Computers in home care. Application of change theory.

Home health care is the fastest growing sector in providing health care in the United States (US Commerce Department, 1993). Among the reasons for this exceptional growth rate are several factors, including an aging population, patient preference for care provided in their own homes, earlier discharge from acute care settings, and reimbursement sources demanding that health care providers reduce costs while expanding patient services in a wider variety settings. As a result, home health care agencies are under increasing pressure to provide efficient, high-quality, cost-effective nursing services to growing numbers of patients. In an effort to maximize productivity and efficiency while reducing costs in home health care, one strategy has been to computerize the nursing records. However, there has been little or no research in the literature on the nursing applications of computer technology in home care settings. Based on Lippitt's Theory of Planned Change as the theoretical model, this case study examines the author's experience as a consultant to the Nursing Department of a home health care agency in automating their nursing records. Included in the discussion are an analysis of the costs and benefits derived by the agency in phases of planned change, evaluation of the process, and recommendations for the future.