Nearly 90 percent of emergency department patients who were enrolled in Penn Medicine's new home recovery program did not need to return to the hospital in the month that followed their original visit, according to a study published in Healthcare.
The Philadelphia-based health system began the project in 2018 as a part of its Center for Health Care Innovation's accelerator program. The team deployed an advanced practice provider to screen hospital bed requests and determine which patients could recover at home, considering the reason for their emergency department visit, vital signs, medical history and social support circumstances.
If a patient was deemed a good fit for the at-home recovery program, the advanced practice provider developed a comprehensive plan with the patient’s care team. Patients enrolled in the program received phone calls and text messages to assess their condition and coordinate outpatient visits. Their care plans also sometimes included diagnostic testing, home nursing visits, physical or occupational therapy and transportation assistance.
The study took place at a single Penn Medicine hospital over 14 days in December 2019. Of 199 possible patients, 52 met the program's eligibility requirements. Thirty patients enrolled in the program.
The study's authors estimated that if those 30 patients had not been enrolled in the program, they would have spent an average of more than two days in the hospital, as well as eight additional hours waiting in the emergency department. Only four patients needed to be re-hospitalized within 30 days of their original visit.
"The culture is shifting where we realize that hospitalization is not always the best option for patients — particularly patients with chronic illness," Austin Kilaru, MD, a Penn Medicine emergency physician and one of the study’s lead authors, said in a May 5 news release. "We need to find better ways of helping patients not just get healthy in a hospital, but stay healthy at home — whenever they are ready to be there."