Innovative ways for you to receive hospital-level care in your own home

Some people pack their favorite pillow or a framed family photo when they’re admitted to the hospital so their stay will feel less impersonal and more like home. Patients participating in ChristianaCare’s Hospital Care at Home don’t need to do that; they’re already there.A growing number of ChristianaCare patients choose to receive hospital-level inpatient care in the privacy of their own homes, surrounded by cherished belongings and loved ones. “Hospital-level” means that patients receive the most appropriate level of personalized medical care from a dedicated team of providers who deliver in-person and virtual support 24 hours a day, seven days a week – just like patients in a hospital receive.The combination of hospital-level care and a comforting, convenient home environment leads to overwhelmingly positive health outcomes. “Our data show that our program does great things for patients and helps heal them as a whole person,” said Marissa Forte, MSN, RN, virtual nurse manager of Hospital Care at Home. “They’re less anxious at home because they’re in their comfort spot.”

Typically, patients are admitted to Hospital Care at Home after visiting the emergency department (ED). Sometimes, they’re admitted to a hospital unit bed before being transferred to Hospital Care at Home. Other times, patients are admitted directly from the ED.Hospital Care at Home is designed for individuals who require ongoing inpatient care but don’t need their vital signs monitored frequently, as patients in intensive care units do. Patients are selected because they are stable enough to thrive as inpatients at home but not well enough to be discharged for outpatient care.Patients admitted to Hospital Care at Home have a wide variety of diagnoses.“They can have respiratory illnesses requiring nasal cannula only... no oxygen needs beyond that,” Forte said. “That can encompass flu, pneumonia, RSV, COVID. We take heart failure patients, patients with kidney injuries and patients with infections of the skin, like cellulitis.”Hospital Care at Home patients must live within a 25-mile radius of Christiana Hospital or Wilmington Hospital.“We have to be able to provide emergent care to the patient within 30 minutes,” said Marybeth McMahon, director of operations for Hospital Care at Home. “That includes 911 services.”Patients must also have a health insurance plan that covers the program. Hospital Care at Home is covered by Medicare Part A and Part B, as well as a growing number of private payers.

When you’re admitted to Hospital Care at Home, our team will deliver equipment to your home to connect you to the hospital virtually, making your household an extension of the hospital. You’ll receive tech items that are linked to the Hospital Care at Home Command Center, including a tablet, router, phone, medical-alert necklace and bedside communication box. “I call the box that goes by their bed the Charlie’s Angels box because they hit it, and we can talk through it,” Forte said.You can also push a button on your tablet to connect virtually with an on-call nurse at the Command Center any time of day or night.You’ll receive a Bluetooth-enabled blood pressure monitor, pulse oximeter, thermometer, scale and glucometer. Bluetooth transmits your vital signs to the Command Center.A registered nurse or paramedic will visit in person at least twice per day. They’ll take your vital signs, dispense medication, monitor your intravenous (IV) fluid drips or provide other services. You’ll meet with your doctors virtually, connecting through the tablet. Your loved ones may attend your in-person or virtual appointments.“If you have a daughter in California who wants to join the visits and hear what’s going on, a link can be provided,” McMahon said.Every day, you’ll receive a personalized daily schedule telling you when to expect in-person visits and virtual appointments. If your doctor prescribes medication or orders meals for you from the hospital, the schedule will list the times that a courier will deliver them.A number of additional services are available to Hospital Care at Home patients, enabling you to receive the same high-quality care that you would have received if you had remained in the hospital.“We work with partners that do physical therapy, occupational therapy, speech therapy, ultrasound and X-rays,” Forte said. “We have home health aides. We have a phlebotomy partner for hard-to-do needle sticks. The only thing we cannot do in the home is CT scans and MRIs.”Since December 2021, ChristianaCare’s Hospital Care at Home team of virtual and in-person providers has treated more than 1,500 patients. The Hospital at Home Users Group named it the 2023 Program of the Year.

Patients experience improved health outcomes, fewer hospital-acquired infections and fewer readmissions to the hospital within 30 days of discharge.Patients feel calmer and less stressed, which benefits their health and recovery. Pet owners don’t have to worry that their dog will feel abandoned while they’re at the hospital. Patients with dementia are less agitated in their familiar homes. The cozy home atmosphere generally helps patients feel more relaxed.“When you’re in the bricks-and-mortar hospital, things feel very sterile,” McMahon said. “Our providers go above and beyond to make their visits special and less sterile.”Hospital Care at Home allows you and your providers to build deeper connections than they would during a typical inpatient hospital stay.“We learn things about patients that you don’t necessarily learn as a bedside nurse,” Forte said. “We see their families, their pets, how they live, the dietary habits that they don’t admit to anybody in the hospital. A lot of the nurses have expressed how nice it is to get more time with the patients. They get to know them and form that stronger bond.”Our patients share overwhelmingly positive feedback about Hospital Care at Home, including Linda Boughman of Middletown, Delaware, whose husband Walter was a patient.“To be home in your own bed and eat your own food was such a plus in expediting his recovery,” Boughman said. “We hope this program is available forever, as it is such a benefit for the patients.”If you’re interested in Hospital Care at Home for yourself or a family member, contact the program directly to see if you’re a candidate. “Often, patients that have frequent stays will call [us] to express interest in coming to our program again,” Forte said.To learn more about ChristianaCare's Hospital Care at Home, visit our website or call 302-956-1008.