PDF(Pubmed)
Abstract：
Hospital at Home (H@H) programs-which seek to deliver acute care within a patient\'s home-have become more prevalent over time. However, existing literature exhibits heterogeneity in program structure, evaluation design, and target population size, making it difficult to draw generalizable conclusions to inform future H@H program design.
The objective of this work was to develop a quality improvement evaluation strategy for a H@H program-the Kaiser Permanente Advanced Care at Home (KPACAH) program in Northern California-leveraging electronic health record data, chart review, and patient surveys to compare KPACAH patients with inpatients in traditional hospital settings.
The authors developed a 3-step recruitment workflow that used electronic health record filtering tools to generate a daily list of potential comparators, a manual chart review of potentially eligible comparator patients to assess individual clinical and social criteria, and a phone interview with patients to affirm eligibility and interest from potential comparator patients.
This workflow successfully identified and enrolled a population of 446 comparator patients in a 5-month period who exhibited similar demographics, reasons for hospitalization, comorbidity burden, and utilization measures to patients enrolled in the KPACAH program.
These initial findings provide promise for a workflow that can facilitate the identification of similar inpatients hospitalized at traditional brick and mortar facilities to enhance outcomes evaluations for the H@H programs, as well as to identify the potential volume of enrollees as the program expands.
The objective of this work was to develop a quality improvement evaluation strategy for a H@H program-the Kaiser Permanente Advanced Care at Home (KPACAH) program in Northern California-leveraging electronic health record data, chart review, and patient surveys to compare KPACAH patients with inpatients in traditional hospital settings.
The authors developed a 3-step recruitment workflow that used electronic health record filtering tools to generate a daily list of potential comparators, a manual chart review of potentially eligible comparator patients to assess individual clinical and social criteria, and a phone interview with patients to affirm eligibility and interest from potential comparator patients.
This workflow successfully identified and enrolled a population of 446 comparator patients in a 5-month period who exhibited similar demographics, reasons for hospitalization, comorbidity burden, and utilization measures to patients enrolled in the KPACAH program.
These initial findings provide promise for a workflow that can facilitate the identification of similar inpatients hospitalized at traditional brick and mortar facilities to enhance outcomes evaluations for the H@H programs, as well as to identify the potential volume of enrollees as the program expands.
摘要：
背景随着时间的推移，寻求在患者家中提供急性护理的医院在家(H@H)计划变得越来越普遍。然而,现有文献在程序结构上表现出异质性，评估设计，和目标人口规模，这使得很难得出可概括的结论来为未来的H@H程序设计提供信息。目标这项工作的目的是为H@H计划开发质量改进评估策略-北加州的KaiserPermanente高级家庭护理（KPACAH）计划-利用电子健康记录数据，图表审查，和患者调查，以比较KPACAH患者与传统医院环境中的住院患者。方法作者开发了一个3步招募工作流程,该工作流程使用电子健康记录过滤工具生成潜在比较者的每日列表,对潜在合格的比较患者进行手动图表审查，以评估个人临床和社会标准，以及与患者的电话访谈，以确认潜在比较患者的资格和兴趣。结果此工作流程成功识别并招募了5个月内表现出相似人口统计学特征的446名比较患者。住院的原因,合并症负担，以及对KPACAH计划中登记的患者的利用措施。结论这些初步发现为工作流程提供了希望，该工作流程可以促进识别在传统砖混设施住院的类似住院患者，以增强H@H计划的结果评估。以及随着程序的扩展，确定潜在的注册人数。
