Providence VA Medical Center, Rhode Island
Hospital-in-Home Alternative to Hospital Stay
Ray Edington, a Woonsocket, R.I., resident and Navy Seabee Veteran of Vietnam, had an infection that required intravenous antibiotics. This kind of treatment would normally mean a hospital stay, but he and his wife, Karen Edington, were offered an alternative.
They asked me, 'How would you like to get treatment at home?'" Ray recalled.
One of seven Veterans Health Administration facilities participating in the new program, the Providence VA Medical Center launched an innovative treatment option in August for Veterans like Ray, who are medically stable, but traditionally would have been admitted as inpatients. The Hospital-in-Home program provides hospital-level care in the Veteran's home.
Lying in a hospital bed for 14 days versus being in a sitting position in his chair could cause him respiratory problems and skin issues, plus there's the possibility of infections from other patients," said Karen. "I can't be with him all the time in the hospital, and they don't have the time to dress him and get him in and out of his chair. At home I can do all that."
Ray is paralyzed from the neck down due to a swimming accident in 1986, and Karen is his primary caregiver. During the first week of the Hospital-in-Home program, visiting nurses train caregivers how to provide care at home. After that, the nurses check in periodically, to bring medications, take any samples needed for lab tests, do a physical assessment of the patient, and generally make sure everything is going well.
"We usually check in three to four times a week, depending on the patient," said Rosemary Hobba, a registered nurse with the Providence VAMC's Hospital-in-Home program. She noted that with some patients daily visits may be necessary, but either way, nurses in the program are available 24 hours-a-day, seven days-a-week, if a patient or caregiver needs assistance.
"It's really about quality of life," said Anthony Witherstone, who is also a registered nurse with the Hospital-in-Home program. "Who wouldn't want treatment at home for two weeks versus being in the hospital?"
Ray, who has previously spent time in a hospital, agreed that receiving care at home is much better for the patient. "You can be a little nervous at the hospital, but at home you're in your own environment with your wife, girlfriend or caregiver," Ray said. "You're more comfortable with them, because you know them."
Since the Hospital-in-Home program started at the Providence VAMC, 104 Veterans have been referred for evaluation, 75 were accepted, and 73 have been successfully treated and discharged. Of the Veterans treated to date, 30 percent were evaluated for admission to the program after coming to the emergency room.
"We've received rave reviews from Veterans and their family members about the program," said Thomas Mock, chief of the Social Work and Geriatric Extended Care services at the Providence VAMC. He added that the Hospital-in-Home program can also improve access to care for other Veterans, by freeing-up hospital beds that may have otherwise been filled without the program.
"Home care helps reduce the risk of infections and falls, and allows Veterans to spend more time with the people they care about," said Dr. Susan MacKenzie, director of the Providence VAMC. "We're honored to be a part of this new program, helping VA provide the exceptional health care Veterans have earned through their service and sacrifice."