This U.K. team brings hospital care into homes. Could more of these programs help Canada?
CBC
Health-care teams in the U.K. are providing hospital-quality care for people in their homes to help ease systems facing a shortage of hospital beds. And while versions of these programs exist in Canada, some experts say we need more of them to help ease our own health-care system's bottleneck.
Hospital-at-home care is designed to look more like a visit to an actual hospital, rather than other community medicine such as long-term care. It can include ultrasounds, blood tests and IV treatments, sometimes checking off a list of services that might otherwise take several separate hospital stays.
Patients could receive one-time visits to assess their condition, or receive regular visits analogous to staying in a hospital for several days or weeks.
"Why make hospital or home binary? You know, you either come to hospital [and] get everything or stay home [and] get nothing," Dr. Dan Lasserson, the clinical lead for the Acute Hospital At Home program in the U.K., told White Coat, Black Art's Dr. Brian Goldman.
In February, Goldman accompanied Lasserson and his team on a visit to a long-term care home in Thame, east of Oxford. They're there to see a patient, Joan Baxter, who is 88.
Baxter had been admitted to hospital a few weeks earlier after a fall, but was then allowed to return home. She was referred to Lasserson's team for a check-in after she told her GP she wasn't feeling well.
Davinia Newell, a team member and nurse working on her master's degree, applies gel to a miniature ultrasound probe, then presses it onto Baxter's stomach. Images of her stomach, then heart and lungs show up on Newell's smartphone.
"My tummy must be the most looked-at tummy," said Baxter with a chuckle.
After consulting the results and asking some follow-up questions, Lasserson and Newell decide Baxter can continue to stay at home for now.
"We did a very thorough assessment with her. Did a point of care, ultrasound, bloodwork, blood cultures, urine," said Newell.
"We deliver it all in the home," she explained, except for some procedures such as X-rays.
Much of the time, Lasserson and his team are on the road. When they're not, they work out of their home base at John Radcliffe Hospital in Oxford.
There, they regularly review the medical profiles of their patients in painstaking detail: medications, test results, blood pressure, and assessing whether they need continuing treatment or monitoring.
They receive about two or three referrals a day from emergency doctors, GPs, paramedics, concerned relatives and patients who've been treated at home and are asking to be seen again.
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