Dr Richard Lucas outlines the new Hospital in the Home (HITH) Service at Lismore Hospital
What is the HITH service?
HITH is an alternative, patient focused, easy to access, voluntary, cost-neutral model of care for acute and post-acute medical patients to be treated outside the hospital inpatient setting.
The model of service delivery is offered as either “in-centre treatment” where the patient returns to the Lismore Base daily or goes to the relevant community health service for treatment. Alternatively, where possible, the service provides treatment in the patient’s home or at the Residential Aged Care Facility (RACF).
Care is provided by appropriately trained registered nurses or a physiotherapist.
The HITH physician also operates clinics at Lismore Base Hospital three times weekly to review patients whose illness requires closer monitoring.
The HITH entry criteria dictate that the patient is an admitted inpatient to LBH.
What are the advantages of hospital patients treated with the HITH service at home?
Patients usually prefer to be treated at home. This is an option if all relevant issues have been reviewed. The aims of the service are explained to the patient and any concerns they have are addressed.
Patients have better health outcomes sooner when treated in their home environment and the HITH service is also more cost-effective than hospital-based inpatient care.
Where is the HITH service located?
The HITH service for Lismore Local Health District is currently located in the Emergency Department at Lismore Base Hospital. The HITH clinic/office is expected to move soon to a larger alternative suite at LBH that can accommodate this new ambulatory care model.
How is the HITH service staffed?
The HITH staff at Lismore Hospital includes five experienced registered nurses, one specialist physician and one physiotherapist.
What geographic area does the Lismore-based HITH team service?
The service covers the Lismore, Casino and Ballina catchment areas.
What clinical conditions are usually managed by the HITH service?
The list of diagnoses commonly treated by our HITH service currently includes:
- skin and soft tissue infections
- lower respiratory infections eg stable pneumonia, bronchiectasis with pseudomonas colonisation
- acute pyelonephritis
- post-operative infections
- joint and bone infections
- endocarditis
- bacteraemia
- venous thrombo-embolic problems transitioning from heparin to warfarin
- type 2 diabetes patients requiring transition to Insulin
- decompensated heart failure and pulmonary hypertension
- hypovolaemia related to diarrhoea, hyperemesis etc
- selected geriatric patients with cardio-respiratory problems and physical deconditioning
- neuromuscular disorders requiring home physiotherapy
This list will expand over time.
Are there any unsuitable patients?
Yes:
- Patients who live outside the Richmond network, Ballina LGA (excluding Nimbin)
- Aggressive or acutely mentally ill patients
- Patients and carers with a poor understanding of their medical condition
- Active drug and alcohol issues
- Aggressive dogs
- No home telephone or mobile phone
How do I refer a patent directly to HITH?
The working hours for the service are 0800 to 1800 hrs 7 days a week and contact is made through the on call HITH Nurse on 0401 711 688.
Dr Richard Lucas, HITH physician, may also be called on request for specific clinical advice during the office hours 0800 to 1700 hrs Monday to Friday on 0408 897 694.
Further information about HITH is listed in the North Coast Health Pathways
