June 1, 2022

Program lets patients receive medical treatment at home

Denis Brock was one of the first to take part in VUMC’s Hospital at Home program.
Denis Brock was one of the first to take part in VUMC’s Hospital at Home program. (photo by Donn Jones)

When Denis Brock needed to be hospitalized for an infection last fall, she was treated in an unlikely place: her home.

Brock was one of the first patients to participate in Vanderbilt’s Hospital at Home program, which allows patients to remain in the comfort of their own home while receiving treatment for acute medical issues that would have previously required hospitalization.

Brock has multiple sclerosis and resulting chronic infections that must be closely monitored to prevent sepsis. Her condition would occasionally require hospitalization.

When the Hospital at Home program started in November 2021, she had the option to be treated at home. Brock readily signed up.

“In this day and age, it is so grand that patients have an option,” she said. “There are a lot of sick people in the hospital and to not have to be there and to have first-class care at home in your own bed with your own pillow and your own dog licking your hands… it was really just first rate.”

Here’s how the program works: Vanderbilt’s nurses and providers help determine whether a patient in the hospital is appropriate for the program, considering both clinical and home safety. The patient and caregivers are then engaged and agree to have care at home. Transportation to the patient’s home will be arranged, and a nurse will see the patient upon arrival at home and set up a remote patient monitoring system that will allow the team to monitor basic vital signs.

Patients are given a tablet with a simple button that allows them to connect to the care team via telehealth 24 hours a day, seven days a week. “I could just touch the tablet, and somebody was on the other end that I could see their face and talk back and forth to,” Brock said.

Nurses and nurse practitioners visit a minimum of twice per day to forward the care plan, and manage medication, vital signs and patient and family communication. Based on the patient’s diagnosis, supplies, medications or therapy services are provided in the home.

“There were no big surprises,” Brock said. “I was just really comfortable with it.”

The program accepts patients who are clinically appropriate for Hospital at Home and have been assessed in VUMC’s Emergency Department or inpatient setting.

The care team represents expertise from Vanderbilt Home Care, Hospital Medicine and Vanderbilt University Hospital and features nurses, pharmacists, physical and occupational therapists, nurse practitioners and physicians. Partnering with the caregivers are those who provide transportation, food, medical equipment, medication and access to telehealth and remote imaging services.

“Our goal is to continuously strive to make health care more personal,” said Tara Horr, MD, medical director of Hospital at Home and assistant professor of Medicine. “By providing care for our hospitalized patients within their homes, we are able to help them recover where they are most comfortable and provide interventions that set them up for success post discharge.”

Brock said she’s very enthusiastic about the Hospital at Home program.

“There’s no place like home,” she said.