Clinical Lightning Talk

Hospital to Home Program: A Unified Team Response to COVID-19

Monday, September 27, 2021, 2:30 pm - 3:30 pm CDT
Sample video
Clinical Lightning Talk Presentation
Sample video
Clinical Lightning Talk Live Discussion Recording
Accreditation Information
The recording of this session has been accredited for Interprofessional Continuing Education credit (IPCE) as enduring material. After watching this recording, you may claim IPCE credit by clicking this link. Interprofessional Continuing Education Credit is available to claim through December 31, 2021. Please see details below.

The genesis of our Hospital to Home (H2H) Program began at the peak of the COVID-19 pandemic in Texas, due to critical hospital bed shortages. Our teams implemented the project to ensure a timely and safe discharge of our patients from the hospital/SNF/ER settings to the patient’s home. The H2H Program expedited patient throughput and increased hospital bed availability in three specific market locations with assigned Hospitalists. A specific referral process was developed for early identification of acute patients, including their individual and home medical equipment needs prior to their facility discharge and transition into home healthcare within the first 48 hours.
The interprofessional approach of the H2H Program significantly improved cross-functional, proactive communication of the patient’s status and disposition for designated team members from the Case Management, Home Health, Patient Transportation, Home Medical Equipment, Supportive/Palliative Care, physicians, and senior leadership. To achieve positive patient outcomes, any existing communication silos between teams were ended. The consistent, active participation of each team representative developed into mutual, professional group rapport, leading to honest and open communication. The interprofessional patient reporting huddles, directed by a lead physician, resulted in early nursing and therapy interventions, improved patient outcomes, reduced ER visits, and decreased hospital re-admissions from 12.9% to 5%.
Other new technologies evolved from the project, including the utilization of secure text messaging communication, virtual patient reporting, a monitored group mailbox, and remote patient monitoring via tablets with Bluetooth periphery equipment for telehealth capability. Based on the consistent, positive outcomes from the H2H Program, the future operations of home healthcare in collaboration with interprofessional teams will support these best practices in parallel with evidenced-based research. Our lessons learned will promote other interprofessional teams to facilitate the delivery of safe, quality patient care for the most acute, high-risk patient populations.

Accreditation Details

In support of improving patient care, this activity is planned and implemented by The National Center for Interprofessional Practice and Education Office of Interprofessional Continuing Professional Development (OICPD). The OICPD is accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

This activity was planned by and for the healthcare team, and learners will receive Interprofessional Continuing Education (IPCE) credit for learning and change.

Physicians: The National Center for Interprofessional Practice and Education designates this live activity for AMA PRA Category 1 Credits™.

Physician Assistants: The American Academy of Physician Assistants (AAPA) accepts credit from organizations accredited by the ACCME.

Nurses: Participants will be awarded contact hours of credit for attendance at this workshop.

Nurse Practitioners: The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts credit from organizations accredited by the ACCME and ANCC.

Pharmacists and Pharmacy Technicians: This activity is approved for contact hours.

IPCE: This activity was planned by and for the healthcare team, and learners will receive Interprofessional Continuing Education (IPCE) credits for learning and change