Aims
To investigate the qualitative and quantitative impact of a Hospital in the Home review on patients returning to their RACF following a Hospital admission.
Methods
Every patient admitted to a Sydney hospital received a review by a Geriatric Registrar and Hospital in the Home nursing staff the day after transfer from hospital through a Hospital in the home service. All patients were reviewed to confirm the discharge plan. If, however, there was a change in care this was communicated to the RACF and relevant referrals made.
Results
88 patients were reviewed with a mean age of 88.2 and clinical frailty score mean of 6.7. Of the 88 patients, 10.2% were converted to end of life care with palliative care input. 7.9% patients had ongoing intravenous therapy to complete their course of therapy. Following shared decision making discussions between Geriatric-led HITH service and patients and carers, 21.5 % choose RACF based care alone in the future. 13.6% were referred to community palliative care. Only one patient was readmitted following this review due to behavioural disturbance.
Conclusions
In this urban single-centre hospital, approximately 49% of inpatients are over 65. This novel geriatric-led HITH service is facilitating return to RACF, with reduced length of inpatient stay, effective use of outpatient services and reduced readmission rate of this vulnerable population. Further investigation into the comparison of data made prior to the implementation of our service is warranted to identify the effectiveness or qualitative analysis from patients, carers and RACFs.