Why acute care at home?
Hospital at Home [HaH] is a voluntary program that offers an alternative to on-site inpatient care. With our program, you can look forward to:
- A patient-centred approach
- Closer family/caregiver involvement
- More privacy to get the rest you need
- Lower rates of hospital-acquired complications, such as delirium, infection, or deconditioning
- Fewer readmissions to hospital
What can the patient expect?
Hospital at Home will supply equipment and set it up in the patient’s home. The nurse will teach the patient and family caregivers how to use the equipment. All participants are required to have their own refrigerator and telephone in the home. Patients use a Samsung tablet and Home Health Monitoring kit to measure their vital signs several times a day.
On a typical day, the Hospital at Home nurses phone their patients between 7:30am and 8:00am to check in and hear how the night went. During this call, they discuss the plan for the day and when patients can expect their daily home visit from the nurse. Nurses visit their patients at least once daily, while other patients may require additional visits depending on their individual needs. Patients and their family caregivers can connect with the nurse anytime by phoning the HaH office.
Patients are asked to set aside their own medications while in the program. All medications are provided by the hospital pharmacy, organized in vials, and documented by the patient on the program’s medication administration record. Intravenous medications are either given by the nurse or self-administered by the patient or family caregiver.
If a patient requires oxygen, the nurse will provide an oxygen concentrator to use in the home and provide instruction on how to use it. If required, the nurse will collect lab samples (including blood tests) in the home and deliver the specimens to the hospital.
During their time in the program, patients and family caregivers are connected to other members of the HaH team, which includes: registered nurses, physicians, pharmacists, dietitians, clinical nurse leaders, occupational therapist, diabetic nurse educator, and rehabilitation assistant. These interactions may take place over the phone, during in-person home visits, or virtually using a tablet.
What can the family caregiver expect?
Family caregivers are an integral part of the HaH program. They are the eyes, ears, and hands of the program, and help to monitor and assist the patient at home while in the program. The involvement of the caregiver depends on the individual needs of the patient. This could include:
- Helping to give the patient medications
- Using elastomeric pumps to infuse IV medications
- Documenting on the medication administration record
- Helping the patient take their vital signs with the Home Health Monitoring equipment
- Being present during home visits by HaH staff
- Conversing with HaH staff over the phone
- Driving the patient to appointments/tests
- Assisting with virtual visit appointments
- Supporting the patient with activities of daily living.
We recognize not all families are able to provide this type of assistance. HaH remains a voluntary program, and families consent to participate in the program. All concerns or difficulties managing the patient at home need to be brought to the attention of the HaH staff.
Patients without family caregivers are still eligible for the program. The program has developed specific criteria for these populations to ensure safe, effective care can be provided in the home.
Additional diagnostics, tests and procedures
Sometimes a patient will require a service not able to be provided in the home, such as an x-ray or transfusion. Patients are brought back on-site to receive the service and return home afterwards. Transport is typically by personal vehicle, taxi, or Medivan, depending on the needs of the patient.
Before being accepted into the program, one of the nurses will speak with the patient (and caregiver, if available) to complete a questionnaire related to the residence and staff safety considerations.
Patients with pets will be asked to secure the animal in a separate room when Island Health staff are present for home visits. Smoking is not allowed when Island Health staff are on the premises. Additionally, occupants will be asked to refrain from smoking for a specified duration prior to home visits.
The care team will wear Personal Protective Equipment [PPE] when they come to your home. Depending on the diagnosis, this could include a mask, gown, and/or eye protection. The patient and other occupants will be asked to wear a medical-grade mask when HaH staff come to the home; these will be provided by the nurse.
Sometimes a patient’s health status may change unexpectedly, or the patient/caregiver no longer wish to participate in the program. If the patient is no longer be suitable to stay at home, the patient will be returned to the hospital.