Boston-based Mass Basic Brigham, one of many leaders of the acute hospital-at-home motion, has acquired grant funding to guage the supply of short-term rehab care at residence.
With a grant of $4.6 million from the Massachusetts Government Workplace of Well being and Human Companies (EOHHS), the well being system will run a randomized managed trial to check the impact of delivering short-term rehab care at residence vs. at a talented nursing facility (SNF).
Nationally, about 40% of older adults discharged from acute care hospitals require some kind of post-hospital care, and about half of these obtain care in an inpatient expert nursing facility. The price of expert nursing amenities is growing, and the COVID-19 pandemic exacerbated the workers shortages and capability challenges these post-acute care amenities face.
Delays in discharging sufferers from acute care hospitals to post-acute care settings have posed a problem that has contributed to capability points nationwide, stopping sufferers from accessing the rehab care they want and stopping open beds for brand spanking new sufferers in want of acute hospital care.
Hospital sufferers can look forward to weeks or months earlier than discovering a SNF mattress and accessing the care they want. Based on the newest report by the Massachusetts Well being & Hospital Affiliation, 1,792 sufferers are awaiting to be discharged from hospitals throughout the state.
“If profitable, this care mannequin might lead to an entire transformation of how we ship superior rehab care to our sufferers,” mentioned David Levine, M.D., M.P.H., M.A., medical director for analysis and improvement for Mass Basic Brigham’s Healthcare at Dwelling program, in an announcement. “There are usually not sufficient rehab beds in Massachusetts, and if we will substitute facility-based care with home-based care, we will assist alleviate the capability disaster that our healthcare methods have been experiencing throughout the state. This could have an instantaneous profit for sufferers, household caregivers and clinicians,” added Levine, who’s principal investigator of the trial.
As a part of the research, 300 sufferers will probably be enrolled from 5 acute care hospitals within the Boston space: Massachusetts Basic Hospital, Brigham and Girls’s Hospital, Brigham and Girls’s Faulkner Hospital, Boston Medical Middle and Cambridge Well being Alliance. Of these 300, 150 sufferers will probably be randomized to obtain short-term rehab care at residence, whereas 150 will obtain care within the conventional expert nursing facility.
Sufferers admitted to rehab care at residence will see a nurse, licensed nurse assistant, doctor, and residential well being aide upon admission. Subsequent care will embrace every day distant doctor and in-home licensed nurse assistant visits. Bodily, occupational, and speech therapies are additionally out there and tailor-made to sufferers’ wants. Sufferers will even obtain 24-hour, in-home responses from cellular built-in well being paramedics and, as wanted, residence well being aide care.
Researchers will even consider the experiences of household caregivers and medical workers, analyzing burden and burnout amongst these teams.
In 2019, Levine and colleagues ran a pilot randomized managed trial of 10 sufferers to check the power to ship SNF-level care at residence. Outcomes have been promising and pointed towards decrease price and a greater affected person expertise in comparison with conventional SNF care, Mass Basic Brigham mentioned.. Nevertheless, the small affected person cohort required replication with a a lot bigger affected person cohort.
“Now, because of this monetary award by EOHHS, we will take a look at this revolutionary care supply mannequin that reimagines how we ship post-acute care,” Levine mentioned. “At Mass Basic Brigham, we’re leaders within the superior home-based care house. Considered one of our targets is to create the proof base that will probably be a pathway for the nation’s healthcare methods to comply with nationwide.”
