Care at Home’s strong program needs ‘culture shift’ to reach next level

November 22, 2022  //  FOUND IN: Strategy & Leadership,

Approximately a 5-minute read

Key takeaways:

  • More than 70 patients have successfully navigated the new Hospital Care at Home program and over 500 have taken part in the Completion at Home program.
  • Care at Home is proving to enhance both the patient and employee experience.
  • To help even more patients participate, providers and care team members are encouraged to consider this care model for their patients.

Last year, when Care at Home was identified as the Initiative of the Year to improve Access (representing the A in U-M Health’s BASE Strategic Priorities) a small, dedicated care team and support staff joined together to build a unique program from the ground up. Their mission was to offer eligible patients an opportunity to receive hospital level care in the comfort of their own homes.

Today that team has successfully admitted more than 70 patients to Hospital Care at Home and over 500 patients to the Completion at Home program by expanding its reach, introducing more providers and new technology to its program and building on its knowledge and reputation. For an update on the team’s efforts, watch this Short Takes Video.

They have built a strong foundation and are headed in the right direction, but what does the team need to keep the momentum going and reach the next level?

A new way of thinking

“A culture shift,” according to medical director and assistant professor of family medicine, Ghazwan Toma, M.D. “More providers and care team members need to consider this new care model for their patients. It is a unique and innovative mode of caring for patients who don’t require aggressive forms of treatment or escalation of care.

“It’s understandable that they would feel more secure with standard care,” he added, “but if the patient is stable enough and amenable to the idea, they can finish their admission at home and have a better opportunity for rest and recovery. Right now, we need to have beds available for more complex cases, so it’s important to encourage our colleagues to consider this option.” 

Toma emphasized that patients are in good hands with the team which now consists of 10 nurses, three nurse practitioners and 13 physicians supporting the program, as well as care transition coordinators on site to work with the initial care teams. Once enrolled in the program, patients also receive care from physical therapy, occupational therapy and social work team members at home, if need be.

Wave of the future

In addition, Care at Home takes advantage of unique remote technology, which was one aspect of the program that drew Soumya Rangarajan, M.D., medical director and assistant professor of internal medicine, to join the team.

“I like to be on the front lines of innovation,” Rangarajan said. “I had heard about some of the interesting new technologies being developed for caring for patients in their own homes and thought it would be a unique opportunity to be on the front end of a new clinical line, much like being in a ‘startup’ in the tech industry.” 

“I think hospitalists should know about this program because it’s the wave of the future in health care,” she added. “There are many companies that have developed technology for remote monitoring and virtual care has come in vogue during the COVID-19 pandemic, so it’s natural that the shift happens in hospital medicine too.”

Improving the patient experience

Rangarajan’s main interest in the program was its impact on the patient experience.

“One of the things I most valued as a geriatrician is being able to sit down and spend time with patients and their families, so I jumped at the chance to see patients in their own homes and have that personal touch,” she said.

“I know of the dangers of hospitalization for older adults, including increased risk of delirium and falls, and thought that Hospital Care at Home would help reduce that risk. I have also noticed that patients are much happier being in their own beds and eating their own food. While the program is an option only for a subset of patients (having a stable housing situation, etc.), it definitely is a great way to increase patient satisfaction.”

Toma agreed. “Studies show that there are fewer readmissions and decreased days for rehabilitation, because patients are less likely to be immobile when they receive care in their own home,” he said. “In general, you get your strength back more quickly after a surgery or illness when recovering in your own home.”  

A win-win for everyone

The organization will also benefit from further adoption of the program due to the increase in bed capacity, providing better access to care for our patients. This also has a trickle effect to the employee experience.

“It benefits the teams because when patients are waiting for beds, they feel they’re in limbo, and so do the staff. It has an impact on ER providers and hospitalists who are caring for these patients. When we can relieve the capacity issues, this reduces burnout,” Toma said.

“Plus, the referring physician has the opportunity to serve their patients’ needs better,” he said. “Your patients can receive superior care at their own home environments, which allows us to treat the whole person.”

Taking it from a personal perspective, Rangarajan explained, “Providing this care has been as healing for me as a provider as it has been for the patients, especially after the stress of facing the COVID-19 pandemic as a front-line provider. In some visits, I’ve been greeted at the door by the patients’ adorable pets. Seeing the patients being able to spend quality time with their families (both human and of the furry variety) and being able to sit down next to them to talk about their care plan has really brought back a lot of what drew me to becoming a physician in the first place!”

How to connect with Care at Home  

Any member of a care team can contact the Care at home team if they feel their patient may be eligible for the program. For questions or to request a consult, call pager 61576 at any time.

To view the modalities and pathways supported by Care at Home, click on this Care at Home Flyer

For more information, visit the  Care at Home website.

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