Wed 18 December 2024
30 years of hospital in the home!
Hospital in the Home (HITH) services deliver clinical hospital care to hospital inpatients in their homes.
While HITH services provide economic benefits by reducing the cost of care, the benefit to patients and their families is the avoidance of prolonged hospital stays for lengthy courses of intravenous therapy to treat a broad range of conditions. A significant aspect of HITH services is provision of intravenous therapy (mainly antibiotics, including Outpatient antimicrobial therapy (OPAT) programs), anticoagulation, wound care and chemotherapy for suitable patients in their own homes.
The benefit to the health system is significant; in 2010 the Victorian HITH program was equated to a 500-bed hospital and has potential for substantial growth; a recent KPMG report noted that HITH programs can treat up to 30% of diagnoses currently treated in ‘bricks and mortar’ hospitals.
Pharmacists and pharmacy services are key to HITH services as administration of medicines, commonly by the intravenous route, is the main reason the patient needs ongoing hospital-provided care. HITH is possibly the first instance of clinical pharmacy services extending beyond the hospital walls.
As HITH was being accepted as a vital model of care in the early 90s, SHPA convened a Committee of Specialty Practice in Home Health Care, which authored the 1998 SHPA Standards of practice for parenteral therapy in home health care to support quality care for hospital inpatients bring treated in their homes, noting the provision of HHC [HITH] requires the team effort of health professionals, including doctors, nurses and pharmacists. The pharmacist’s role is the optimisation of pharmaceutical services provided to patients in this setting. AdPha’s recently published Standard of practice for pharmacy services specialising in transitions of care echoes this sentiment.
As technology and therapeutics advance, more patients will be able to receive their hospital care in the home. Many AdPha members are integral members of the HITH team and optimise medication safety through their key roles compounding, researching stability and innovative delivery methods, modifying dosage regimens, antimicrobial stewardship and more.