A patient requiring hospital admission for one of the Hospital at Home target illnesses is identified in the Emergency Department or ambulatory site. The patient’s appropriateness for care in the program is assessed using validated criteria.
If the patient is eligible and consents to participate in the program, the Hospital at Home physician evaluates the patient. The patient is then transported home, usually by ambulance.
Once home, the patient receives extended nursing care for the initial portion of their admission. When appropriate, nursing care transitions to intermittent nursing visits. Nurses are available 24 hours a day/7 days a week for any urgent or emergent situation.
The patient is evaluated daily by the Hospital at Home physician who completes an assessment and continues to implement appropriate diagnostic and therapeutic measures. The physician makes one or more home visits per day and is available 24 hours a day/7 days a week for any urgent or emergent situation.
Illness-specific care maps, clinical outcome evaluations, and specific discharge criteria provide a pathway for care.
The patient can receive diagnostic studies such as electrocardiograms, echocardiograms, and x-rays at home, as well as treatments including oxygen therapy, intravenous fluids, intravenous antibiotics and other medicines, respiratory therapy, pharmacy services, and skilled nursing services. Diagnostic studies and therapeutics that cannot be provided at home, such as computerized tomography, magnetic resonance imaging, or endoscopy, are available via brief visits to the acute hospital.
The patient is treated until stable for discharge. When the patient is discharged by the Hospital at Home physician, care reverts to the patient’s primary care physician.
program follows the following steps:
