Promoting and re-establishing Hospital in the Home (HITH) - Acute Care @ Home (AC@H) service - at princess Alexandra hospital.
HITH service is a hospital substitution service of inpatient care in a virtual HOME ward (HOMEPA) for suitable patients. The service medical governance is provided by a Consultant Physician (FRACP), one for each of the AC@H hubs major four hospitals (Princess Alexandra Hospital, Logan, Queen Elizabeth I and Redlands).
The HITH service in Metro South Hospital and Health Service (HHS) is provided to patients according to their catchment areas. Metro South is divided into four catchment areas which include; PAH, Logan, QEII and Redlands. The clinical governance is provided to patients from the parent hospital HITH regardless of their location in Metro South. The Nursing governance however is provided according to the catchment areas.
The HITH service is available seven days a week including public holidays. The working hours currently vary depending on facility. The service hours are from 7 am to 7pm.
MSHHS has a paperless medical record system (IEMR) which facilitates care for these patients. Nursing staff visiting patients in the AC@H service have access to laptops on which they can enter data which can be reviewed by staff in the acute facilities.
We wanted to improve nursing staff numbers, appoint a junior doctor for the service and expand the service in hospital
Suitable Conditions under HITH include;
2. Acute Anti-coagulation for DVT PE or AF
3. UTI, Pneumonia
4. Acute Pre / post-op anticoagulation including daily LMWH injections
6. IV/A/B management e.g. Wound infections/Abscesses
7. Short term acute IV management for Chronic disease patients (COPD, Congestive Heart Failure -IV Frusemide)
8. Uncomplicated diverticulitis
9. Monitoring of stable AKI
10. Patients from RACF with above mentioned problems (Hospital in The Nursing Home)
11. QEII has recently commenced Geriatric Evaluation and Management/Rehab HITH (GEMRHITH) program