of care.  

  • It provides caregivers with more access to information and allows them to find up-to-date resources quickly. 
  • Helps ensure consistency in the delivery of services, which leads to better outcomes for clients as their condition is managed more effectively over time, giving caregivers increased confidence in their treatment plans.  
  • It provides an up-to-date record of your client’s progress and can help identify any changes or trends that might be missed with manual processes. 

“Our [hospital] resubmissions have decreased by 65%. This is because nurses are able to see their patient charts and see the outdated PEDs and frequencies right on the spot [with electronic health records (EHR)].”

Sarah Smith, Senior Administrative Assistant, Partners in Community Nursing

2. Communicate effectively with clients 

Communicating effectively with clients contributes to the uninterrupted and coordinated delivery of home care services to meet your client’s needs over time. Since clients in home care require ongoing care and support from multiple providers or caregivers, it is important to keep your clients up to date with proper communication providing transparency between your agency and the client.  

Effective communication with clients is important for it: 

  • Builds trust 
  • Identifies changes in health status 
  • Ensures consistency 
  • Increases collaboration with other healthcare providers 

There are different ways to make sure your caregivers are providing effective communication with your clients. These tools can increase transparency for your clients and their family members, by giving them access to parts of their client health record, to perform self-assessments and complete forms, provide feedback through surveys and visit ratings, easy access to schedule information to view and request any changes, and access to billing and invoicing.

“Consistent and quality communication with our families is crucial. Our families need to know who is working with their child, and how their child is doing. Having the Family Portal allows our families to have easy access to the information they need in order to feel comfortable and have confidence in the care their family is receiving.”

Charles Wong, Founder & President, CarePros.

3. Develop a comprehensive care plan 

Developing a comprehensive care plan can increase continuity of care in your home care agency because it ensures that all caregivers and staff are working together towards the same goal by providing consistent care.  

You can develop a comprehensive care plan in several ways: 

  1. Having clear goals and objectives
  2. Providing detailed information about the client 
  3. Identifying any risks or challenges
  4. Encouraging communications and collaboration 
  5. Regularly adjusting and readjusting as needed

In 2021, poorly managed care plans were in the top 10 complaints from care providers and nurses in home care organizations, according to Home Care Pulse. We’ve developed a free worksheet to help home care providers work through improving their care plans.  

Sometimes writing things down can make all the difference! Seeing your current health care plan written down in front of you, what changes you need to make, how to make those changes, and how to keep them going allows you to see the full picture. 

“It’s really important to make sure that your care plan is involved in the workflow. So, making sure that you’re not duplicating your documentation, you’re not resulting in discrepancies because you’ve got your care plan on one hand, and you’ve got the actions that you’re completing on the other hand.”   

Lorraine Toderdash, Senior Product Manager, AlayaCare

4. Invest in scheduling optimizer solutions 

If you want to make sure your agency has the best continuity of care for your clients, you need to focus on optimizing your scheduling method. Missed visits or late appointments can put a dent in your client’s continuity of care. According to a report by Home Care Pulse, missed visits occur in 5.5% of all home care appointments. It also found that scheduling errors are 24% of the reason for missed visits. To remove human errors, increase efficiency and reduce the possibility of missed or late visits, try investing in a tool that can optimize your scheduling.

With the right software tools, your scheduling can be improved and optimized with: 

  1. Automated scheduling – the software will use algorithms to assign caregivers to clients based on availability, skills, distance, and more.  
  2. Real-time monitoring – software can monitor the schedule in real-time to identify any conflicts such as double-booking or overlapping schedules which are more likely to happen with manual scheduling.
  3. Predictive analytics – changes can be made to the schedule based on historic data and other factors so you can plan for future needs and make proactive adjustments as needed.  
  4. Optimized algorithms – software will use AI algorithms to find the best way to schedule your caregivers by making decisions that will reduce overtime costs and minimize travel time and costs for the caregivers.  

AlayaCare Scheduling Tool on Mac

To learn more about what software tools you should consider investing in for optimized scheduling, take a look at our blog 4 Tech solutions on how to optimize daily home care scheduling and routes.  

5. Encourage homecare provider education & training 

Lastly, continuity of care is only made possible by the caregivers and staff at the home care agency. This is why it is important that they stay up to date with the best practices in the industry, know how to effectively use the resources and tools available, and continuously improve the quality of care for their clients. Home care providers should encourage their staff to continue training and education. In addition to increasing continuity of care, continuing education and training can: 

  1. Improve the quality of care for clients
  2. Enhance caregivers’ skills and career growth
  3. Promote client and caregiver safety 
  4. Comply with regulations
  5. Attract and retain quality talent

It is recommended to invest in software tools that can help agencies keep track of their caregivers’ education, orientation, and training. Most home care software solutions provide training tools or can integrate with partnered e-learning providers.  

“It’s been so much easier to train staff. Before we were printing things out than trying to figure out who was the coordinator. Now it’s instantaneous. It’s pressing a button and it’s gone to that coordinator who gets it.”

Val Akeson, Client Services Coordinator, Acclaim Health

Interested in learning more about caregiver training and education? Check out episode 02 from the Home Health 360 podcast about Modern caregiver training with guests Mari Baxter, COO, and David Chandler, Senior Director of Strategic Programs at Senior Helpers Franchising. 


Continuity of care allows for more consistent and reliable care for your clients while improving trust and communication ultimately creating better client outcomes.   

Interested to learn more about how technology can help increase continuity of care in your home care organization? 

Watch our webinar on 3 ways to supercharge your home care business in 2023. 

3 ways to supercharge your home care business in 2023 webinar recording
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