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.
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.