This information will help you know what to expect during your child's appointments with Children's Hospital Home Care.

Role of parents, guardians

It's very important for a parent or guardian to be there when your child has a home care appointment. You should be prepared to ask any questions you have. Some parents find it useful to write down quick notes before the appointment so they don't forget anything they want to ask the nurse, therapist or technician.

Please have a list of your child’s prescription and over-the-counter medications, the medicine bottles, and a list of your child’s known allergies available at each visit.

If your child receives care from multiple providers or service lines at the Children’s Hospital of Philadelphia (CHOP), we encourage you to start a "Care Binder." A Care Binder is a notebook or binder used to organize important information related to your child's care needs. It is a compact way to keep track of all the important documents about your child's care in one place.

Your child’s first home care visit

Before your child is discharged from the hospital, the Children's Hospital Home Care office staff will call you to:

• Introduce our services and your child's Home Care team
• Discuss the services ordered by your child's physician
• Verify your child’s demographic information
• Schedule your child's first visit and/or delivery of medicine, supplies and equipment from Children's Hospital Home Care
• Let you know how long the visit will take (1 to 4 hours depending on your child’s needs)

A registered nurse (RN) or respiratory therapist (RT) from our Home Care team will arrive at your home at the scheduled time for your child's first visit. They will bring all of the necessary forms, supplies and equipment that will be needed for your child’s care, unless a medical supply delivery has already been arranged.

During the first Home Care visit, we aim to teach parents or guardians all you need to know so you feel confident, skilled and able to take care of your child on your own at home. More visits from our team may be necessary. This will depend on any extra medical help needed and how comfortable you feel taking care of your child by yourself.

The length of our visits can vary:

• Initial respiratory therapy visits usually last from two to four hours, and follow-up visits last from one to two hours.
• Initial nursing visits usually last about two hours, and follow-up visits last approximately one hour.

Depending on the Home Care services prescribed by your child's physician, our clinician visits may initially be daily, weekly or monthly. Children's Hospital Home Care will work closely with your child’s physician and your insurance provider to make sure your child’s Home Care needs are met at required intervals for as long as necessary.

During your child's scheduled Home Care visit, the registered nurse or respiratory therapist will need a parent or legal guardian present to review and ask you to complete forms that are important to your child’s care and treatment.

The clinician will also explain how to contact the Home Care office with questions about reordering supplies, equipment malfunction, and/or questions about your child’s care between Home Care visits.

Customized team to meet your child's needs

Our team has more than 75 skilled healthcare workers. They help connect the care your child gets at CHOP with the care they need at home. Our goal is to be the best in the world at taking care of kids at home. We do this by creating special ways to give care, using new tools to help us, and making sure you and your child have the best experience possible.

Your child’s care team may include:

• Clinical support coordinators who support care coordination, patient scheduling and operations
• Distribution team members, including warehouse technicians and drivers, who fulfill patient orders, clean and repair durable medical equipment, as well as deliver supplies to families
• Patient access coordinators who perform new patient intake activities and ongoing care coordination for patients who need enteral feeding and durable medical equipment
• Pharmacy care coordinators who support pharmacy authorizations and care coordination
• Registered dietitians who review each child’s nutritional plan, provide dietary recommendations and formula mixing instructions, as well as coordinate care between family and physicians, as needed
• Registered pharmacists who review medication orders for dosing and allergies, perform medication reconciliation, provide education to families, create individualized care plans, monitor the child’s response to therapy, and coordinate care between family and physicians
• Registered nurses who provide skilled nursing assessments, medication reconciliation and education, create individualized care plans, perform procedures, administer medications, and coordinate care between family and physician, as needed
• Registered respiratory therapists who provide skilled cardiopulmonary (heart and lung) assessments and education, create individualized care plans, troubleshoot and evaluate respiratory equipment, as well as coordinate care with your child’s physicians
• Social workers who support your family by evaluating social and/or financial needs and connecting you with community resources to enhance your family’s ability to care for your child

Consents, benefits and responsibilities

The visiting registered nurse or respiratory therapist will review and explain essential documents such as your Home Care Consent and Assignment of Benefits. This document has many uses. It:

• Documents your consent for care and treatment to be provided to your child by Children’s Hospital Home Care
• Serves as an explanation of your rights and responsibilities as a Home Care client
• Makes you aware of your financial responsibility for Home Care services
• Allows Children's Hospital Home Care to bill your insurance provider for home care services

Assessments

At our first visit, we perform assessments to check your child's health to see how they are doing. This helps us understand their starting point and compare it to future visits. If your child’s Home Care services include a nursing visit, the nurse will conduct:

• A complete physical assessment of your child
• A psychosocial assessment
• A home environmental and safety assessment

This includes a review of your child's living space to make sure there are no safety concerns that would impact your family's ability to safely care for your child. If there are any safety issues, the Home Care clinician will work with you to correct them or connect you with resources that can help.

As the nurse performs these assessments, they will ask you and your child a series of questions. They'll ask the same questions at every visit.

Medication reconciliation

During each visit, the registered nurse or respiratory therapist will ask to see all the medicines your child is taking, including ones the doctor prescribed and ones bought without a prescription. They will check these medicines against the ones the doctor ordered for your child to make sure that you understand each medicine and that your child is taking them as the doctor said to.

Caregiver training

The doctor will teach you and your child's main caregivers everything you need to know, like how to use equipment and care for your child. After they demonstrate these things to you, they'll ask you to do them yourself to ensure you can safely care for your child at home.

During a visit for respiratory therapy, you should expect that the therapist will check how your child breathes and give you important information on:

• Effectively and safely managing your child’s care
• Operating and troubleshooting the equipment
• Monitoring compliance with therapy and services
• Managing emergencies

During a visit with the registered nurse, the nurse will do things the doctor has asked them to do, like giving your child intravenous medications (medicine through a needle in the vein or muscle) and doing sterile procedures.

Communication with other team members

To help everyone involved in your child's care stay in touch, the doctors and nurses at Children’s Hospital Home Care and other healthcare partners share information in one computer system, called the electronic medical record. This way, everyone involved in your child's care can see the notes and assessments from home visits. Our Home Care team also meets every day to discuss and plan the care we give to your child.

For more information, view our Home Care Welcome Folder.