Ashlee Baird1, Julien Graciet1, Simon McHugh1, Isaac Wedderburn1, Julie Depiazzi1, Denisha Lee1, Dr Andrew Wilson1, Dr Andrew Martin1, Dr Cloe Benz PhD1
1Perth Children's Hospital, Nedlands, 15 Hospital Avenue
Abstract:
Introduction:
Hospital in the Home (HITH) provides acute inpatient equivalent care at home. Recent HITH expansions, including multidisciplinary care models, enables more patients to be cared for at home. HITH can positively impact cost of living pressures for families and improve patient flow challenges. Since 2006, Perth Children’s Hospital’s (PCH) HITH has offered part-time physiotherapy cover, and in 2024, a pilot was funded to expand this service.
Methods:
The HITH Physiotherapy expansion launched on April 15, 2024, increasing staffing from 0.7 FTE to 2.2 FTE across 7 days/week. A Plan-Do-Study-Act (PDSA) model was used, beginning with chronic respiratory patients transferred from a ward. Three new referral pathways were introduced: direct to HITH, Hospital Avoidance, and HAPI Outreach. Data collection included consumer and referrer feedback, admission, treatments, travel, bed days, and clinical costings data.
Results:
To-date at week 46, for 65 admissions, 967 physio sessions were completed, up from 240 in 2023. Over 75% of families live >20kms from PCH, with an average travel time of 31min. HITH substituted 678 hospital bed days, allowing more young people to access hospital-based care and an estimated $1,499,736 cost-reduction. Net promoter scores were excellent for consumers (+93) and referrers (+72), with overwhelmingly positive written feedback. The 52-week data set will be completed on April 13, 2025.
Conclusion:
HITH physiotherapy’s expansion measures positively across all metrics, is well received and provides high quality care. Future considerations include strategies for service coverage across geographical locations given that many families live a significant distance from the hospital.