August 30, 2023

UW Health launches innovative hospital at home program

MADISON, Wis. – Patients who meet certain criteria can now get the same level of care at home as they would if they were admitted to a hospital at UW Health.

The Home-Based Hospital Care program, which began in early July, will admit up to four patients 18 years old and older at a time to start but could expand to care for more than 300 patients each year beginning in 2024.

Decades of research support that care in the home is safe and effective, and the demand for advanced health care at home has increased in recent years, triggering organizations like UW Health to offer a broader scope of services in the home environment, according to Mandy McGowan, director of home-based care programs, UW Health.

Patients can often remain more active at home, which means older patients less frequently need to be transferred to nursing homes, and patients of all ages face reduced risk from complications that can occur in a hospital like delirium or confusion or certain infections that can happen in hospital environments, she said.

Beyond purely clinical benefits, the home lets patients eat food they enjoy, sleep in their own beds, spend time with loved ones and pets and continue to play an active role in their families, which is difficult to do behind hospital walls, McGowan said.

“These studies have shown that not only do patients want to be at home, they also have better outcomes,” she said. “Patients also tend to prefer to be home, if they can be.”

Patients enter the program through emergency departments at University Hospital and East Madison Hospital. They are identified as candidates by physicians and nurses on-site in the emergency department, aided by specially designed software in the electronic medical record system at UW Health.

Once a patient is identified, they are taken home by a medical transport service, and all the equipment they need for their care is set up in their homes, from intravenous pumps to oxygen tanks.

The home will also be assessed to make sure it is safe for the patient as they recover. If modifications need to be made, like adding handrails or fixing tripping hazards, the program collaborates with community partners to address those needs.

A physician visits the patient at home at least once a day, nurses visit at least twice each day and there is a physician and nurse on call at all times. Additionally, certain specialty care is available through video visits.

Because the patient may need care at a moment’s notice, the patients will be provided with a tablet that will give them immediate access to the care team by video. The patients will also wear a smartwatch on their wrists that allows them to reach a nurse immediately, if the tablet is out of reach, just like the call button on the remote control attached to a hospital bed, McGowan said.

“This is the same level of care they would receive if they were in the hospital,” she said. “We even have mobile ultrasound machines.”

The program will also take pressure off hospital capacity over time, according to McGowan.

“We know hospital capacity can be a challenge at many health systems, and this is one way we can help address that in our hospitals by freeing up patient beds for people who can’t recover or receive care at home,” she said.

In total, the program includes UW Health physicians, nurses, a nurse manager, a social worker and a team support coordinator, and the program is looking to add more specialty providers over time, according to McGowan.

“This is just the beginning, but we are hopeful this program can be a bigger part of the future of health care,” she said.