Care Where You Need It

Coming home from the hospital after receiving treatment for COVID-19 can be understandably distressing. “COVID is such a new thing, and it affects everybody differently,” says Kim Zaverton, RN, nurse care manager at UHS. “No one knows exactly what to expect.”

For Bonnie and Jim VanAbs, a couple from Harpursville, N.Y., who tested COVID-positive in late January, recovery was complicated by a broken foot and concussion.

“My husband had a deep cough—we thought it was pneumonia—and I wasn’t feeling well either, so I decided to sleep on the couch, and Jim was on the other couch,” says Bonnie. “I got up in the middle of the night to go to the bathroom and I fell down the stairs.”

The next day, Bonnie visited her orthopedic specialist and learned she had broken her foot. On that same day, COVID tests she and Jim took earlier in the week at their primary care provider’s office came back positive. Two days later, both she and Jim were feeling sick. After seeing how sick they were, Bonnie and Jim’s children took them to UHS Wilson Medical Center where they were treated for COVID for about a week.

Although Bonnie and Jim received close attention from UHS providers while staying in the hospital, it didn’t end there. The VanAbs were among the first patients to take advantage of UHS’ new Hospital Care at Home Program.

Continuing Care

“As a rural medical director, there are two guiding principles that I am always working to accomplish: getting patients home, whether that means to their actual home environment or their local hospital, and keeping patients at home,” says John Giannone, MD, rural medical director and medical director of nyuhs.org’s Virtual Health. “The question we asked with UHS Hospital Care at Home was: Can we get patients who have been admitted with COVID-19 out of the hospital and back into their homes?”

Dr. Giannone explains that the UHS Hospital Care at Home Program offers patients many benefits. “These are patients who may not be completely symptom-free,” says Dr. Giannone. “Some are still on oxygen, having never been on oxygen before. They have the comfort of knowing they will get a call and/or visit from a provider every day. There are constant touch points throughout the day between UHS providers and patients in the program.”

The providers working with Dr. Giannone and others at UHS experience firsthand how this program makes COVID-19 recovery easier.

“I haven’t had a patient yet who didn’t appreciate it—even patients who were leery at first,” says Karena Trimball, RN, CEN, nurse in the UHS Wilson Care Management Department. “We talk to the patients and give them guidance. Recently, a patient was admitted to the program. The patient’s spouse was having COVID symptoms. We were able to coordinate someone going into the home to perform a COVID swab. She was negative, so I provided guidance on social distancing and safety. It becomes a family affair.”

The VanAbs were grateful for the follow-up care they received through the UHS Hospital Care at Home Program, even if it took Jim a day to warm up to the idea.

“The doctor would call us every day, and then we had a nurse that would come to visit us,” says Bonnie. “My foot was broken, and my husband was on steroids, and he was a little out of it—he’s never taken drugs in his life. He was miserable until my daughter brought up hunting. We have a deer head in our living room, and Jim loves to hunt. The nurse started saying that she goes deer hunting with her husband and family.

It was awesome because at first Jim was saying ‘I don’t need anyone,’ and after that he would say ‘Oh, she can come.’”

“It gets to be like you’re having a visit with a friend,” says Dr. Giannone. “For the patient, it’s a tremendous emotional support, and for the family, they’re not just left out there trying to care for their family member without support.”

Growing Strong

For the dozens of patients who have participated since the UHS Hospital Care at Home Program started in December 2020, it has been a win-win situation: Patients get to stay home or stay local, where they feel comfortable, and still receive the benefits of physician monitoring like they would in the hospital. For the community, it means that more beds are open at UHS hospitals for people who need them.

After a couple weeks of monitoring through the UHS Hospital Care at Home Program, Bonnie and Jim VanAbs felt much better.

“The COVID part is completely gone, and if it wasn’t for my foot, I’d be in great shape,” says Bonnie. “Jim is doing really well—he even went out this morning and cleared the driveway of snow, so the nurse who is visiting us could get in. He’s also helping take care of my foot, helping me get up and down the stairs and waiting outside while I take a shower to make sure I’m OK.”

Both Bonnie and Jim would recommend the program to other patients, which is a good thing because UHS Hospital Care at Home will only expand from here. While it is currently only available to COVID-19 patients, the success of the program has UHS physicians and administrators eyeing an expansion into chronic disease management and more.

“It was always the intention to expand this program into a larger disease management program,” says Dr. Giannone. “And we are really looking to broaden the whole concept. I remember, not more than two years ago, [President of UHS Medical Group] Dr. Alan Miller said, ‘There will come a time when the hospital is going to be in the patient’s living room.’ That idea was a seed, and we have grown from there, but there is a lot more room to grow.”