Patients with COVID-19 and other conditions have been recovering in the comfort of their homes instead of the hospital, thanks to a program called Sentara Hospital to Home, which provides hospital-level care at home.
The Sentara Hospital to Home program combines state-of-the-art remote technology, hands-on nursing care and virtual doctor visits every day to serve hospital patients safely and successfully at home. Hospitalists are physicians who manage patient care during hospital admissions, and they are responsible for Sentara to Homepatients. Physicians are finding the program is very successful with COVID-19 patients as well as patients with such conditions as congestive heart failure (CHF), atrial fibrillation (A-fib) with fast heart rates, patients who require IV antibiotics, chronic obstructive pulmonary disease (COPD) and deep vein thrombosis (DVT).
How Does the Program Work?
When a patient is in the hospital, the physician responsible for their care will evaluate their situation and determine whether the patient is stable enough to return home, but not stable enough to return without daily visits from a nurse or doctor.
“These patients may need monitoring, but not necessarily in the hospital. Or, they may be very anxious to return home for personal reasons,” said Dr. William Knight, hospitalist at Sentara Martha Jefferson Hospital. “In either case, the physician can decide to send them home with follow up care.”
To ensure the patient continues to receive the care they need, Sentara Home Care Services uses tablet-based remote technology to enhance their engagement and involvement in their care. Hospitalists receive current vital signs and assessments from the nurse digitally and see patients via video chats. Patients also use the tablets to record their own blood pressure, weight, heart rate, and other data, which a nurse can view remotely, allowing clinical staff to address developing issues and triage home visits promptly. The software includes medication reminders and education modules to promote self-care.
“They may get daily IV medications, daily lab draws, they go home with vitals equipment and we are able to take care of them somewhat in a hospital like fashion but in the comfort of their own home,” said Dr. Knight.
In addition to remote monitoring, patients in this program receive a visit from a nurse daily. This nurse does a physical exam and checks labs if needed. The physician overseeing the patient’s care also speaks with the patient on the tablet daily and provides any changes to the care plan, such as prescribing new meds as needed.
“Home health services checks the patient’s vitals frequently throughout the day. They have a nurse on call all the time, and if needed, the doctor is contacted for any issues that arise,” said Dr. Knight.
Benefits of Sentara Hospital to Home
“The primary benefit of the Sentara to Home program is that as evidence shows, patients do better at home,” noted Dr. Knight. “Patients feel more comfortable at home and their families can be there to support them, and for appropriate patients their outcomes are better when they’re cared for at home.”
Telehealth technology has been used for many years to monitor and manage patients with chronic conditions. In fact, Dr. Knight noted that Hospital at Home programs have been in place for 20 years, and through them we have seen that patients have better outcomes overall. They are less likely to be readmitted, and they are less likely to face complications such as deconditioning and delirium. The Sentara to Home program also frees up inpatient beds for sicker patients, and it costs less than inpatient admissions.
“Many people believe that programs like this will be the future of healthcare,” said Dr. Knight. “You can do quite a bit of the hospital care at home with the technology we have available today.”
Overall, the hope is that, through the program, patients can get back on their feet as quickly and safely as possible, in a comfortable setting.
“As a hospitalist over 11 years, I see over and over again patients that have a permanent decrease in function or cognition after a long, stressful hospitalization,” noted Dr. Knight. “I firmly believe that minimizing the time in the hospital is a critical component of maintaining the strength of our elderly population. They can walk more freely and more frequently. They can eat the food they are used to. They can sleep through the night without begin woken. And their family can be with them more at ease.”
For more information about Sentara Martha Jefferson and the Sentara to Home program, visit Sentara.com.
