Hospital at home for the management of COVID-19: preliminary experience with 63 patients

Pericàs, Juan M.; Cucchiari, David; Torrallardona‐Murphy, Orla; Calvo, Júlia; Serralabós, Jùlia; Alvès, Elisenda; Agelet, Aleix; Hidalgo, Judit; Alves, Eduarda; Castells, Eva; Seijas, Núria; Hernández, Carme; Bodro, Marta; Cardozo, Celia; Coloma, Emmanuel; Nicolás, David

doi:10.1007/s15010-020-01527-z

Cited by 40 publications

(45 citation statements)

References 7 publications

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“…Finally, HaH Units have played different roles during the COVID‐19 pandemic, but mostly provided first line care of COVID‐19 patients at their homes or in medicalized civil buildings such as hotels 11 . During this period, HaH units have accumulated a large amount of experience in dealing with COVID‐19 patients, the evolution of the disease and the criteria for HaH admission (Table 1) or conventional hospitalization transfer due to clinical worsening.…”

Section: Figurementioning

confidence: 99%

Hospital at Home units in the post‐COVID 19 era

Coloma

Nicolás

2020

Eur J Clin Investigation

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Section: Figurementioning

confidence: 99%

Hospital at Home units in the post‐COVID 19 era

Coloma

Nicolás

2020

Eur J Clin Investigation

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“…This care model remains a viable solution to the increasing global need for acute care hospital beds, rising healthcare costs, and aging population 2 , 3 . While HaH is not novel, the emergence of the coronavirus disease 2019 (COVID-19) has brought new urgency to this mandate as the world grapples with the accelerating need for hospital beds and increased risk of nosocomial infections 4 . Studies have shown that HaH is a safe and effective alternative for COVID-19 patients with mild symptoms, which can reduce pressure on healthcare in the hospital 5 , 6 .…”

Section: Introductionmentioning

confidence: 99%

Perceptions of Hospital-at-Home Among Stakeholders: a Meta-synthesis

Chua

Lai

et al. 2021

J GEN INTERN MED

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Background Hospital-at-home (HaH) provides acute healthcare in patients’ homes as an alternative to traditional hospital inpatient care. HaH has been shown to improve clinical outcomes, increase patient satisfaction, and reduce hospitalization costs. Despite its effectiveness, the uptake of HaH remains slow and little is known about factors that impact the quality and transferability of HaH. This review aimed to qualitatively synthesize existing literature to examine the perspectives of stakeholders to identify areas of improvement in this model of care. Methodology Six electronic databases (Cumulative Index of Nursing and Allied Health Literature, PubMed, Embase, PsychINFO, Scopus, and Mednar) were searched from inception date until 3 February 2021. The included studies were assessed for quality using the Critical Appraisal Skills Program tool. This review was registered on the International Prospective Register of Systematic Reviews. The meta-synthesis was completed according to Sandelowski and Barroso’s guidelines. Results Sixteen articles met the inclusion criteria. The overarching synthesized theme was “the intricacies of developing HaH,” and the four main themes were (1) factors influencing patient selection, (2) advantages of HaH, (3) challenges of HaH, and (4) enablers for HaH development. Conclusion Overall, high levels of satisfaction were expressed by various stakeholders. Continuity of care remains an important factor for patient-centeredness in HaH. Caregivers should be involved in the decision-making process and supported throughout the HaH duration to prevent caregiver burnout. Collaboration and coordination among healthcare professionals are vital and can be strengthened through training and technological advancements of remote patient monitoring. Institutional and organizational support for stakeholders may make HaH a viable solution to modern healthcare challenges. Supplementary Information The online version contains supplementary material available at 10.1007/s11606-021-07065-0.

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“…The current COVID-19 pandemic is one of the greatest public health crises of our time (European Centre for Disease Prevention and Control, 2019;World Health Organization, 2020a), and has forced health systems worldwide to urgently find ways to relieve pressure on overstretched hospitals and increase bed availability. One outcome has been an increase in the use of HaH programmes, which have proven to be both an efficient and safe option for providing care to selected at-risk patients (Coloma and Nicolás, 2020;Moghadas et al, 2020;Pericàs et al, 2020;Shoukat et al, 2020). OPAT patients, for example, are a COVID-19 risk group because of their susceptibility to severe infections and extensive contact with the healthcare system (Mansour et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Applicability of Quality Indicators for Appropriate Antibiotic use in Outpatient Parenteral Antimicrobial Therapy (OPAT): A Point Prevalence Survey

et al. 2021

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The ability to measure the quality of antibiotic prescription is a critical element in any antimicrobial stewardship programme. The aim of this study was to evaluate the clinimetric properties of 33 quality indicators (QIs) developed to assess Outpatient Parenteral Antimicrobial Therapy (OPAT) and to identify potential room for improvement in a hospital-at-home (HaH) unit. Study performed in a healthcare district in Barcelona, Spain with 260,657 inhabitants, nine primary healthcare centres, a 400-bed acute care teaching hospital, and an HaH unit. We studied 33 QIs on appropriate antibiotic use and classified them as qualitative or quantitative. Quantitative QIs were further categorized as measurable or non-measurable depending on the availability of data in the patients’ medical records. Data from 202 OPAT episodes in 192 patients were assessed. Adherence was found for 22 of the 24 qualitative QIs analyzed; the other two showed room for improvement. Four of the nine quantitative indicators were non-measurable. High adherence rates were achieved for QI-17 “The OPAT plan should be documented” (84.65%), QI-26 “The OPAT treatment plan should include choice, dose, frequency, duration and follow-up plan” (79.70%), and QI-33 “The team should document clinical response” (94.55%). Adverse events were documented in just 1.98% of cases (QI-32) and 92.57% patients were classified as alive on discharge (QI-24). The QIs evaluated were applicable to clinical practice and proved useful for identifying areas with room for improvement in our setting and for guiding the design of future interventions with specific objectives.

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Hospital at home for the management of COVID-19: preliminary experience with 63 patients

Cited by 40 publications

References 7 publications

Hospital at Home units in the post‐COVID 19 era

Hospital at Home units in the post‐COVID 19 era

Perceptions of Hospital-at-Home Among Stakeholders: a Meta-synthesis

Applicability of Quality Indicators for Appropriate Antibiotic use in Outpatient Parenteral Antimicrobial Therapy (OPAT): A Point Prevalence Survey

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