Provider Collaboration to Treat COVID-19 Patients at Home

Abstract and Introduction

Abstract

In March 2020, COVID-19 cases were beginning to emerge in North Florida and concern over hospital bed capacity started to rise. Baptist Health System in Jacksonville, Florida quickly formed a multidisciplinary team to explore how we could increase hospital bed capacity. Utilizing the resources within our affiliated home healthcare agency, an Enhanced Home Support Model (EHSM) with a COVID-19 protocol was developed. The protocol was implemented by home health nurses and included COVID-19 testing, blood tests, and the ability to start oxygen at home on admission. Patients were provided self-monitoring equipment and information about self-isolating and infection control within the home. After the initial visit, the home health nurse and the primary care physician shared collaborative oversight through virtual visits. This article discusses how we initially approached identification of severity and the methods we used to implement the protocol. The results section offers information about the number of patients utilizing this protocol between April and December 2020; patient and physician satisfaction; and considers strengths and weaknesses of the program. In conclusion, the EHSM protocol allowed patients to receive high quality emergent care at home and increased access to hospital emergency departments and inpatient hospital beds for more seriously ill patients.

Introduction

In March 2020…concern over hospital bed capacity started to rise. In March 2020, COVID-19 cases were beginning to emerge in North Florida and concern over hospital bed capacity started to rise. Using a combination of demographic and clinical data gathered from seven weeks of COVID-19 patient care early in the coronavirus pandemic, Johns Hopkins (2020) researchers published a "prediction model" that was used to help hospital-based providers care for COVID-19 patients and make important decisions about planning and resource allocations. The Johns Hopkins COVID-19 prediction model showed a surge of COVID-19 cases with an extreme shortage of hospital beds within the Jacksonville and surrounding areas (Johns Hopkins, 2020).

Baptist Health System has five hospitals and over 200 primary care physicians and specialists serving the 5-county area in Northeast Florida. To prepare for the predicted COVID-19 surge, we created a multidisciplinary team led by a doctorally-prepared Advanced Practice Registered Nurse (APRN). Our goal was to reduce utilization of hospital and emergency department services by safely managing patients in their homes under an Enhanced Home Support Model (EHSM). Caring for mildly ill patients in their homes opened hospital beds for the patients with more severe illness.

This article discusses how we initially approached identification of severity in the population of those diagnosed with COVID-19, and the methods we used to implement the protocol. The results section offers information about the number of patients utilizing this protocol between April and December 2020; patient and physician satisfaction; and considers strengths and weaknesses of the program.