WellSpan at Home

 Technology 

Agency:
WellSpan Visiting Nurse Association in York, Pennsylvania.

Agency Description:
For more than 100 years, WellSpan VNA has served the eastern Pennsylvania population. It is understood that the best place to treat the body is where the heart is—at home. Often when patients are recovering from an illness or accident, are disabled, have a chronic illness, or are terminally ill, they do not need to be hospitalized, but do need health care assistance. The Community Services program enables clients to remain at home, maintaining the quality of life with which they are accustomed to living. Private duty services are customized to fulfill the patient’s individual home care needs, including assistance with daily living, assistance with personal care, meal preparation, light housekeeping, and respite care.

Population Impacted:
All at-risk patients.

Strategic Partners:
Critical Signal Technologies (CST). CST provides the technology and call center support. Further information on CST can be found here.

Project Description:
Beginning on March 1, 2013, all WellSpan VNA patients now receive a “nurse call button” that they are instructed to “push for any reason.” When the button is pushed, a call center contacts the patient asking how they can assist. Services include reviewing discharge orders, arranging for groceries to be delivered, and providing a medication reminder. The call center will also contact the doctor for a new appointment on behalf of the patient. The call center provides virtually anything the patient needs. The goal is to provide discharge security in the home upon admission to home health. All patients receive the button for the first 60 days after hospital discharge with the option to extend the service.

Results:
To date, we have seen strong service improvement and lower rehospitalization rates. Thus far, 105 high-risk patients avoided the emergency department because of intervention.

Outcome Measures:
To date, the average patient pushes the button 3.4 times within the first 60 days of the service. The acute care hospitalization metric was reduced by four percent. However, it is unclear if this is just the patients who have call buttons. It is difficult to determine if the reduction was caused by the call button or by nursing intervention. The organization is currently examining the results of WellSpan At Home (WAH) patients and non-WAH patients.

Barriers to Implementation:
There were some technical issues with devices in the home and language barrier issues. CST would not have the exact language interpreter available when needed.