Lessons from the Mayo Clinic, Michigan Medicine and Presbyterian Health

0

Hospital-at-home programs are proliferating across the country, as more health systems partner with companies like Medically Home or create their own in-house programs. Waiver flexibilities spurred by the pandemic have also made these programs more viable for hospitals.

Getting a program up and running is no small feat, however. Becker’s spoke with three health systems that have successfully launched hospital-at-home programs and agreed to share tips and insights on their efforts.

Michael Maniaci, MD. Chief Physician at Mayo Clinic Advanced Care at Home (Rochester, Minn.).

Question: Why did you decide to launch the program?

Dr. Michael Maniaci: Even before the onset of the COVID-19 pandemic, Mayo Clinic was preparing to introduce Mayo Clinic Advanced Care at Home. Hospital-at-home models across the country have been proven to deliver safe care, reduce hospital readmissions, improve patient mobility, and achieve high levels of patient satisfaction .

Q: What do the first results show? Have there been changes in key metrics like bed space or patient experience?

MM: Our Mayo Clinic Advanced Care at Home patients tell us how much it means to them to recover in the comfort of their own home. Caring for these patients at home also made it possible to provide additional hospital beds for patients who needed them. This has been very beneficial during the outbreaks of COVID-19 infections and will continue to help moving forward.

Q: What advice would you give to hospitals looking to establish their own program?

MM: Simulations, practice scenarios and continuing education in clinical skills are essential to providing care at home. We have found it useful to continue this training beyond the launch of the program.

Elizabeth DePirro, MD. Medical Director of the Hospital-at-Home Program at Presbyterian Healthcare Services (Albuquerque, NM).

Question: Why did you decide to launch the program?

Dr. Elizabeth De Pirro: Presbyterian was an early adopter of hospital-at-home, launching our program in 2008. Our leadership at the time saw it as an innovative and successful program for critically ill patients who could be treated and recovered in the comfort of their own homes, with pets and family nearby for support. Caring for these more stable patients at home would also open up additional hospital beds for the most seriously ill.

Q: What do the first results show? Have there been changes in key metrics like bed space or patient experience?

PDE: We admit patients to hospital at home with seven diagnoses, such as chronic obstructive pulmonary disease and community-acquired pneumonia. Our results show higher patient satisfaction, lower falls rates, reduced mortality, and 42% lower costs than we would expect for hospitalized patients with similar conditions.

Q: What advice would you give to hospitals looking to establish their own program?

PDE: The most important consideration is deciding which patient population you want to serve. How will Hospital at Home help provide excellent care for this population and who will be your partners in developing this plan?

Next, building your team is critically important. You need providers who are willing to work from their cars and drive with an assortment of medical supplies to see patients in their homes. You will need nurses who are comfortable working independently, even when unexpected situations arise. You should also determine if additional contracted services are required to provide care for this population.

Grace Jenq, MD. Associate Clinical Director, Post-Acute Care Services at Michigan Medicine (Ann Arbor).

Question: Why did you decide to launch the program?

Dr. Grace Jenq: We started our journey with hospital home care in August 2018. It was a partnership with Blue Cross Blue Shield of Michigan and we started our pilot project for hospital home care in July 2020. So it took two years to get it out of anchor and develop all the different pieces to be able to support patient enrollment. Our goal is to continue to grow the program, we have a capacity issue here at the University of Michigan Hospital, which is no different than many other academic medical centers. What we recognize is that there are patients who are in our hospital beds, who can receive very basic IV medications, IV fluids, lab tests and a combination of in-person and virtual visits at home which are equal to what they get in the hospital.

Q: What do the first results show? Have there been changes in key metrics like bed space or patient experience?

GG: We actually had zero readmissions, zero use of emergency departments, exceptional patient satisfaction for all of them. We had no adverse events. So even though we don’t have that many numbers [of patients] like other institutions, certainly just with our pilot project, it has been very, very promising in terms of results.

Q: What advice would you give to hospitals looking to establish their own program?

GG: I think one of our key things is that it’s the strategic initiatives of the year, so the whole health system has to be fully engaged in moving this hospital nursing home agenda forward or you’re You’ll end up with chunks here and there where people are willing to expand, but then you’re going to be held back in another area. We need everyone, not just doctors, not just nurses, but you need everyone in HIT to build platforms in a timely manner, you need people in compliance with regulations, to move forward to make sure we’re doing it right. You can’t underestimate the hundreds and hundreds of hours spent at the system level just to be able to enroll even a few patients upfront. It takes everyone, so you have to have the commitment of the entire health system to get something like this off the ground.

Share.

About Author

Comments are closed.