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Hospital at Home A prototype model for home care provision Dr. E. Papazissis MD MSc. Department of Hospital at Home HYGEIA Hospital Athens - Greece The trend: Hospital Home The evidence: “as safe as treatment in hospital”. Caplan et. al. MJA 1999

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hospital at home a prototype model for home care provision
Hospital at HomeA prototype model for home care provision

Dr. E. Papazissis MD MSc.

Department of Hospital at Home

HYGEIA Hospital

Athens - Greece

slide2

The trend:

Hospital

Home

slide3

The evidence:

“as safe as treatment in hospital”.

Caplan et. al.

MJA 1999

Patients“would use the service again if the opportunity arose”.

Montalto M.

Int J Qual Health Care 1996

Hospital in the home was significantly cheaper than in-hospital care, particular as a total episode substitution

MacIntyre C. et. al.

Int J Qual Health Care 2002

what is the very essence of a hospital
What is the very essence of a hospital?

What is the element, without which it would not continue to be a hospital?

hosp doc
Hosp - doc

Let’s imagine

that we isolate:

the doctors somewhere…

The nurses elsewhere …

… and the patients somewhere else …

short distances
Short distances

ARE

the key-point

facilitating:

  • teamwork
  • observation
  • Rapid intervention
  • Diagnostic / therapeutic flow
slide9

L o n g d I s t a n c e

HAH model

How do we

overcome

this barrier?

ICT

L o n g d I s t a n c e

nurses are near the patients
Nurses areNEARthe patients

In a Hospital:

In the Hospital at Home model:

  • Ward rounds
  • Ward rounds
  • Vital signs
  • Vital signs
  • Infusion rates
  • Infusion rates
  • medication
  • medication
slide11

In a Hospital:

These facilities are unlikely to

become available

in the home evironment

in the near future

Patients areNEARmajor facilities

In the Hospital at Home model:

CT scan

For these examinations patients should be transferred to hospital

BUT

MRI

Nuclear Medicine

They may return back to their homes

As soon as the examinations are complete

PET

slide12

In a Hospital:

X-rays and encephalography are two examples of examinations which can be easily performed at home

Patients areNEARminor facilities

In the Hospital at Home model:

Radiology

Encephalography

slide13

In a Hospital:

Doctors areNEARnurses

In the Hospital at Home model:

Care records

Frontis application enables handling of the same patients’ care records by different care workers, at different places sumultaneously

Instructions

Doctors get quick information from nurses and nurses rapidly undertake and follow doctors’ instructions for implementation

slide14

In a Hospital:

Doctors areNEARpatients

In the Hospital at Home model:

All of our medical and nursing teams are trained, experienced and properly equipped to be able to act at the site of the crisis and provide aid exactly as they would do in the emergency department of a hospital

Ward rounds

  • Ward rounds

Emergency intervention

Different spceialties

Telemedicine facilities reduce the necessity of physical bedside presence of other specialists, who can contribute with their excellent expertise from a distance

conclusion
Conclusion:

Intelligent administrative structures

telemedicine oriented ICT solution

Canprovide at home high quality medical care

to almost any patient

who does not require

surgery or ICU

  • safely
  • Efficiently
  • Costeffectively
what we need
What we need:

More and

carefully designed studies

Addressing local needs and peculiarities

In order to create robustevidence

And establishstandards

upon which

POLICIES have to be based

slide17

Ireally appreciate your attention

Ireally appreciate your attention

factors to be considered for offering hospital at home care
Factors to be considered for offering Hospital at Home care:
  • Likelihood of life-threatening complications
  • Dependency of possible complications to ICU or surgery
  • Degree of monitoring / delay of complication alerts
  • Time interval for efficient intervention
  • Readiness of hospital at home /Maximum time of response
  • Efficiency to act at the site of crisis
  • Readiness of the receiving hospitalfor emergencies
  • Proximity of the receiving hospital
  • Availability ofambulances
  • Local traffic conditions