Care, to go

Care, to go

Registered nurse Lupita Pantoja checks patient Sheila Anderson’s leg during a recent Hospital at Home visit. HEALTH FIRST PHOTOS

Hospital at Home gets patients back where they belong

According to Hospital at Home medical director Dr. William Johnson, the Hospital at Home concept has already proven itself in patient outcomes.

When Health First patient Sandra McCoy was given the choice between hospitalization or enrollment in the Hospital at Home program, the Melbourne resident said it was a no-brainer. 

“They asked me if I’d like to explore this program, and, oh, by the way, it would be based at home,” McCoy, herself a nurse, said. “So, I was like, ‘Yeah, let me go home and sleep in my own bed; eat my own food; take care of my cat.’ It was awesome.” 

Health First’s Hospital at Home — officially billed as an inpatient service — is one of those rare, beneficial by-products of the pandemic. Initially developed out of necessity to make room for the influx of COVID-19 patients, the program was among the first of Florida’s “hospital outside the hospital” models, now a trend sweeping the nation. This past spring, Hospital at Home marked 1,000 patients served and counting. 

As noted in the Annals of Internal Medicine, a nationwide analysis by Mass General Brigham indicates that the home-hospital model provides an important option for managing acute illness. Recent studies also reveal that patients who receive hospital-level care at home experience fewer visits to the emergency room and hospital readmissions. They are also at less risk from infections that further complicate healing. 

“The concept has really shown success in patient outcomes,” said Dr. William Johnson, medical director of Hospital at Home. 

The program is, in large part, successful because advances in healthcare technology have enabled a more sophisticated level of treatment for patients sick enough to be admitted into a traditional hospital setting, but stable enough to receive services in the home. Eligibility is determined in the emergency room, based on condition, diagnosis and the severity of the medical issue. Patients seen at any of Health First’s four Brevard hospitals can be evaluated for possible admission to Hospital at Home. A patient’s insurance is also a determining factor. 

Likely candidates for Hospital at Home services include patients with medical issues such as simple pneumonia, congestive heart failure, dehydration, chronic obstructive pulmonary disease, skin infections, COVID-19, bronchitis, asthma and urinary tract infections. Care is provided, for as long as needed, at a cost that does not differ from comparable treatment in a hospital setting. 

“Health First and similar programs across the country have demonstrated that acute-care conditions can, in many cases, be safely treated in home settings with proper monitoring and treatment protocols — and in a majority of cases results in fewer readmissions, lower infection rates and higher patient satisfaction,” said Joseph Lavelle, Health First’s vice president for Hospital at Home. 

CONNECTIONS

Joseph Lavelle, vice president of Hospital at Home, expects more and more patients to opt for Hospital at Home care when they become aware of the option.

Once a patient is admitted into the Hospital at Home program, the individual can receive transport back home if needed. Health First will deliver and set up all necessary equipment, medications and supplies, as well as provide 24/7 remote monitoring of vital signs by the clinical team, daily in-home or virtual visits from a nurse practitioner, physician assistant or physician, plus two in-home visits by a clinical team member. A coordinator, specifically assigned to the patient to guide care, maneuvers through all needed services and supports follow-up appointments after discharge. Patients have access to the care team at any time, through a telehealth video platform. 

“You get all the hospital care you need,” McCoy added. “Nurses visit at least three times a day. They provide your meds. They even brought meals and stocked my fresh — you know, fresh fruit, cereal, milk, all kinds of dinners and desserts. Anything they would otherwise do for you in the hospital, this program does for you at home.” 

Hospital at Home depends on three distinct aspects of care. Wearable monitoring technology allows the care team to track patients’ vital signs, to follow telemedicine visits done through video conferencing and the in-person home care. 

“Patients are still receiving all the same care they would normally receive in the hospital setting, because we can do many of the same things from home,” Johnson said. “Because we’re in the home, we also get to see how the patient operates in their environment, what they’re doing to care for themselves, whether there are hazards in the home, what, and how well, they’re eating, whether they’re taking their medications on schedule, or if they’re delayed here or there. We get a view into the environment they would otherwise be discharged into after leaving a hospital, and we’re able to tailor care around their home environment.” 

Hospital at Home not only provides a more layered connection between care team and patient, but it also benefits family members. Melbourne Beach snowbird Bob Anderson’s wife, Sheila, was admitted to the program to recuperate from surgery to repair arterial damage that caused intense leg pain.

RN Brittany Guilbeau chats with patient Sandra McCoy during a recent visit as part of McCoy’s participation in Health First’s Hospital at Home. McCoy, a nurse herself, considers opting for the convenient program a no-brainer.

“You’re more involved than if you’re in the hospital,” Bob Anderson said. “With Hospital at Home, the staff is focused exclusively on you, and your spouse and family member. I felt there was great communication and understanding between us and the hospital team. For example, they would have a blood test taken, and I would ask ‘What’s her hemoglobin?’ Within two hours, we had the results. They would call me and let me know. It was a very open communication, very organized overall.”

Serving more than a thousand patients in the three years since the inception of the program has provided Health First administration with validation of Hospital at Home’s value. 

“That success will reinforce a new wave of hospital-at-home care into the future,” added Lavelle, who expects a continued surge in the program’s popularity.

As McCoy put it, the choice between a hospital stay or recuperating at her home with the help of Hospital at Home is an easy decision to make, for the comfort of a familiar setting and the presence of friends, family and pets — together with a robust clinical infrastructure — can make healing easier and faster. 

For more information, visit hf.org/healthcare-home/departments-services/hospital-home-inpatient-services or call 321.434.1868.

See the original article in print publication