ChristianaCare’s hospital-at-home program, launched in December 2021, has benefited over 500 patients with high satisfaction and improved outcomes. Despite challenges, the program offers valuable advantages, including reduced readmission risk and lower healthcare costs. ChristianaCare plans to expand the program across Delaware and increase the number of patients cared for concurrently, embracing digital transformation opportunities fueled by the CMS waiver.
ChristianaCare’s dedication to providing exceptional healthcare has led to the successful implementation of its hospital-at-home program, which has benefited more than 500 patients since December 2021. This innovative approach has resulted in high patient satisfaction and improved outcomes, making it a high priority for the organization.
Despite the increasing popularity of hospital-at-home programs nationwide, the process of establishing and maintaining such programs poses several challenges. These obstacles range from creating new clinical workflows to addressing social determinants of health, such as internet connectivity. However, the advantages of these programs, including reduced readmission risk and lower healthcare costs, outweigh these challenges.
The growth of hospital-at-home programs gained momentum following the introduction of the Acute Hospital Care at Home waiver in November 2020. This waiver allowed hospitals to provide acute, hospital-level care to Medicare beneficiaries in their homes. As of July 12, 2023, 290 hospitals across 37 states had received approval for the waiver, including ChristianaCare in Newark, Delaware. The hospital launched its hospital-at-home program in December 2021 after obtaining the waiver in June of the same year.
Katie Muther, RN, director of nursing and strategic partnerships at ChristianaCare’s Center for Virtual Health, emphasized the organization’s commitment to reaching patients wherever they are, particularly when they are unwell, which often means being at home. Bringing hospital-level care to patients in their homes is a top priority for ChristianaCare, and they aspire to extend this service to as many patients as possible in their community.
ChristianaCare’s hospital-at-home program is part of the organization’s broader digital transformation efforts. The program admits patients from the emergency room or inpatient units after a thorough evaluation by clinicians to determine eligibility. Apart from clinical criteria, a social stability screening is conducted to ensure patients have a safe home environment to receive care. Those eligible are transported back home, where treatment begins. The care team, consisting of advanced practice providers, physicians, nurses, and paramedics, conducts in-person examinations and leverages telehealth to monitor and support patients throughout the program.
To facilitate communication and engagement, patients are provided with a tablet and telephone to connect with their care team and patient digital ambassadors who assist with technology-related issues. Patients also receive Bluetooth-enabled devices to measure vital signs and a personal emergency response system (PERS) for urgent assistance.
Implementing the hospital-at-home program at ChristianaCare came with its share of challenges, notably amid the pandemic and related public health emergencies. Staffing and resource allocation were critical issues, as establishing an at-home hospital required significant resources and infrastructure. ChristianaCare addressed digital health literacy issues by creating the role of patient digital ambassadors. The organization also partnered with external entities and utilized existing community resources to support in-home care.
The results of the program have been remarkable, with a notable increase in patient satisfaction. ChristianaCare’s tracking efforts have revealed reduced rates of hospital-acquired infections and readmissions to inpatient units and emergency departments.
Looking ahead, ChristianaCare plans to expand the hospital-at-home program further across Delaware and increase the number of patients cared for concurrently. The organization has set ambitious growth goals and is committed to embracing digital transformation opportunities fueled by the CMS waiver.
Overall, the hospital-at-home model has become a beacon of healthcare innovation at ChristianaCare, enabling patients to receive high-quality care in the comfort of their homes—a vision the organization plans to uphold indefinitely.
