2. Is the patient in a location that would be conducive to a quick response if needed?
To allow for a quick response in the event of a sudden change in condition, HAH patients should be located within 30 minutes of an acute care facility. HealthPartners learned that personal protective equipment (PPE) was challenging to don inside a vehicle when heavy winter outerwear was necessary or in rainy weather. Special procedures were implemented to use the vehicle's tailgate or the patient's garage to shelter from the elements while donning PPE.
3. Has the HAH healthcare team received adequate in-home care training?
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Successful HAH programs establish a dedicated team - physicians, nurses, paramedics, and staff thoroughly trained in remote and at-home care nuances.
They must be well-versed in operating monitoring devices and telehealth equipment and prepped to understand patient cues over telehealth devices. They must also be extremely alert to subtle signs that the patient’s condition may be changing for the worse – earlier than they would in the hospital.
Keeping all departments engaged and up to date on the HAH program is also essential. Making sure that your pharmacy, lab, and transportation teams, for example, are in the loop contributes to a seamless operation.
4. Is the patient hesitant to receive care outside of the hospital?
There should never be a push to place a reticent patient in a HAH program. Organizations considering a HAH program should know that the single most important contributing factor to HAH program success is the patient’s willingness to comply with their plan of at-home care. Patients who express that they feel safer in a hospital setting would not be the best candidates for the program.
HealthPartners found that patient engagement correlates with their success under the HAH program. They learned early on that those patients who do not engage with their healthcare providers in the hospital are less likely to engage satisfactorily in a HAH program.
The HAH model’s impact on health outcomes, costs, and systems holds promise. Careful planning that includes a dedicated, fully trained team, a thorough assessment process, and emergency planning can help reduce the risks associated with this model of care and result in a successful and satisfying experience for patients and their families.
About the author: Solveig Dittmann, RN, BS, BA, BSN, CPHRM, CPPS, has more than 30 years of healthcare and administrative experience focused on risk management, patient safety, nursing management, and clinical quality improvement. She is a manager of risk and analytics at Coverys.
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