Home Care: The Missing Link

At NYC Health + Hospitals/Kings County, providers and nurses have formed the Collaboration Council between NYC Health + Hospitals/Home Care and the Kings County Doctors Council.


Sunday Oladunmoye, RN 
Head Nurse, Home Care

 Before a three-day training by the Institute for Healthcare Improvement, all members of the Collaboration Council were required to complete a patient care experience observation in order to learn through the patient’s eyes. 

As part of the exercise, Augustine Umeozor, MD, Hospitalist, Department of Medicine, Kings County, decided to join Sunday Oladunmoye, RN, Head Nurse, Home Care, on a home visit. “I’ve worked as an inpatient doctor for 15 years,” explains Umeozor. “I know that what happens at home plays a major role in readmission.” 

Lauren Johnston, Chief Nursing Officer, NYC Health + Hospitals, says, “Home care has often been overshadowed by inpatient nursing, but in truth it can be pivotal in preventing avoidable readmissions and keeping patients healthy. I’m glad to see a provider with such curiosity and enthusiasm for home care. Home care is a major player in the future of our system — we need to recognize that and treat it as such.”

During the home visit, Umeozor noted the definitive advantage medical professionals have when they visit the home and the ability to identify firsthand the complexities that can play a major role in readmission. The patient they visited had such significant visual impairment that they required a magnifying glass just to read the nutritional labels on their groceries. “Many times, we discharge patients with all sorts of materials without assessing their ability to understand and use the information we give them,” says Umeozor.

The patient also had many groceries around the house that were not suitable for their medical condition, which reminded Umeozor that inpatient care has its blind spots. The immersion into the patient’s world made possible by the home visit, provided valuable information regarding what to discuss with the patient and how to approach their continuing education and treatment plan.

“The Augustine Umeozor, MD, Hospitalist, Department of Medicine, NYC Health + Hospitals/ Kings County Sunday Oladunmoye, RN, Head Nurse, Home Care INSIDER

patient had learned a great deal as well,” explains Umeozor. “The patient has had this condition for more than 20 years, and while they still have more to learn, they are in a much better state due to their home care visits.” Vickie Norvell, Interim Executive Director, Home Care, adds that, “Home Care has a rich history of teaching patients to manage their health at home.”

“In the patient’s home, you play many roles: the nurse, the confidant, and advocate,” says Oladunmoye. “You are able to see people in their natural environment and you are able to catch problems as they are happening. I love it because you see the output of your work in person and help people learn to care for themselves.”


“Unless we address what happens at home, we cannot decrease the readmission rate.
Home care is the missing link,” confirms Umeozor.
Are you interested in referring a patient to NYC Health + Hospitals/Home Care?

Email homecarereferrals@nychhc.org

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