Featured Post from ChristianaCare

Hospital at Home: Understanding How It Works

Sep 22, 2023

3 min

Sarah Schenck, M.D., FACP


As the ChristianaCare Hospital Care at Home program grows, we see the benefits of improving the way we deliver care to our patients. With each patient we care for, we are reminded that a big part of recuperating and getting better is not just physical but mental and emotional. Being home allows patient to visit with loved ones, cuddle with pets and sleep in their own bed.


It also helps our health care providers better understand a patient’s living environment, making it possible for us to provide the individual services they need.



Q. What is hospital care at home? 


A. I think of a virtual hospital as three components: a command center, technology and in-home care.


The command center is a 24/7, 365-day- a-week center staffed by physicians, nurses, advanced practice clinicians and patient digital ambassadors.


This team of health care providers is tethered to patients in the home by way of our technology. We give our patients a tablet that lists their daily schedule so they know who to expect in their home and the time our health care providers will arrive. It also allows them to contact the command center at any time by pressing a button. When they do that, a nurse appears on the screen right away.


Edwin Bryson Sr. said ChristianaCare made it easy to treat his diabetes complications from the privacy and comfort of his own home. With hospital care at home, he said, “all I do is hit the button and a nurse comes on to assist me with anything I need. It was 24-hour service here, just like I was in the hospital.”


Technology also allows us to monitor patients’ vital signs at home as we would in the traditional hospital setting. We use Bluetooth technology to upload that information into the electronic medical record.


In-home care is made up of a team that goes into the home to deliver the services that a particular patient needs. This includes radiology (X-rays and ultrasound), blood tests, intravenous medications, physical therapy, occupational therapy and more.


A licensed professional, such as a nurse, also visits the patient at home at least twice a day.




Q. Who is eligible for hospital care at home?


A. There are requirements for participation. Patients need to live within 25 miles from our Delaware hospital campuses which are in Newark and Wilmington.


We also are looking for patients that meet our acute, inpatient level of care. So if they’re in observation status, for example, they wouldn’t be a good candidate. We also need patients who don’t require continuous monitoring: If a patient has telemetry monitoring or if they’re in the intensive care unit or a step-down unit, they would not be a good candidate.


Our team works every day with caregivers at both Delaware hospitals to identify patients who would benefit from hospital care at home.


Q. What are common sicknesses that can be treated at home?


The first 20 patients we admitted into this program had 20 different diagnoses. But after treating more than 500 patients, the most common diagnoses that we see are cellulitis, sepsis, pneumonia, chronic obstructive pulmonary disease (COPD) exacerbation and congestive heart failure.


Hospital at home may not be the solution for all patients, but in many cases it can help patients get better quicker and in a place where they most feel comfortable. As ChristianaCare strives for greater access to care, home may be where the health is.



Connect with:
Sarah Schenck, M.D., FACP

Sarah Schenck, M.D., FACP

Executive Director for ChristianaCare's Center for Virtual Health

Dr. Sarah Schenck is an expert in practice transformation for Primary Care and leads ChristianaCare's COVID-19 Virtual Practice.

Ambulatory Covid CareClinical Care TransformationVirtual Health CareTelemedicineInternal Medicine

You might also like...

Check out some other posts from ChristianaCare

2 min

Forbes Ranks ChristianaCare Among America’s Best Employers for Women in 2024

ChristianaCare has been recognized as one of America’s Best Employers for Women by Forbes for 2024, marking the first time the company has received this prestigious recognition. In a survey of 150,000 women working for companies of at least 1,000 employees in the U.S., ChristianaCare ranked 150 on the list of 600 employers that were recognized. “This important recognition is a testament to our culture and the remarkable women who have chosen to build meaningful careers at ChristianaCare,” said Chris Cowan, MEd, FABC, ChristianaCare’s Chief Human Resources Officer. “Empowering women to succeed is integral to our culture and strengthens our organization. Together, we’ll continue to advance equity and inclusion in the workplace while transforming health and clinical care.” Forbes partnered with market research firm Statista, which surveyed employees on various aspects such as workplace environment, growth opportunities, compensation, diversity, parental leave, schedule flexibility and family assistance. ChristianaCare continues to cultivate a strong, inclusive, and diverse culture for women inside and outside the company by investing in professional development through its Women’s Employee Network (WEN) and providing a comprehensive benefits package that includes various flexible leave options for employees, including at least 12 weeks of paid parental leave. “Receiving this recognition from Forbes is an honor,” said Pamela Ridgeway, MBA, MA, SPHR, chief diversity officer and vice president of Talent and Acquisition at ChristianaCare. “In addition to offering workplace benefits such as paid maternity and paternity leave, ChristianaCare is firmly committed to empowering and advancing talented individuals within the workplace. Receiving this award for the first time signifies our unwavering dedication to ensuring that every individual has a voice and feels truly valued within our organization.” The Forbes recognition follows other national recognitions of ChristianaCare’s commitment to an inclusive workplace. Earlier this year, Forbes ranked ChristianaCare as one of the best employers for diversity in the U.S. Additionally, Forbes ranked ChristianaCare as the top health care employer for veterans in the United States. Both ChristianaCare’s Wilmington Hospital and Christiana Hospital have been named Leaders in LGBTQIA+ Healthcare Equality since 2012.

2 min

ChristianaCare, Delaware’s Largest Private Employer, Raises Minimum Wage to $16.50 an Hour

ChristianaCare has increased its minimum wage to $16.50 an hour effective July 21, 2024. The new $16.50 per hour minimum wage exceeds federal, Delaware, Maryland, New Jersey and Pennsylvania minimum wage rates. “At ChristianaCare, we are committed to creating health so that people can flourish, and that begins with our caregivers,” said ChristianaCare System Chief Operating Officer Ric Cuming, Ed.D., RN, NEA-BC, FAAN. “By investing in our caregivers and supporting their wellbeing, we support their ability to provide the very best care to our patients." ChristianaCare is the largest private employer in Delaware with nearly 14,000 employees. This is the second time in recent years that ChristianaCare has raised its minimum wage; in 2019, ChristianaCare was among the first health systems in the region to raise its minimum wage to $15/hour. This new increase to ChristianaCare’s minimum wage impacts approximately 850 caregivers who were below or near $16.50/hour. Download "It's important for us to lead by example in paying wages that support the financial wellbeing of our workforce,” said Chris Cowan, MEd, FABC, ChristianaCare’s Chief Human Resources Officer. "Substantially increasing wages is one way we continue to attract and keep top talent at all levels in this highly competitive market. By recognizing the valuable contributions of our caregivers, we can enhance staff retention, boost morale and support an exceptional experience for everyone we serve.” The increase is a part of ChristianaCare’s overall Total Rewards package for its caregivers, which includes a wide variety of benefits and support for caregivers and their families through all stages of life. Learn more about ChristianaCare’s Total Rewards here.

3 min

First in Delaware to Offer MR-Guided Ultrasound for Treatment of Essential and Parkinson’s Tremor

Revolutionary technology gives patients immediate relief from debilitating tremors without the need for invasive surgery. ChristianaCare is the first health care provider in Delaware to offer FDA-approved focused ultrasound treatment for people suffering from essential tremor and Parkinson’s disease. The new option – called MR-guided focused ultrasound – uses sound wave energy to destroy precise areas of brain tissue that is the source of the tremor. No surgical incision or anesthesia is necessary, and many patients experience immediate and significant reduction in tremors, which can make daily activities challenging. Dr. Martello explains that the procedure involves the use of high-frequency sound waves directed with pinpoint precision by magnetic resonance imaging to ablate, or burn, the focal point deep within the brain that is causing tremors. “This minimally invasive technology dramatically improves the lives of patients with essential tremor and tremor-dominant Parkinson’s who haven’t fully responded to traditional treatments,’’ said Justin Martello, M.D., director of the Parkinson’s and Movement Disorders Programs, and Focused Ultrasound Program at ChristianaCare. What is tremor? Tremor is a neurological condition that includes involuntary shaking or trembling movements in one or more parts of the body. It most commonly affects the hands and can make daily tasks such as writing, eating and using a computer or phone extremely difficult. Tremor affects approximately 1% of the population overall and 5% of adults age 60+. It is expected to increasingly impact Delawareans as the state’s population ages. Essential tremor is the most common type of tremor. It can occur at any age but is most common in older adults. Tremor is also the most well-known symptom of Parkinson’s disease. An estimated 1.5 million Americans suffer from Parkinson’s disease, a progressive neurodegenerative disease that affects movement and can also affect speech, balance and cognitive function. A newer, better option for patients who don’t respond to medications The procedure of MR-guided focused ultrasound involves the use of high-frequency sound waves directed with pinpoint precision by magnetic resonance imaging to ablate, or burn, the focal point deep within the brain that is causing tremors. Patients are fitted with a frame affixed to a specialized helmet that combines the focused energy of more than 1,000 high-frequency sonic beams directed through the skull. The treatment does not require cutting through the skull, or radiation, as in gamma knife technology. “Today, there are basically three options for managing tremor,” said Pulak Ray, M.D., of Delaware Neurosurgical Group and associate director of the Focused Ultrasound program. “The first is medication, which is effective and affordable for many patients, but its effectiveness tends to diminish over time. The second is deep-brain stimulation, which is the most invasive and costly treatment option. The newest is MR-guided ultrasound, which tends to be the preferable option for most patients who do not respond well to medication, because it is a simple, non-invasive outpatient procedure that is highly effective, safe and produces instant results.” Benefits of MR-guided Focused Ultrasound MR-guided focused ultrasound reduces tremor immediately, with shorter recovery time, lower risk of side effects and lower associated health care expenses compared to surgical alternatives. This treatment dramatically improves patient experience and quality of life for people with Parkinson’s disease or essential tremor. For many patients, MR-guided ultrasound reduces their dependence on caregivers to assist with activities of daily living. Candidates must first undergo a CT scan to ensure a skull density sufficiently thick to accommodate the procedure. The patient is awake during the procedure and situated within an MRI machine for real-time imaging of the brain. The physician tests the precise location by heating the area, then ensuring the patient is able to control tremors by tracing lines on a spirograph. At that point, the physician then permanently ablates the focal point, usually a sphere a few millimeters in length. “Our team is very excited to bring this technology to Delaware and to open up access to potentially life-changing treatment that until now has required long wait times and significant travel for patients,” said Kim Gannon, M.D., Ph.D., medical director of the comprehensive stroke program and physician executive of Neuroscience Service Line at ChristianaCare. “Many tremor patients have suffered for years or even decades with this debilitating and progressive condition and helping them live a more active and independent lifestyle is extremely rewarding.” MR-guided focused ultrasound is covered by Medicare and most insurance plans.

View all posts
Powered by