Background: A growing number of homebound frail older adults have multiple chronic diseases with frequent flare-ups of acute episodes. A physician house call program affiliated with a nonprofit community health system was deployed as a strategy to improve quality of care for homebound patients. Program Description: A medical team (either a physician and a medical assistant or a nurse practitioner), with a vehicle filled with portable medical equipment and supplies, fulfills the house call and primary care physician functions, establishes diagnoses, designs a treatment plan, arranges for any other needed services, and fosters continuity of medical care. Evaluation: Interviews and focus groups with selected patients, family caregivers, program staff, and other service providers indicated that the program operated consistently with its intent. For example, the patient and caregiver interviews converged on four major themes: (1) the program improves patients' medication and health management and optimizes health, (2) caregivers felt more informed about the patients' medical conditions and medications and relieved of the burden of transporting patients to physicians, (3) the program reduces use of hospital and emergency services, and (4) the programs enables patients to die at home. Discusson: The success of any future programs and further replications will depend on creating trusting relationships with local service providers and getting decision makers of affiliated community health systems or hospitals to embrace the necessary vision.
Document Type: Research Article
Publication date: May 1, 2004
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Published monthly, The Joint Commission Journal on Quality and Patient Safety is a peer-reviewed publication dedicated to providing health professionals with the information they need to promote the quality and safety of health care. The Joint Commission Journal on Quality and Patient Safety invites original manuscripts on the development, adaptation, and/or implementation of innovative thinking, strategies, and practices in improving quality and safety in health care. Case studies, program or project reports, reports of new methodologies or new applications of methodologies, research studies on the effectiveness of improvement interventions, and commentaries on issues and practices are all considered.
Also known as Joint Commission Journal on Quality Improvement and Joint Commission Journal on Quality and Safety