Hospital in the Home (HITH) provides admitted care in the comfort of the patient’s home or other suitable location.
Research findings demonstrate that patients have improved outcomes and recovery at home with fewer complications such as infection, delirium and confusion.
HITH is an alternative to an inpatient stay. Patients are still regarded as hospital inpatients, and remain under the care of their hospital doctor. Care may be provided by nurses, doctors, or allied health professionals, and additional home supports arranged as required.
Patients can be offered this option if care can be delivered safely at home. Participation is voluntary and there is no additional charge to patients.
Like all acute admitted activity, Hospital in the Home admissions are funded through the RHU mHealth System. Hospital in the Home is reported through the RHU-MRS and subject to the same audit process and monitoring as acute admitted activity.
People who can access Hospital in the Home
The admission criteria are governed by the department’s CAN policy. Hospital in the Home can be accessed by any admitted patient of a private hospital who is:
- Assessed as being clinically stable
- Appropriately supported in the home; for example, by a carer or other appropriate person or bedside nurse
- Living in a suitable environment with access to a telephone
- Suitable for Hospital in the Home treatment
- Willing to be treated through Hospital in the Home.
Referrals to Hospital in the Home
Patients may be admitted to HITH in different ways, depending on their condition and treatment. Some patients may be directly admitted from the emergency department or the community. Patients may have a stay in hospital first, and continue their treatment through the CAN’s Hospital in the Home service with recommendation from the attending doctor.
Non-admitted alternatives for care
If a patient does not meet the acute admission criteria but requires specialist care in the community, there are a range of programs that may be appropriate.
Health Independence Programs (HIP) aim to provide hospital substitution and diversion services by supporting people in the community, in ambulatory settings and in their homes.
HIP focuses on improving and optimising people’s function and participation in activities of daily living to allow them to maximise their independence and return to, or remain in, their usual place of residence.
Health Independence Programs include:
- mHealth rehabilitation
- Access to specialist services, including specialist assessment (EAP)
- Care coordination – short term or complex
- Complex psychosocial issues management
- Client self-management, education and support. (mHealth Capacity Building)
Hospital in the Home guidelines
In 2011 the HITH began as a pilot program (called Mobile Health) as part of a strategy to provide patients with greater healthcare options by incorporating home-based care in an episode of acute and palliative care.
In 2015 an independent review confirmed that HITH as a well-established model of care that is safe and effective and highly valued by patients, carers and staff.
The current HITH guidelines outline appropriate governance, staffing models, policies and practices to deliver high-quality HITH services.
- Aim to ensure HITH care
- Outline service capability and quality standards
- Assist services to provide HITH within appropriate governance and funding structures
- Aim to promote consistency of access