Almost Family_688x376

Almost Family

April 1, 2021
April 1, 2021


Using HealthStream as a platform for learning, checklists, and competency, Almost Family has been able to:

  • Create a strong onboarding assessment and training system to meet the needs of a large, decentralized home health agency staff
  • Demonstrate a serious commitment to continuing education and improved processes and procedures to achieve better outcomes
  • Accommodate increased training needs as staff numbers expand through both growth and acquisition
  • Add checklist and competency measurement components to ensure excellent care is provided
  • Support Almost Family’s success as a home health provider of choice and desired care partner for leading acute care hospitals

Almost Family, Inc. is a leading provider of home health nursing, rehabilitation, and personal care services, with over 250 locations in 15 states. Almost Family and its subsidiaries operate two segments: Visiting Nurse, which provides skilled nursing and physical, occupational and speech therapy services primarily to Medicare beneficiaries; and Personal Care, which provides custodial and personal care services. Almost Family’s services are generally covered by federal and state government programs, commercial insurance, and private pay.

Almost Family has thousands of clinicians serving patients every single day, including nurses, therapists, caregivers, social workers, and also affiliated physicians. As Raj Kaushal, MD, President of Operations at Almost Family puts it, We strongly believe that good care is the result of clinical staff that is better trained, better educated, and has improved competency.

The Challenge:

Almost Family is Joint Commission-accredited at the enterprise level; they recently went through a third round of accreditation renewal. The Joint Commission emphasizes quality of care at the patient level; they focus on education, training, and the competency of the staff in their skills, as well as in newer ways of serving clients. Dr. Kaushal shares, We integrate the Joint Commission approach for education and training in our policy and procedures and in our education material content.M

Having a good onboarding solution is a strategic commitment for Almost Family, from courses and curriculum to the classroom or virtual setting, and managing that process through proper reporting and looking at assignment completions is very important. Continuing education is another big focus to ensure that staff receive training on newer ways of approaching patient care, to achieve even better outcomes.

According to Dr. Kaushal, Almost Family tried various training methodologies over two decades. When a smaller company, the organization could do in-person, one-on-one teaching and education, as well as competency measurement. Then we tried various systems as we were growing, through Webinars or learning management systems. A stumbling block occurred as Almost Family found that there were not many systems, methodologies, or platforms available that were very focused on the needs of healthcare professionals. Dr. Kaushal explains that for the system that we had six years ago, healthcare was just a small component of their offering. It was challenging to work with their teams. This prior system didn’t adequately serve the needs of healthcare professionals in a diverse environment. Almost Family needed a learning provider with a centralized approach to development and delivery but a decentralized approach to execution and adoption of education and training.


After an evaluation, Almost Family started working with HealthStream, and we quickly realized that HealthStream was more in sync with the needs of the post-acute environment. Over three years as they almost doubled the size of the company, Almost Family has benefited from a smooth operation from a scalability perspective in the way our HealthStream systems were set up. Right now we have nearly 9,000 employees who are actively using the system.

Kaushal adds,

What we like about the approach of HealthStream is that not only do they provide a platform but also they provide the knowledge and the content partners. Their approach is more of a marketplace to unite acute care and post-acute care providers in a partnership model where the content experts, the subject matter experts, and different kinds of providers can share knowledge and work together.


Over three years collaborating with HealthStream, Almost Family successfully implemented hundreds of courses, and onboarding curriculum. To this they are adding the building blocks of the checklist methodology and competency center. Kaushal offers that over the next year or two, all the pieces will be functioning in sync, and we will have a 360 degree approach to hiring right, training right, and motivating all our clinicians in the right way. For we believe that is the formula for better care, better outcomes, and satisfied patients.

Almost Family has created a learning structure that works for the unique decentralized environment of home health staff. They put the courses and curriculum on Pathway (The internal branding name for the HealthStream Learning Center at Almost Family is Pathway.), which clinicians and other staff can access, supplemented by mentoring by their supervisors, who do hands on programs and ride-alongs to patients’ homes, etc. Almost Family then uses the virtual classroom methodology by providing some lessons where they can have the book learning and participate in that. We find that having the three ways in combination has a better result than just giving people courses to complete on a computer or on paper.

Kaushal ends by sharing that he would like to thank HealthStream for everything the company has done for us. The HealthStream team has been very responsive, very collaborative, and very knowledgeable about helping us to go through the new wave of challenges that this industry is facing. We really value our relationship as partners, and also I want to thank the leadership at HealthStream for making post-acute care a strong focus.