N-Care Homecare Operations Manual

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Section 1: Introduction and Organizational Philosophy

1.1 Mission Statement

N-Care Homecare is dedicated to delivering next-generation, high-acuity medical and concierge care within the comfort and privacy of the client’s home. Our mission is to reduce the burden on acute care hospitals by seamlessly transitioning complex medical services, ensuring comfort, dignity, and clinical excellence for every client.

1.2 Our Operating Model: The Boutique Medical Concierge

N-Care operates a Boutique Medical Concierge model. This is not a volume-based service. It emphasizes highly personalized care, direct access to management, integrated use of advanced technology, and a commitment to exceeding standard care expectations. Every interaction must reflect exclusivity, professionalism, and unparalleled quality.

1.3 The N-Care 4N Strategy

All operational procedures and staff behaviors are governed by the 4N Strategy:

1. 1. Nurturing: We provide emotionally supportive and empathetic care, focusing on the client's holistic well-being, not just their medical needs.

   2. Noble: We uphold the highest standards of professional ethics, integrity, and respect for privacy and cultural norms (particularly relevant in the Riyadh region).

   3. Next-Gen: We utilize cutting-edge remote monitoring technology, advanced protocols, and continuous education to ensure the highest level of clinical care, including services traditionally limited to the ICU.

   4. Network: We maintain a robust and responsive network of specialized healthcare professionals, hospital partners, and support services to ensure comprehensive client support.

1.4 Regulatory Alignment (Vision 2030)

N-Care is explicitly aligned with Saudi Vision 2030's Health Sector Transformation Program. Our operations are structured to contribute to national health goals by:

• • Decentralizing high-level care.

  • Improving patient flow and reducing hospital stays.

  • Promoting digital health and remote monitoring solutions.

Section 2: Core Services and Scope of Care

2.1 Scope of Practice

N-Care specializes in high-acuity, complex care services. The scope includes, but is not limited to:

2.2 Exclusions from Service

N-Care will not provide services that compromise the safety of the staff or are beyond the legal scope of practice within the client’s home (e.g., non-medically necessary tasks, unauthorized medical procedures). All exclusions must be communicated to the client during the initial intake assessment.

Section 3: Operational Procedures

3.1 Client Intake and Assessment

1. 1. Initial Contact: All inquiries (phone/web) are directed to a dedicated Care Coordinator.

   2. Triage: Coordinator collects basic demographic, medical history, and service needs.

   3. In-Depth Assessment (48-Hour Guarantee): A registered nurse (RN) Specialist, overseen by the Medical Director, conducts a mandatory in-home assessment within 48 hours of service request. This includes:

      • Clinical evaluation.

      • Home environment safety check.

      • Client/Family care goals and preferences.

      • Cultural/Linguistic needs assessment.

   4. Care Plan Generation: The RN Specialist develops a detailed, customized Personalized Care Plan (PCP), including measurable goals, required staffing levels (skill and hours), and necessary equipment (including remote monitoring deployment).

3.2 Staffing and Scheduling

• • Matching: Staffing is based on the complexity of the PCP, prioritizing clinical skill (ICU experience, Geriatric specialty) and personality fit (Boutique Model focus).

  • Scheduling: Schedules are prepared two weeks in advance. Any changes must be approved by the Scheduling Manager and communicated to the client at least 24 hours prior to the shift change, except in documented emergencies.

  • Documentation: All staff must complete electronic medical records (EMR) documentation immediately after the shift using the designated, encrypted platform.

3.3 Financial and Billing Procedures

• • Pricing: Due to the concierge nature of service, pricing is customized per PCP. Standard rates for services (ICU nurse hours, specialized equipment rental) are maintained internally.

  • Invoicing: Invoices are generated bi-weekly (or monthly, per client agreement) and include a detailed breakdown of services rendered, staffing hours, and equipment used.

  • Payment Terms: Payment is due net 15 days from the invoice date.

Section 4: Clinical Standards and Safety Protocols

4.1 Infection Control and Hygiene

All N-Care personnel must adhere to universal infection control precautions at all times.

• • Hand Hygiene: Mandatory handwashing or use of alcohol-based rub before and after all client contact, before and after glove use, and before any invasive procedure.

  • Personal Protective Equipment (PPE): Proper use of gloves, gowns, and masks as dictated by the PCP and the client’s infectious disease status.

  • Equipment Sterilization: Use of disposable equipment whenever possible. Non-disposable equipment must be sterilized or appropriately disinfected according to manufacturer guidelines and N-Care’s policy after each use.

4.2 Emergency Response Protocol (Code Green)

In the event of a client emergency (e.g., cardiac arrest, sudden acute deterioration, severe bleeding), staff must follow the Code Green protocol:

1. 1. Immediate Action: Initiate appropriate life-saving measures (e.g., CPR, hemorrhage control) according to the staff member's training and the client’s DNR/DNI status.

   2. Call: Simultaneously call local emergency services (e.g., 997 in KSA) AND the N-Care Central Command Center (CCC).

   3. CCC Notification: Report the client’s name, location, and nature of the emergency. CCC will coordinate physician oversight and communication with family/hospital.

   4. Transfer (If necessary): Prepare client for transfer, ensuring all medications, medical records, and PCP details accompany them.

4.3 Remote Monitoring (Next-Gen Care)

• • Setup: The assigned RN is responsible for verifying the correct functioning and secure connectivity of all remote monitoring devices at the start of every shift.

  • Thresholds: Staff must be proficient in recognizing critical alert thresholds as defined in the PCP.

  • Response: Any remote monitoring alert exceeding the defined threshold must trigger an immediate physical assessment of the client and documentation of the intervention.

Section 5: Personnel Policies and Conduct (Noble and Nurturing)

5.1 Dress Code and Professionalism

• • Attire: N-Care branded uniform (scrubs or professional business attire, as appropriate for the role and service setting). Must be clean, pressed, and worn with the ID badge visible.

  • Confidentiality: Strict adherence to patient privacy laws (HIPAA equivalent for the region). Discussing client information outside the professional care team is grounds for immediate termination.

5.2 Mandatory Continuing Education

All clinical staff must complete the following annually:

• • Advanced Cardiac Life Support (ACLS) or Basic Life Support (BLS).

  • Infection Control & PPE proficiency.

  • Data Security and EMR utilization training.

  • Cultural Competency Training (specific to the Riyadh service area).

5.3 Communication Protocol (Network)

1. 1. Shift Handoff: Mandatory, detailed verbal handoff between incoming and outgoing caregivers, signed off in the EMR.

   2. Physician Communication: All changes to the PCP or client status must be reported to the Medical Director or On-Call Physician immediately via secure channel.

   3. Client/Family Feedback: All feedback, positive or negative, must be documented in a dedicated Feedback Log within 24 hours of receipt. Critical complaints trigger immediate management review.