HaH Regulation – Examples, Ideas & Comments

HaH Regulation – Examples, Ideas & Comments

by WHAHC Community Team -
Number of replies: 8
HaH Regulation – Examples, Ideas & Comments

The regulatory environment is one of the main challenges in the Hospital at Home model. Hospital at Home is not fully implemented in the health system and in most cases is governed by regulations that are not uniformly applied or monitored. What are the regulations in your own country? What should be changed or improved? 

Please share examples and ideas and learn from the other countries experience!

To reply to this post, please click on the "Reply" link below on the right.


In reply to WHAHC Community Team

Re: HaH Regulation – Examples, Ideas & Comments

by Itamar Offer -
Hi All
Hospital at Home (acute care) exists in Israel for 2 years.
The Israeli ministry of health had just issued a draft of the Guidelines and standards for providing HaH services in Israel.
I'm sharing a translation that was made for the purpose of this discussion and will be happy to get your comments, ideas, reservations etc.
Itamar
In reply to WHAHC Community Team

Re: HaH Regulation – Examples, Ideas & Comments

by Elisabeth Crisci -
Hi all and thank you for initiating this thread which couldn’t be more timely. My name is Elisabeth Crisci and I am a hospitalist on Vancouver Island in British-Columbia, Canada. We are in the process of developing our very own HaH program to launch in September 2020. We also have encountered legislative barriers but we will be meeting shortly with our provincial MOH to hopefully spear this initiative forward. We were told that all we need is a Ministerial order in favor of HaH. We are pretty confident we will get there!
Itamar, I really liked the document you shared, it's exactly the sort of guidelines / standards we will be looking for but I'm wondering if it should also have a section in there about escalation / repatriation. Thank you!
In reply to Elisabeth Crisci

Re: HaH Regulation – Examples, Ideas & Comments

by Karen O'Leary -
Hi Elizabeth

The state of Victoria in Australia has had a hospital in the home program for acute admitted care for over 25 years. Al state run hospitals and some private hospital offer acute home-delivered care. Last year hospital in the home across the state provide admissions equivalent to 700 or so acute hospital beds.
Home-delivered care is seen and treated as a virtual ward / clinical unit. Therefore all legislation, funding, admission criteria, quality metrics etc. are identical to those use / applied to in-hospital care. The guidelines for the program are several years old under review but you may find them of interest https://www2.health.vic.gov.au/hospitals-and-health-services/patient-care/acute-care/hospital-in-the-home.
Karen
In reply to WHAHC Community Team

Re: HaH Regulation – Examples, Ideas & Comments

by Beatriz Massa -
In Spain there is no common state regulation that regulates hospitalization at home and it is each autonomous community that assumes these powers.

This has generated an irregular and heterogeneous implementation.
Sehad,within its strategic plan, will present in the next National Congress of Alicante (April 2020) the consensus document that defines the entry criteria and the portfolio of services
In reply to WHAHC Community Team

Re: HaH Regulation – Examples, Ideas & Comments

by Mariana Borges Dias -
Hello everybody:
Here in Brazil we have a well established national public program focused in HAH, to whole country since 2011, with almost 1200 teams working nowadays, with prospects for expansion to more than 1500 teams still in the first half of 2020.
In the private initiative we have more than 400 home care companies, many of them operating in the Hospital at Home logic, but with still fragile and heterogeneous self regulation.
In reply to Mariana Borges Dias

Re: HaH Regulation – Examples, Ideas & Comments

by Itamar Offer -
Mariana, thanks for the update.
Can you please share with us, what types of patients / clinical situations are included under the description of HaH in Brazil? Home Hospice Patients? Rehabilitation? Long term Chronic care? Acute Care? Psychiatry? etc.
thanks
Itamar
In reply to Itamar Offer

Re: HaH Regulation – Examples, Ideas & Comments

by Mariana Borges Dias -
Hi Dr Itamar, thanks for ask!
Here in Brazil ,only in our public program of HAH ,we managed to serve around 48 thousand people per month. A large number is care for chronic and rehabilitation, but our focus is on the acute, acute chronic, antibiotic therapy, palliative care and complex situations such as invasive and non-invasive home mechanical ventilation. Our patients are 68%> 60 years old, but we serve any age group.
In reply to WHAHC Community Team

Re: HaH Regulation – Examples, Ideas & Comments

by Amanda Brown -
Hello everyone! I am a part of a new Hospital at Home program that just started up this past November (2022) in the united States. We seem to be struggling with safe medication administration when patients want to utilize their own medications. The issue seems to arise when we need to do virtual visits. We are currently trying to prepare medications beforehand and place them in packages with a label that states what is in the package. We identify the medications on our pharmacy site called Micromedics that includes pictures of what every medication looks like. The issue is that no one feels it is a safe practice to administer medications that were set up by others. I am wondering what you all have tried and found to be effective as far as safe medication is involved.