Hospitalization can be difficult, especially for senior patients. There are the sleep interruptions, the sounds, the unfamiliar environment.
Holy Name Medical Center's new program – Hospital at Home - enables eligible patients to get high-level hospital care in the comfort of their homes for acute conditions such as COPD, congestive heart failure, skin infections, COVID, and other medical issues requiring intravenous (IV) antibiotics.
Holy Name Medical Center is the first hospital in New Jersey to offer this type of program, which transfers a hospitalized patient from a nursing unit within the hospital to essentially a new unit: his or her own home.
Hospital at Home launched in June and is now available to eligible Medicare patients, who must live with someone who can participate in their care and must reside within 30 minutes of the medical center.
Not Your Traditional Home Care
Hospital at Home differs from traditional home care, for which nurses deliver post-hospitalization follow-up care, education, and support. Hospital at Home is high-level acute care, the same type of care patients would receive if hospitalized. A patient’s care team is the same as if they were in a hospital, and in addition to physicians and nurses, might include specialized therapists, medical assistants, and others.
Hospital at Home also allows patients to spend time with family and caregivers – often good medicine in and of itself.
Connecting Patients with Telemedicine
Patients are set up at home with a telemonitoring kit that includes an easy-to-use tablet, blood pressure cuff, thermometer, and pulse oximeter, which measures the oxygen level in the patient’s blood. The tablet connects patients with their healthcare team 24-7. Their team monitors the patient’s vital signs, and if needed, can initiate a daily telemedicine or in-person visit with a physician or a nurse practitioner.
The tablet also features a call button that functions much like the one at a hospital bed, which, when activated, can dispatch a nurse to a patient’s home at any time of day or night. Patients also have the option to transfer back to the hospital at any time.
Hospital at Home patients are provided with a daily plan so they know what to expect. The program features twice-daily home visits from a registered nurse and 24-hour telemonitoring by hospital staff. Nurses administer the same highly skilled care they would be providing at Holy Name, initiating diagnostic testing and delivering treatments such as oxygen therapy and intravenous medications. Other skilled staff may draw blood and provide respiratory therapy and other treatments.
This innovation in acute care was developed by researchers at the Johns Hopkins Schools of Medicine and Public Health with an eye toward lowering costs and reducing complications among vulnerable patients. We’ve martialed many resources at Holy Name to pioneer this service in New Jersey, from our medical staff to pharmacists to our policy writers and executives – we’re all in. We review our protocols regularly and take counsel from successful programs elsewhere, such as Mount Sinai Hospital in Manhattan.
Treatment and Rest
One of our first Hospital at Home patients had COVID-related pneumonia. Once her vital signs stabilized at Holy Name, she went home and received her last two doses of the antiviral medication Remdesivir, as well as oxygen and steroids. She responded well to her treatment and got the good night’s sleep that she craved – in her own bed!
Bringing the hospital to patients’ homes has required much coordination and attention to logistics: Nurses make two visits per patient during a 12-hour shift. We’re encouraged by the positive feedback from patients and hope to expand the program in the future. Patients generally are a lot happier and more comfortable in their homes, and this new program can speed their recovery!
Michele Amundson, DNP, RN, FNP-BC, is a board-certified family nurse practitioner, who oversees the Hospital at Home program at Holy Name. This program is covered by Medicare for patients who meet eligibility criteria. In the future, it may also be covered by Medicare Advantage plans and other health insurance plans.
For more information on Hospital at Home at Holy Name, call 201-833-3560.