Hospital at Home: Imagining New Models of OT Delivery

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We’ve had compelling evidence for a while now about the benefits of providing acute care hospital services from the comfort of a patient’s home. (This model is widely known as “hospital in the home.”) 

But, for us in the US, it has been hard to imagine how our complex medical system would ever change to accommodate such a fundamental shift in healthcare delivery. 

Enter: the pandemic. Now, our whole society is looking at the inadequacies of limiting acute care to the number of beds available in a hospital. 

OT is uniquely poised to deliver services in this model—and you’ll see in the research that our care is considered a central component. 

This podcast is intended to be an introduction to the hospital at home model. It’s designed to help you imagine the healthcare models of the future—and OTs place in them. We will anchor our discussion in a Cochrane review of the evidence. Then, we’ll welcome our guest Monika Lukasiewicz, who has made a career of thinking creatively about OT in the home, all while working in traditional OT settings. Whether you deliver OT in the home or the hospital, she’ll help us think through how this trend could impact your practice. 

Examples of hospital at home

Per this article, 56 health systems and 127 hospitals across 29 states have been accepted as participants in the Centers for Medicare & Medicaid Services’ (CMS) hospital-at-home initiative.

Here are some examples of hospital at home programs:

• Mount Sinai at Home
• Dignity Health Home Recovery Care
• Contessa Home Recovery Care 

Primary Research Explored

When you log in, be sure to check out the OT Potential Club’s written breakdown of the following research article. Then, share your questions and thoughts with fellow practitioners.

• Early discharge hospital at home

Secondary Research 

• Exploring the feasibility, acceptability and potential benefits of using digital technology to undertake occupational therapy home assessments
• Home quick – occupational therapy home visits using mHealth, to facilitate discharge from acute admission back to the community

Learning Objectives

• You will be able to recognize the positive OT-related outcomes associated with hospital at home. 
• You will be able to identify assessments OTs can utilize to help track outcomes in this setting.

Agenda

Intro (5 minutes)

Breakdown and analysis of journal article (10 minutes)

• Introduction to hospital at home
• Why was this paper written?
• What were their methods?
• What were the results?
• Discussion and conclusions
• Takeaways for OT practitioners

Discussion on practical implications for OTs (with guest Monika Lukasiewicz) (45 minutes)

• What were your initial impressions of the journal article?
• What do you see as the downsides to our current model of care in the US, where acute care is so distinct from home health?
• How did the article make you think differently about your care as a home health therapist?
• For OT’s working in hospital settings how can you imagine this could make them think differently about their care?
• Do you see avenues for OTs get involved in these programs and to shape the policy around them?
• What technologies are you seeing coming to OT in the home that would enable the shift to more home-based care for acute patients?
• Where would you like to see our profession in 5-10 years in terms of our involvement in hospital at home programs?
• What support is needed in order to help OTs stay at the table and keep innovating in the home?

Target Audience/Educational Level

Our target audience is occupational therapy practitioners who are looking to learn about hospital at home and occupational therapy. The educational level is introductory.

Financial and Non-financial Disclosures

It is the policy of OT Potential to disclose any financial and non-financial interest the provider or instructor may have in a product or service mentioned during an activity. This is to ensure that the audience is made aware of any bias of the speaker.

We here at OT Potential have no financial stake in this topic. Our guest, Monika Lukasiewicz, has no financial interest in this topic to disclose.

Speakers

Monika Lukasiewicz, OTR/L, CLIPP:

Monika earned her Master’s of Occupational Therapy from College of St. Mary in 2009. Since then, she has worked in acute care, acute rehab, ICU, skilled nursing, outpatient, as an adjunct professor and home health. The majority of her career–and passion–has been in home health. She is trained in motivational interviewing, healthy habit development, lifestyle redesign, Certified Living In Place Professional (CLIPP) and is in the process of being certified in evidence-based caregiver training for dementia care through the Skills2Care Training.

She started writing in 2012 on topics including flow, motivational interviewing and then strategies for home health occupational therapists (OTs). After falling in love with being an occupational therapist in the home yet clearly noticing the struggles of working in a remote health care system, she began creating more content including an e-book and other downloadable templates to serve home health OTs. This led to a being a guest on podcasts and founding a short podcast called “Home Health Occupational Therapy Explorer.”  Read full bio.

Sarah Lyon, OTR/L:

Sarah’s passion is helping fellow OT practitioners translate evidence into daily practice. Sarah earned her BA in religion from St. Olaf College, then earned her master’s degree in occupational therapy from New York University in 2011.

Since then, she’s worked in numerous facilities, including a critical access hospital, an acute trauma hospital, and a state inpatient psychiatric hospital. Sarah is the founder/owner of OT Potential. Read more about OT Potential here.

This course was designed to meet your continuing education requirements

We designed the courses in the Club to meet the requirements for “online” and “independent/self-study” courses. To verify the requirements from your specific state (within the US), check out our post, OT Continuing Education Requirements. If you are outside of the United States and have questions, please contact us.

We are proud to be an AOTA Approved Provider and to meet the requirements for your NBCOT renewal.

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