Beyond Hospital Walls: A Nurse’s Perspective
For London Davis, being with a patient in their home is a special experience. “It’s the ultimate healing environment,” she explains. Davis is a nurse for the Huntsman at Home™ program at the Huntsman Cancer Institute.
“Patients have their own smells, pets, and photos,” she continues. “They have the support of family, friends, and neighbors.” And as their nurse, she makes sure they have what they need for a successful outcome.
Giving Patients Autonomy in Their Healing
University of Utah Health’s Heal at Home is another home-based care program. Now live in 13 specialties, Heal at Home is transforming how we deliver care. In collaboration with Community Nursing Services (CNS), U of U Health providers offer safe and effective post-acute care from the comfort of a patient’s home.
Heal at Home gives patients autonomy in their own healing journey.
Davis remembers being anxious to see her first prostatectomy patient at home. It’s not typical to return home the same day after a procedure like this. But Davis was amazed to see how well the patient was doing. They were wearing their own clothes, sleeping well in their own bed, eating their own food, and controlling their pain well.
Staying in the hospital post-op wasn’t necessary. “We were able to do everything they needed at home,” Davis remembers. “I just had to come in and provide ongoing monitoring.”
Recommending a Patient for Home Care
There are a lot of considerations when recommending a patient for home care. A rigorous screening process helps us know who is likely to have successful outcomes at home.
Emergency department readmission rates for home care patients are similar to those who stayed in the hospital. But Heal at Home patients are much more satisfied with their experience. Ninety-four percent of them say they are “likely or very likely” to refer someone to the program.
Seamless Communication and Preparation
“The program takes a big team effort,” Davis says. “A lot of amazing clinicians and very experienced providers come together to make sure it’s successful.”
Transitioning from the structured hospital environment to the dynamic setting of a patient’s home can be a big change for care providers. CNS helps ease that transition.
Bumps in the road—often related to anesthesia—are normal after surgery. The community nurse and referring provider establish quick, efficient communication so patients get the care they need.
Heal at Home leans on the collective intelligence of the team. Detailed protocols, thoughtful decision-making processes, and individualized care also distinguish this program.
The nurse providing in-home care learns what supplies they need to have and what to stock in their bag and car from the hospital. “Good preparation before you get there is essential,” Davis explains. “It’s cool to think outside the box and come up with solutions in the home setting. Like, where can we hang this IV bag? Or how can we make sure this wound care is working?”
Fundamental Shift in Health Care
Davis’s experiences as an in-home nurse reflect the essence of providing innovative care beyond hospital walls. We believe Heal at Home stands at the forefront of a fundamental shift in health care. Beyond healing bodies, we are going home with the patient to deliver compassionate, genuine, personalized care.
Juan Hernandez, RN, MSN
Juan Hernandez is a senior nursing director at University of Utah Health and one of the founding members of the Heal at Home program. He is nationally recognized for his research on enhancing transitions of care from the hospital to home and nursing leadership development. Hernandez completed a Bachelor of Nursing at the University of Utah and a Master of Nursing Leadership at Weber State University.
Jared Huber, MD
Jared Huber is an assistant professor of internal medicine at the Spencer Fox Eccles School of Medicine at the University of Utah and hospitalist for University of Utah Health and Huntsman Cancer Institute. Huber was recently appointed Medical Director of Home-Based Care at U of U Health, a strategic pillar of U of U Health Population Health and the Medical Group. His primary research interests focus on transitions of care, specifically on home-based care and its development and implementation at the University of Utah. Huber completed an MD at the Perelman School of Medicine at the University of Pennsylvania and completed an internal medicine residency at Oregon Health & Sciences University.
Joel Macey is president and CEO of Community Nursing Services (CNS), a non-profit home health and hospice organization established in 1928 to serve communities throughout Utah. Prior to CNS, he was a senior leader for Intermountain Health. Macey is a CNS board member and a member of the Utah Commission on Aging.