RecruitingNot ApplicableNCT06396897

Hospital @ Home Model of Care for Cirrhosis

The Hospital @ Home Model of Care: A Novel Healthcare Solution for the Management of Decompensated Cirrhosis

Sponsor

Indiana University

Enrollment

30 participants

Start Date

May 10, 2024

Study Type

INTERVENTIONAL

Conditions

Decompensated Cirrhosis

Summary

The purpose of this study is to work with patients diagnosed with end-stage liver disease to understand their perspectives on the Health at Home (H@H) Program, including desired outcomes and expectations, perceived barriers, and drivers. H@H is an emerging model of home-based care, designed to extend traditional, inpatient hospital care which may address these needs. Through H@H, acute medical care services as well as ancillary care such as rehabilitation therapy can be delivered in the home. The study is divided into three phases: Phase 1 occurs while the participant is an inpatient. Phase 2 is when the actual H@H program takes place as part of the participant's clinical care. The study team will not be involved in the Phase 2 - H@H program as it will be conducted by the clinical staff. Phase 3, at which point the participant enters a rehabilitation phase to transition the patient to self-management, involves a research jam session with the participant and caregiver to assess the value of the program.

Eligibility

Min Age: 18 Years

Inclusion Criteria8

Enrolled into IUH's H@H program
At least 18 years of age
Chronic liver disease/cirrhosis based on characteristic clinical, laboratory, and imaging findings
English speaking
Able to provide consent
Caregiver able to be present during the acute phase of care (first 48 hours post-hospital discharge)
Able to perform activities of daily living independently
Lives within IU Health Home service area

Exclusion Criteria9

Unable to complete study questionnaires due to neurocognitive disease, legal blindness or hearing loss
Transplant of organ other than liver
Pregnant
Incarcerated
New hemodialysis
Blood pressure < 90/60, Pulse > 120, O2 > 6L or >2L above baseline
HIV+/CD4 count < 200
Receiving hospice services
Concurrent enrollment in a related research study

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Interventions

OTHERIndiana University Health Hospital at Home Program

Structure of Care in IUH H@H Program: The IUH H@H program allows patients to be cared for at home using home remote monitoring devices, travel laboratory services and both in-person and virtual rounding by the health care team. The team includes registered nurses (RN), advanced practice provider (APP, nurse practitioner and physician assistants) and hospitalist physician. Care at home is divided into 4 consecutive phases after initial hospitalization: (1) evaluation/planning, (2) acute, (3) recovery, and (4) rehabilitation. All patients are sent home with a RPM tablet used to obtain vital signs, send messages between patient and RN, \& perform video visits. The device is Bluetooth enabled and does not require WiFi or a phone line. All data obtained is automatically pulled into the electronic medical record. The RN uses a device which enables remote physical exams, i.e., obtain heart, lung and bowel sounds, pictures (wounds, lines, etc.) for review by APP/MD.