Hospital in the Home (HITH)
Here is some information regarding the developing SCGH HITH Service:
The Team:
- Both Geriatric Medicine and General Medicine teams – but one point of referral
- Medical Teams:
- Consultant, RMO, Registrar
- Can review daily
- Allied Health Teams:
- SW, OT, PT, Dietetics available Monday to Friday
- Pharmacist available 7 days a week
- Other disciplines on request
- Nursing
- 7 days a week, up to twice daily home visits
- AH nurse manager takes calls from pts/carers overnight on 24/7 phoneline
Admission Criteria:
- Currently only SCGH patients (OPH to be included at later date)
- Currently only patients living in SCGH+OPH catchment
- Patient + Carer consent
- Clear Diagnosis
- Medically Stable for HITH
- Active treatment and/or monitoring requiring hospital substitution
- Minimum daily care contact
- Maximum BD nursing
- Home environment is safe for staff, and suitable to provide care
- Patient has means of communication
- Clinical governance accepted by HITH team
Exclusion Criteria:
- Same day care
- Telehealth/virtual only for non-admitted care
- Assessment only, without ongoing acute care
- Unsafe/inadequate home environment
- Lack of carer (if required)
- IV fluids, oxygen, sliding scale insulin
- Currently not accepting nursing home patients, but hope to provide this service soon
HITH Catchment Areas (yellow and orange areas):
Investigation/Mx in HITH:
- All Radiology can be done in HITH at same priority level as other inpatients, including:
- MRI
- CT
- US
- Radiologically-guided procedures
- Other tests are also available e.g. bloods, echo, holters
- Consults from specialty teams can be done
- IVABs, IV frusemide, iron infusions, blood transfusions etc. can all be done
Referrals:
- In hours = 08:30 – 16:00 Monday to Friday:
- Call the HITH registrar (see SCGH daily roster on intranet)
- Out of hours = 16:00 – 08:30 ?Sunday to Thursday:
- HITH reg will attend ED obs 0830 M-F to pick up any referrals from night before
- Other time periods = Friday 16:30 to Sunday 16:30
- refer to MAU / GAT as per usual indications
Date implemented – 08/2024
Review date – ?12/2024
Author – Wheeler / Liz Feher (Geriatrics) / Hung Do Nguyen (General Medicine)
