Revolutionizing Care: The Hospital at Home Model (Podcast)

Amid growing pressure on traditional healthcare systems, Cleveland Clinic's innovative Hospital Care at Home program is transforming how inpatient care is delivered by bringing it directly into patients' homes. Designed in response to the COVID-19 pandemic and the persistent challenges of hospital overcrowding, the program relies on a centralized command center staffed with nurses, physicians and pharmacists to provide around-the-clock virtual monitoring.

“Our team is managing inpatients — we’re just caring for them in their own homes,” explains Danielle Crow, MSN, RN, TCRN, Nurse Manager of the Hospital Care at Home program. “We’re able to provide the same level of service they’d receive on a typical med-surg unit, but in a more comfortable environment. This flexibility has provided a multitude of benefits to both caregivers and patients and has resulted in lower readmission rates and fewer hospital-acquired infections.”

In this compelling episode of the Nurse Essentials podcast, Crow shares insights from her two-decade nursing career and details how she and her team are able to harness technology to provide hospital-level care in the comfort of patients' homes. They discuss:

• Fostering deeper patient connections through virtual care
• Leveraging technology to improve patient outcomes, nurse satisfaction and hospital overcrowding
• Differentiating between home care and hospital care at home
• The benefits and operational challenges of providing high-level care outside the hospital
• Determining eligibility and preparing patients to be active participants in their own care

Click the podcast player above to listen to the episode now, or read on for a short, edited excerpt. Check out more Nurse Essentials episodes at my.clevelandclinic.org/podcasts/nurse-essentials or wherever you get your podcasts.

Podcast excerpt

Podcast host Carol Pehotsky, DNP, RN, NEA-BC: What skills do nurses who are effective in [virtual] roles need?

Crow: There are a lot of nurses who are very interested in this model. I’ve hired 17 since February! I think anybody can do it…but there’s a very steep learning curve. Nurses who are already skilled in technology [have an advantage]. We work with three screens and bounce around in all kinds of different systems that some nurses aren't used to. It takes four to five weeks of orientation, even for the most experienced nurses. The physical demand isn't there, but the mental demand is high. Flexibility [is important], as is the ability to prioritize and look at things differently. If you get stuck in how we've always done things, it's difficult to transition into this role.

I feel really good about the care that [our team] is providing. We've got…nurses from many different backgrounds, from the cath lab to the ER, to observation units, to med-surg units. It really is cool to see all these different people come together to provide care in this way.

Pehotsky: Nurses often use touch and [conversations] to build trust and rapport with a patient. How do you build [those relationships] through a video call?

Crow: One of the first things that surprised me about the virtual model was that we all felt like we could get a deeper connection with the patient this way. It makes sense. The patients are more comfortable, more open and surrounded by the things that they love. We are actually in their home…seeing art behind them on the wall and asking them about it or getting to know their pets and talk to them on the video. I feel like you get to know more about the patient as a person quicker and more intimately, honestly, by seeing that little window into their life.