Five Questions With: Candace H. Sharkey

Candace H. Sharkey is CEO of Visiting Nurse Services of Newport and Bristol Counties.
Candace H. Sharkey is CEO of Visiting Nurse Services of Newport and Bristol Counties.

Candace H. Sharkey is a graduate of the University of Rhode Island College of Nursing and received her master’s degree in health care administration from Salve Regina University. She was an assistant director of nursing at Rhode Island Hospital for many years before pursuing a career in home care as the executive director for HealthTouch Inc. She joined the Visiting Nurse Services of Newport and Bristol Counties in May 2013 as the chief compliance officer and was appointed as the CEO in October 2014. She is an alumna of Leadership Rhode Island (Chi Class) and avid volunteer for the Cystic Fibrosis Foundation.

PBN: As CEO of this independent nonprofit, what are your day-to-day objectives for the organization?

Sharkey: The dynamics of health care are changing at an incredibly fast pace. My primary objective is to prepare the agency to meet current demands and be well-positioned for the upcoming challenges on the horizon while maintaining financial stability. The key to this, particularly as a stand-alone not-for-profit organization, is to provide superior care and continuously implement strategies to improve our quality indicators. Quality is a key influencer in expanding our referral network and will be directly linked to reimbursement in the near future. Quality care is also what our patients deserve and expect. Although we have a five-star rating, there is always room for improvement.

PBN: You offer home care, hospice, community health and rehabilitation. Which of these is most in demand and why?

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Sharkey: Each of our programs has its own unique demands. Recently, we have seen significant growth in our Palliative Care Program. These patients are often medically complex and require highly specialized coordination of care. Hospice is always in demand, patients want to remain in their homes for as long as possible but often delay in electing hospice when it would be most beneficial. The demand is also growing in rehab services. The majority of these patients are going directly home after joint replacement surgery. The key to successful rehab is expedient admission to home care and daily rehab for the first 7-14 days. In each of these programs, the ability to accept, admit and treat promptly has been the key to our success.

PBN: Earlier this year you launched a blog. How is it helping get the word out about your services and what other marketing does it supplement?

Sharkey: Our blog discusses items that are on specific clinical topics as well as general news and announcements that are relevant to the community at large. We use our blog as a forum of news, events, announcements, awards, unique clinical tidbits and general community health education. It goes hand in hand with our social media postings, our e-blasts and e-newsletters to the clinical as well as the general community, and our press releases. Through our blog we are seeking to put timely and changing content on our home page, so that we become more and more relevant to our website visitors.

PBN: Describe your pharmacy for home care program. What makes it unique?
This is our third year having a PGY1 (postgraduate year one) pharmacy resident in collaboration with the University of Rhode Island College of Pharmacy. The resident spends one year gaining in-depth knowledge of community health. They are able to make home visits, reconcile medications with patients and follow up with the PCP as needed; enhancing their ability to understand the challenges patients face whether during an acute care hospitalization or while picking up medications at the local pharmacy. The resident is required to conduct a research project as a part of their training. Our first resident’s research focused on increasing medication adherence and decreasing rehospitalization rates for patients with heart failure. Our preliminary research indicated a reduction in re-hospitalization and emergent care visits for chronically ill patients receiving pharmacist interventions. This inspired URI and the VNS to attain grant funding to expand the program. Now, in addition to the pharmacy resident, we have a part-time pharmacist on staff performing medication reconciliation, education and disease state management to high-risk patients. We are collecting data in the hopes to demonstrate a 5 to 10 percent decrease in 30-day hospital admission rates, an increase in patient medication adherence and an increase in patient quality life. The concept is very unique in home care, and we anticipate our results will pave the future for pharmacists as part of the home health care team.

PBN: What is your biggest challenge as an independent nonprofit and what are you doing to address that?

Sharkey: We are one of two remaining not-for-profit independent agencies in R.I. Our board of directors feels strongly that maintaining independence is essential in continuing to achieve our mission and maintain our core values. Having served Aquidneck Island and the surrounding areas for over 65 years, the organization is deeply tied to the community. The No. 1 challenge today is that selecting a home care provider is less about patient choice, and more about affiliations. Competition has never been stronger, and although patients voice their preferences, referral sources “encourage” them to remain within their own network.

Our second-biggest challenge is the ability to continue to offer programs that are underfunded but key to our mission. Programs such as First Connections (support services for high-risk mothers and infants), Personal Emergency Response Systems (Lifeline) and Medicaid Waiver programs all operate in the red, but we continue to provide them because they are vital to our community and keep patients at home. Private contributions and generous benefactors are crucial in enabling us to continue these services.

Although the challenges sometimes appear daunting, we have a highly dedicated staff, many of whom are lifelong “Islanders,” and we have a genuine commitment to quality. I truly believe these have been key to our longevity and success.