Home-Based Acute Care Model for Older Patients

Introduction

            The American population is aging as the number of older citizens is becoming higher due to the baby boom generation (Goeschel, 2011). The increased number of older citizens who need special attention has increased pressure on the hospitals and special models need to be developed in order to meet their needs. The numbers of the older people who are admitted in the hospital emergency departments could be greatly reduced if appropriate care was provided in their residence. Moreover, most of the older people have difficulties walking and the idea of being admitted in a hospital setting with many younger patients may create psychological problems to such patients.

According to (Herr, 2010) hospital admission of older patients is likely to subject them to a myriad of complications such as pain and delirium. In my previous hospital environment, some older patients who were admitted in the emergency department reported some discomfort. Therefore, admission of such patients could be reduced greatly if innovative home-based care models were provided for such patients.

Home-Based Acute Care Model

            The home-based model is an innovative acute care program, which is based in the home and its aims are to register the older patients so that healthcare services can be provide at the home of the elderly patients. The program provides the eligible patients with hospital-level quality healthcare. Furthermore, for those patients who are admitted in the hospital emergency program, multidisciplinary team shall take them home.

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Nurse Led and Nurse Managed Health Care

            The home-based care shall serve patients aged 65 years, over, with the program led, and managed by registered nurses. The home-based care multidisciplinary team shall consist of one RN, nursing assistant and a physician. A multidisciplinary team shall be responsible for provision of healthcare, which includes x-rays, provision of IV fluids, oxygen therapy and echocardiograms. The patients shall receive daily visits by the physician, while the RN and nurse assistant shall serve the purpose of coordination of the care delivery through provision of ancillary services and patient education.

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Partnerships and Collaboration

            Partnerships and collaboration have been hailed as best strategies of enhancing patient care delivery. Through partnerships and collaborations between patients and hospital staff, the patient care shall be delivered in time and with the focus, that improves patient satisfaction (Craig, Eby, & Whittington, 2011). The program shall draw extensively on the collaboration from the patient’s family in order to assist in the provision of patient care. Most of elderly people need assistance and monitoring when they are under medication. In order to enhance patient satisfaction and care delivery, the members of the patient family shall be involved in the patient education program and in the delivery of the medication program.

Continuity of Care across Settings

            The home-based care delivery programs transcend the traditional acute care delivery model into managing the acute care in the modern fragmented care setting. The home-based acute care model relies in the transition of the RNs from the traditional care delivery into being a primary care giver. Therefore, the RNs under the home-based care program shall take up the responsibility of overseeing the patient care from admission to discharge and making follow-ups on the progress of such patients. In order to ensure these smooth transitions, the nurse practitioners shall be required to receive education with focus on primary patient care.

Technology

            There is increasing adoption of technology among the households in American. The program shall leverage the adoption of new technology amongst the population and the hospitals to increase its efficiency. The program shall employ the use of mobile phones for monitoring of the patient progress. To reduce unnecessary workload that may result from documentation, the care shall integrate an electronic intensive care system in the hospital records system, to allow for ease of access and monitoring of patient data.

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Development/Implementation Team for the Home-Based Acute Care Model

            The team for home-based acute care model shall include a physician, a RN and a nurse assistant. The RN shall be responsible for the initial patient observation at his/her home, while the physician, on daily visits, shall be responsible for the patient assessment and offering of medications such as IV of fluid drips, performing x-rays, electro-cardiograms, oxygen therapy and other medications as deemed necessary. The nurse assistant shall assist the RN in the monitoring of the patient. Since the model is specifically designed to offer healthcare for acute cases such as chronic obstructive pulmonary diseases, pneumonia and heart failure, it requires specialized care, which can be offered better by a physician in collaboration with RNs.

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Evaluation of Home-Based Acute Care Model          

The implementation of any new model must focus on the measurement of outcomes to determine if the model leads to improved patient care, reduces costs and increases healthcare efficiency (Lustbader, Block, Stuart, & Deremo, 2014). The home-based acute care model is a patient focused-care model and its evaluation shall be conducted through the measurement of the patient satisfactions levels. The patient satisfaction levels will provide a measure whether the model enhances quality of care. Moreover, the efficiency of the care delivery under the model shall be measured in terms of the costs incurred in its implementation compared to the same, if care was offered in the hospital bedside. For example, a comparison of costs and satisfaction levels shall be made between the hospitalized patients and those provided with home-based care.

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