As he arrived at ChristianaCare’s emergency department because of diabetes complications that were causing excruciating pain in his left foot, Edwin Bryson Sr., 71, of Wilmington, Del., had resigned himself to what seemed inevitable—he was going to need hospitalization. But he was surprised when his care team offered him the chance to get the hospital care he needed in the place he likes best — his own apartment.
For 20 days, Bryson was a patient in the ChristianaCare hospital care at home program, which offers in-home services to patients who would otherwise require inpatient hospitalization. Daily, members of his care team visited his home to take his vital signs, give him medication and assist him with getting dressed. They also helped with additional tasks to improve his overall health and safety, such as buying an extra lamp and flashlights to ensure the lighting in his home was adequate for his safety, and assisting him with ordering food.
“It was a good feeling to be at home,” Bryson said. “My friends would knock on my door and make sure I was OK. My son and my nephews could stop to see me when they felt like it or had the time. They always say, ‘There’s no place like home,’ and it’s true. All I do is hit the button and a nurse comes on to assist me with anything I need and check on my vitals. It was 24-hour service here, just like I was in the hospital.”
ChristianaCare has admitted and cared for more than a dozen patients in the hospital care at home program since it launched in December 2021, designed in partnership with the Medically Home Group Inc.
The program, which offers the highest level of in-home acute care in Delaware, combines virtual and in-person care provided by a team of physicians, nurse practitioners, registered nurses and other providers. In-person and virtual visits from the health care team, along with mobile imaging and lab services, delivery services for meals and nutrition, and pharmacy medication and management, mean a patient doesn’t need to leave home to get better. Virtual technology and home health equipment brought into the patient’s home ensure round-the-clock monitoring and care that mirrors a traditional hospital setting.
“One of the things we’ve learned in a short time about the hospital care at home program is how patient-centered this approach is and how we’re able to customize the care we deliver,” said Sarah Schenck, M.D., medical director of the program.
“Most of the things we can do in the hospital we can also do at home. And it turns out patients really prefer that venue. They’re in their own home with their loved ones, their pets, sleeping in their own bed and eating their own food.”
Currently, to be considered for hospital care at home, patients must live within 25 miles of Christiana and Wilmington hospitals. Patients who come to the emergency department with common chronic conditions such as congestive heart failure, respiratory ailments, diabetes complications and infections like pneumonia, are eligible for consideration.
All hospital care at home patients receive a technology kit that connects them to the command center, powered by the ChristianaCare Center for Virtual Health. With a touch of a button, patients can access an expert team of ChristianaCare physicians and nurses. When patients are well enough to be discharged, the care team collaborates with the patient’s primary care physician to ensure a seamless transition.
ChristianaCare joins an elite group of health systems nationwide offering at-home hospital care. Clinical research studies comparing patients in traditional hospitals with patients who received hospital-level care at home have found those who received in-home care experienced fewer readmissions, lower mortality rates, reduced falls and lower costs.
“Patient satisfaction is really high with this program,” said Steaphine Taggart, director of operations for the program. “There’s more caregiver interaction with families because they are allowed to come into the home. And overall, there’s more patient-centered care and delivery because it’s in the home,”
Registered nurse Mary Pat McCabe has treated patients for 17 years. Working in the hospital care at home command center, she has the opportunity to be even more personable in the virtual setting than a traditional inpatient encounter.
“You get to know them and their family members and if they have a pet. You can see into their home and get more of a feel for who they are,” McCabe said.
Dr. Schenck said hospital care at home is an exciting example of how new, innovative models of care can improve patient outcomes, reduce costs and transform care. “It’s really foundational for the future of health care delivery. This is our first step, but it’s definitely going to grow,” she said.
For Bryson, who was recently discharged, it’s even simpler: “You get better, get back out there and get back into life again.”
