Hospital
at
home?

December 22, 2021 -- Kaiser is in the news again. As a cost-saving measure, it now promotes "hospital-at-home" -- care-at-home programs that use iPads and other digital technology for remote patient monitoring 24/7.

They conflate this with "aging in place" -- who doesn't prefer home to hospital?

But nurses slam the program. My nurse friend Ann Farrel points out,

Hospitals (bean counters) see RNs on balance sheet as largest expense labor [cost], easy to cut to optimize profits though it's long proven RN hrs. per patient day is a key driver of inpatient mortality and morbidity... [I blogged about this here.] Acute and critical nursing care cannot be replicated by family and technology (often unreliable) connected to call center and visits by roving "care teams". But what a money saver! We've forced lower RN staff, now let's transfer nursing care to home and family unable to assume this role, even with patients wired to multiple monitors.

Another RN friend, Saskia, offers this nuanced view:

I'd rather see it as a choice. Some patients may be cut out for it. However, after 'getting discharged home too early' now we have 'too early and without proper resources', double whammy. No, we don't want nosocomial infections. But people need to be over the hump, symptoms well-controlled, before going home.

Want top-notch nursing care, reliable and competent? Don't expect it from family, often overtaxed and stressed-out. Go to the hospital!

Go Ann! Go Saskia! Go nurses!

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