Hospital in the Home (HITH) provides acute care to public hospital patients in the comfort of their home or other suitable environment. There are a core set of conditions for which HITH is the preferred care model, such as intravenous antibiotics for infections, anticoagulant therapy for deep vein thrombosis and pulmonary embolus.
Research findings demonstrate that patients have improved outcomes and recovery at home with fewer complications such as infection, delirium and confusion.
An alternative to an inpatient stay
HITH is an alternative to an inpatient stay. Patients are still regarded as hospital inpatients, and remain under the care of their hospital doctor. Care may be provided by a nurse, doctor, or allied health professional, with additional home supports arranged as required.
Patients can be offered this option if care can be delivered safely at home. Participation is voluntary and there is no charge to patients.
HITH programs are funded through casemix payments for which the unit of payment is a Weighted Inlier Equivalent Separation (WIES).
HITH is reported through VAED and subject to the same audit process and monitoring as acute admitted activity.
People who can access HITH
HITH can be accessed by any patient of a public hospital who is:
- assessed as being clinically stable
- appropriately supported in the home; for example, by a carer or other appropriate person
- living in a suitable environment with access to a telephone
- suitable for HITH treatment
- willing to be treated by HITH.
Referrals to HITH
Referral to HITH is generally made by a hospital doctor or nurse. However, for some programs, affiliated general practitioners can refer patients.
Patients may be admitted to HITH in different ways, depending on their condition and treatment. Some patients may be directly admitted from the emergency department or the community. They may have a stay in hospital first, and then be transferred into HITH to continue their treatment (for example, after surgery or after their condition has stabilised).
There are 52 HITH service sites across Victoria.
Alternatives to HITH
If a patient does not meet the acute admission criteria but requires specialist care in the community, there are a range of programs that may be appropriate.
Health Independence Programs
Health Independence Programs (HIP) aim to provide hospital substitution and diversion services by supporting people in the community, in ambulatory settings and in their homes.
HIP focuses on improving and optimising people’s function and participation in activities of daily living to allow them to maximise their independence and return to, or remain in, their usual place of residence.
HIP services consist of six components, which are:
- ambulatory rehabilitation
- access to specialist services, including specialist assessment
- short-term supports
- care coordination - short term or complex
- complex psychosocial issues management
- client self-management, education and support.
Review and guidelines
In 1994 the HITH began as a pilot program as part of a strategy to provide patients with greater healthcare options by incorporating home-based care in an episode of acute care.
In 2009 an independent review confirmed that HITH as a well-established model of care that is safe and effective and highly valued by patients, carers and staff.
As a result of the review recommendations, the HITH guidelines were reviewed, updated and distributed to health services at the end of 2011.
These guidelines outline appropriate governance, staffing models, policies and practices to deliver high-quality HITH services.
- aim to ensure HITH is acute care substitution
- outline service capability and quality standards
- assist services to provide HITH within appropriate governance and funding structures
- aim to promote consistency of access
- reduce variation of service profiles across the state within the context of a complex service system.
HITH mobile computing guide and toolkit
The HITH mobile computing guide and toolkit were developed by the Department of Health & Human Services and the Australian Centre for Health Innovation. They are aimed at HITH services but may be applicable to other home visiting services.
Help with choosing computers and mobile devices
The goal of the guide and toolkit is to provide information for organisations to make an informed decision about computing and device selection.
Please read the guide before progressing to the toolkit.
The toolkit survey has four sections:
- Project Preparation
- Clinical Process
- Software Considerations
- Hardware Considerations.
A summary report on the best options
On completion of the survey a summary report will be issued. This will reflect the requirements identified and suggest the type of device that will most suit the organisation's stated needs.
The suggested devices are generic in nature, either iOS, Windows or Android. Examples of laptops and tablets are provided within functional groups. The functional group is recommended, rather than a specifically named device, because there are new device options becoming available all the time.
Any reputable manufacturer or model that matches the requirements should be investigated.