Development of Wearable System for Home Care Support System : The Hyper Hospital at Home

EinleitungPatienten in kritischen Gesundheitssituationen und solche mit therapeutisch-technischem Unterstützungsbedarf sollen auch in Deutschland vermehrt im häuslichen Umfeld versorgt werden. Die Voraussetzungen der als High-Tech Home Care (HTHC) oder Hospital-at-Home (H@H) international bekannten Versorgungsform und die mit dem Transfer der Medizintechnik von der Intensivstation ins Wohnzimmer verbundenen (un-)erwünschten Effekte – besonders für die Nutzer – erfahren aber noch selten die notwendige Aufmerksamkeit.

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Connected care for endocarditis and heart failure patients: a hospital-at-home programme

Netherlands Heart Journal ◽

10.1007/s12471-021-01614-2 ◽

2021 ◽

Author(s):

J. van Ramshorst ◽

M. Duffels ◽

S. P. M de Boer ◽

A. Bos-Schaap ◽

O. Drexhage ◽

...

Keyword(s):

Heart Failure ◽

Home Care ◽

Nurse Practitioners ◽

Care Group ◽

Proof Of Concept ◽

Home Setting ◽

Curative Care ◽

Care At Home ◽

Hospital At Home ◽

At Home

Abstract Background Healthcare expenditure in the Netherlands is increasing at such a rate that currently 1 in 7 employees are working in healthcare/curative care. Future increases in healthcare spending will be restricted, given that 10% of the country’s gross domestic product is spent on healthcare and the fact that there is a workforce shortage. Dutch healthcare consists of a curative sector (mostly hospitals) and nursing care at home. The two entities have separate national budgets (€25 bn + €20 bn respectively) Aim In a proof of concept, we explored a new hospital-at-home model combining hospital cure and nursing home care budgets. This study tests the feasibility of (1) providing hospital care at home, (2) combining financial budgets, (3) increasing workforces by combining teams and (4) improving perspectives and increasing patient and staff satisfaction. Results We tested the feasibility of combining the budgets of a teaching hospital and home care group for cardiology. The budgets were sufficient to hire three nurse practitioners who were trained to work together with 12 home care cardiovascular nurses to provide care in a hospital-at-home setting, including intravenous treatment. Subsequently, the hospital-at-home programme for endocarditis and heart failure treatment was developed and a virtual ward was built within the e‑patient record. Conclusion The current model demonstrates a proof of concept for a hospital-at-home programme providing hospital-level curative care at home by merging hospital and home care nursing staff and budgets. From the clinical perspective, ambulatory intravenous antibiotic and diuretic treatment at home was effective in safely achieving a reduced length of stay of 847 days in endocarditis patients and 201 days in heart-failure-at-home patients. We call for further studies to facilitate combined home care and hospital cure budgets in cardiology to confirm this concept.

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Proposal for a general framework for the administration of anticancer immunotherapy in a hospital-at-home care

Bulletin du Cancer ◽

10.1016/j.bulcan.2021.09.014 ◽

2021 ◽

Author(s):

Anne-Claire Toffart ◽

Amélie Feyeux ◽

Maurice Pérol ◽

Nicolas Girard ◽

Aurida El Bouanani ◽

...

Keyword(s):

Home Care ◽

General Framework ◽

Anticancer Immunotherapy ◽

Hospital At Home ◽

At Home

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Hospital at Home care for older patients with cognitive impairment: a protocol for a randomised controlled feasibility trial

BMJ Open ◽

10.1136/bmjopen-2017-020332 ◽

2018 ◽

Vol 8 (3) ◽

pp. e020332 ◽

Cited By ~ 2

Author(s):

Maaike A Pouw ◽

Agneta H Calf ◽

Barbara C van Munster ◽

Jan C ter Maaten ◽

Nynke Smidt ◽

...

Keyword(s):

Cognitive Impairment ◽

Home Care ◽

Older Patients ◽

Hospital Care ◽

Feasibility Trial ◽

Nursing Home Admission ◽

Advantages And Disadvantages ◽

Hospital At Home ◽

Randomised Controlled ◽

At Home

IntroductionAn acute hospital admission is a stressful life event for older people, particularly for those with cognitive impairment. The hospitalisation is often complicated by hospital-associated geriatric syndromes, including delirium and functional loss, leading to functional decline and nursing home admission. Hospital at Home care aims to avoid hospitalisation-associated adverse outcomes in older patients with cognitive impairment by providing hospital care in the patient’s own environment.Methods and analysisThis randomised, non-blinded feasibility trial aims to assess the feasibility of conducting a randomised controlled trial in terms of the recruitment, use and acceptability of Hospital at Home care for older patients with cognitive impairment. The quality of care will be evaluated and the advantages and disadvantages of the Hospital at Home care programme compared with usual hospital care. Eligible patients will be randomised either to Hospital at Home care in their own environment or usual hospital care. The intervention consists of hospital level care provided at patients’ homes, including visits from healthcare professionals, diagnostics (laboratory tests, blood cultures) and treatment. The control group will receive usual hospital care. Measurements will be conducted at baseline, during admission, at discharge and at 3 and 6 months after the baseline assessment.Ethics and disseminationInstitutional ethics approval has been granted. The findings will be disseminated through public lectures, professional and scientific conferences, as well as peer-reviewed journal articles. The study findings will contribute to knowledge on the implementation of Hospital at Home care for older patients with cognitive disorders. The results will be used to inform and support strategies to deliver eligible care to older patients with cognitive impairment.Trial registration numberNTR6581; Pre-results.

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