Hospital at Home: Imagining New Models of OT Delivery

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

1. You will be able to recognize the positive OT-related outcomes associated with hospital at home.

2. You will be able to identify assessments OTs can utilize to help track outcomes in this setting.

• Intro

• Breakdown and analysis of journal article

  • 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)

  1. What were your initial impressions of the journal article?

  2. 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?

  3. How did the article make you think differently about your care as a home health therapist?

  4. For OT’s working in hospital settings how can you imagine this could make them think differently about their care?

  5. Do you see avenues for OTs get involved in these programs and to shape the policy around them?

  6. What technologies are you seeing coming to OT in the home that would enable the shift to more home-based care for acute patients?

  7. Where would you like to see our profession in 5-10 years in terms of our involvement in hospital at home programs?

  8. What support is needed in order to help OTs stay at the table and keep innovating in the home?

Primary

• Early discharge hospital at home

Additional

• 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

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.

OT Potential pays guest speakers an honorarium for their participation, either directly or to an institution of the speaker's choosing at their request. We invite guests whose expertise often comes from practices, programs, or building products in their field. Where a speaker has a financial interest in the subject of a course, we disclose it below so you can weigh it for yourself.

OT Potential's interest in this topic: We have no financial stake in this topic.

Speaker interests: Monika Lukasiewicz has no financial interest in this topic to disclose.