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Hospital in home service extends to Eastern BOP

Hospital in the home service extends to Eastern Bay

Eastern Bay residents requiring hospitalisation will soon have the option of being provided with hospital level healthcare at home.

Hospital in the home has been running successfully in the Western Bay for two years now, and is planned to start in the Eastern Bay on 1 July.

Hospital in the home (HITH) is a free service established by the Bay of Plenty District Health Board’s provider arm, Pacific Health, to deliver specialist level treatment to patients outside the hospital environment. The HITH service is based on the premise that healthcare and treatment provided in the patient's home could be, at least in certain conditions, the same as or better than that provided in the hospital environment.

Eastern Bay HITH Coordinator, Lois Austin, says the benefits for patients of HITH are many.

“Under the HITH programme patients can retain a degree of independence, and can remain in the comfort and privacy of their own home with their families. They can receive their own visitors when they like, they can eat the type of foods that they like, and best of all they can sleep in the comfort of their own bed,” says Mrs Austin.

During the patients ‘virtual hospital stay’ they remain under the direct care of a specialist consultant. The core of the service is provided by the district nurses, although medical specialist practitioners, physiotherapists, occupational therapists and social workers are all part of the HITH team.

Individuals who are suffering from an acute illness or an acute episode of a chronic illness and require specialist level medical and nursing care are eligible for this service. Each individual is assessed by medical and nursing staff for their suitability to receive this service. However, not all patients are suitable candidates for HITH. Patients that are not suitable for this service remain in hospital.

Mrs Austin says that because the service is delivered primarily by district nurses the type of patients that are suitable for the HITH service is limited. However, patients with acute infections requiring intravenous antibiotics are ideal candidates for the new service at this early stage.

“We plan to start small and expand slowly. Initially we will offer the service to patients within five minutes drive from Whakatane Hospital,” says Mrs Austin.

Australian and New Zealand studies have demonstrated that for selected patients, a carefully managed Hospital in the Home programme offers increased patient satisfaction and improved health outcomes.

The Quality in Australian Health Care Study, as reported in the MEDJ Australia, 1999, says that there was a significantly lower occurrence in the HITH group of confusion, urinary (either incontinence or retention) complications, and bowel (either constipation or faecal incontinence) complications. Satisfaction was significantly higher for HITH patients and carers.

Whakatane Hospital General Manager Karen Smith says the service also has benefits for the hospital, freeing up beds that would otherwise be occupied. This is particularly of benefit over the winter months when there is extreme pressure put on medical beds by the influx of patients with winter ills.

Risks are managed by education of the patient and their carer and by the training and certification of the district nursing service, and back up support for the patient is only a telephone call away.

Patients are monitored by the district nursing service on a daily basis, and are required to have weekly blood tests taken and attend a weekly outpatient appointment with their consultant specialist who will review their treatment plan and adjust their treatment management accordingly.

HITH patients have immediate access back into the hospital should their condition deteriorate or they experience any difficulties.

Mrs Smith says that she is confident that this new service will be enthusiastically received by both the patients and their families and by medical and nursing staff throughout the Eastern Bay of Plenty.

Tauranga Hospital treated 280 through the Western Bay HITH service last year.

The HITH concept has been successfully implemented in Australia, the United States and Canada.


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