Hospital at Home care models - evaluation and quality assurance

By developing an evaluation concept and supporting network activities for quality assurance, the project aims to promote the understanding of the success conditions of this integrative form of care.

Factsheet

Situation

Hospital at Home (HaH) is a new form of care in Switzerland that aims to foster patient autonomy. HaH is defined as the treatment of patients in their own homes by interprofessional teams and supported by technology, with the aim of avoiding hospitalisation (admission avoidance) or shortening it (early supported discharge). Hospital-equivalent HaH care models are currently acting as ‘pilot projects’ whose funding is not secured in the long term. In order to integrate HaH into the healthcare system, scientific evaluation and quality assurance are required. It is unknown which indicators are suitable for presenting and assessing the quality, safety, satisfaction and cost-effectiveness of HaH models. The Swiss Hospital at Home Society (SHaHS) has developed a draft for a minimum data set (MDS), but this has not yet been scientifically validated.

Course of action

The interdisciplinary team at BFH, consisting of the Department of Health and the Department of Engineering and Information Technology, works together with the SHaHS. Founded in November 2023, the Society aims to establish the HaH form of care in the Swiss healthcare system and acts as an exchange partner and link to Swiss HaH providers and representatives of Spitex. Through workshops and close exchange between BFH, SHaHS and three active HaH providers (Klinik Arlesheim, Zollikerberg Hospital, Hospital@Home-AG), concepts for generating comparable data will be developed. Based on the analysis of the current situation, the first step is to develop a concept for implementing the MDS at the HaH providers and, building on this, to create a draft for a joint quality network. Furthermore, a concept for the presentation of patient and family satisfaction will be developed. In addition, the project aims to identify the gaps in the use of technology in patient care and the interprofessional flow of information. A further objective is the development of a concept for a standardised survey of the cost structure at the HaH providers and the measurement of cost and benefit aspects.

Result

The project aims to develop an evaluation concept that helps to generate practice-relevant and comparable data in terms of quality, safety, satisfaction and costs or costs/benefits. Quality-orientated network activities and the development of customised technological support tools are intended to support the progress of HaH.

Looking ahead

The evaluation and quality assurance concepts will be piloted and implemented in externally funded projects with the HaH providers. The expected results should further the understanding of the conditions for success and (cost-) effectiveness of the new form of care and contribute to its integration into the healthcare system. The concepts developed will also be used as a blueprint for future HaH programmes in order to support their implementation.

This project contributes to the following SDGs

  • 3: Good health and well-being