In 2020, the word “home” has taken on a new meaning, with many people spending more time at home than ever before. Likewise, the word “ventilator” has been used probably more times in 2020 than it has in all of human history. Many people learning what exactly a ventilator is for the first time.
This brings us to our topic of home ventilator program, which to be clear is not a new concept. These programs have been around since before the pandemic and we recently spoke with AARC member, Denise Willis, RRT, RRT-NPS, AE-C, who is currently working at Arkansas Children’s Hospital, about what it takes to run a successful home ventilator program.
Defining your program goals
“Simply put, a home ventilator program is a comprehensive service focused on providing care to individuals requiring long-term mechanical ventilation outside of the hospital setting,” Willis said.
According to Willis, the goal of a home ventilator program is to safely discharge patients into their own homes and provide ongoing care and management.
“A multi-disciplinary care team is one of the main components of a successful program,” Willis said.
Weigh the Pros and Cons
Willis provided us her own list of pros and cons for developing a home ventilator program:
- Home ventilator programs do a great job of training patients and families to prepare for discharge at home.
- They often have standardized practices and streamlined processes to provide a seamless transition from hospital to home.
Be Mindful of These Challenges:
- Once the initial goal of discharge home is achieved, available support tends to gradually decline. Care does not stop once the patient goes home. It is ongoing and requires an outpatient team to manage and coordinate continued care.
- Evidence-based practices for home care of ventilator dependent individuals is limited. More research is needed for best practices for ventilator liberation and tracheal decannulation. A national home ventilator registry is needed.
- Because of the complexity of these patients and multiple specialists typically involved, care can become fragmented and some patients may become lost to follow-up or some aspects of care overlooked.
- The resources available for home care are generally limited. This includes equipment, supplies, therapies and in-home care services such as home nursing.
The list of pros and cons helps us to see what is still needed to make sure home ventilator programs best support the patient. How does one ensure in this current climate that patients receive the best care possible?
“A designated coordinator is vital for the success of the program,” Willis said. “Depending on the institution’s structure, it may be necessary to have both an inpatient and outpatient program coordinator. This can help bridge the gap between the inpatient and outpatient care team and prevent patients from becoming lost to follow-up.”
- Stay informed of the latest research and best practice guidelines for this patient population.
- Ensure all stakeholders are involved in decisions impacting the care of these patients.
- Keep communication between all involved specialists strong.
Connect with Denise on AARConnect.
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