Breaking out of the hospital’s walls: Ubiquitous and seamless healthcare experiences

10 November, Wednesday, 15:10 – 16:40

Learn and be inspired by brief presentations of innovative programs, projects, and good practices from various organizations.

Hospital at Home: Breaking hospital walls in times of COVID-19
Presented by: Dr. David Nicolás
The presenters will explain their experience in coping with the COVID19 pandemic in a large tertiary University hospital in Barcelona by strengthening a Hospital at Home (HaH) program. Their HaH unit contributed to decongesting the hospital by treating COVID-19 patients in three different settings (as Hospital at home, in a Medicalized hotel and with a virtual hospital) providing different levels of care intensity. But also the HaH boosted other preexisting programs for non-COVID patients aiming to shorten the mean length of stay for patients at hospital. The presentation will provide key information in order to facilitate the extension of the model to other centres and systems.

Post-emergency ward oxygen-therapy at home during the early phase of COVID-19: A shift of paradigm for Hospital-at-Home
Presented by: Ghislain Promonet
The emergency department of the Argenteuil hospital and Fondation Santé Service’s hospital-at-home service (HAH) have built a process for COVID-19 patients who return home in the early phase and still require oxygen. The objectives of the project were to allow a safe return of patients at home and to preserve the bed capacity of the hospital for their most severe patients.
The process was set up in November 2020 and still operating in May 2021. From 5 patients per week, it has gone up to 7 per day. More than 450 patients were treated and up to 115 simultaneously.
The number of patients included, the number of hospitalizations avoided and patient satisfaction testify to the success of the project.
It has significantly made change French HAH model by enforcing quick admissions at home, integrating telemedicine, increasing the use of local nurses and sharing the data through the regional patient information system.

Final consultation by nurse as key to emergency care efficiency of a region hospital (GIDA)
Presented by: Meritxell López Hernández
An innovative healthcare management project “Infermera Management of Acute Demand” (GIDA) in response to the sustained increase in demand in the Emergency Department of Viladecans Hospital and recognizing the value of the nursing resource to contribute to the sustainability of the system.
A finalist consultation is created where an advanced practice nurse trained to diagnose and prescribe attends to minor acute pathologies in the emergency department.
GIDA goes beyond advanced triage, where delegated tasks are performed to improve patient comfort or advance tests while waiting to be seen by a physician. The objective of the GIDA is to provide a solution to the health problem presented by a patient by a nurse, in an agile and efficient way.
A transformation in the care of mild pathologies where the GIDA performs more than 30% of this activity, helping to reduce congestion and optimizing resources with the same quality and safety.

Making outpatient consultation patient visit demands and hospital capacity meet
Presented by: Maria Gutiérrez-San Miguel
Vall d’Hebron University Hospital has developed an adaptive methodology that merge organizational and care knowledge to help both clinicians and managers assign the required humans resources and hospital facilities that match patient and staff over-time-changing demands to make all care processes sustainable and value-based from a patient and professionals point of view. This methodology has been piloted for ophthalmology outpatient consultation (around 54.000 visits/year in the hospital) having as result the justification of less number of consultation cabinets that were firstly instinct-based requested.

Macro-process of surgical patient management: A value-based healthcare project
Presented by: Joana Seringa
The “macro-process of surgical patient management” project guides and defines the main activities, response times, and responsibilities at each of the stages of the surgical patient journey (from referral for the surgical specialty consultation to the postoperative follow-up consultations). This model is based on the best international practices and has the potential to be adapted to other healthcare institutions.
By defining and standardizing the journey of the surgical patient in the health system, this project allows for greater clarity of the entire process, potentially improving the effectiveness, efficiency, and satisfaction of professionals and the experience of the surgical patient.

The Queralt System: a new patient classification system for hospitalizations developed in Catalonia
Presented by: Marc Coca, Júlia Folguera Profitós and David Monterde
Comorbidity measures and Patient Classification Systems are extremely powerful tools for healthcare management, research, benchmarking or resources allocation.
Queralt System has been developed using machine learning algorithms and aims to offer patient-level scores (indices and groups) for diagnosis and procedures separately. Thus, the user can combine both perspectives in order to achieve better performance. 
This presentation aims to compare and evaluate the Queralt System outputs against other risk adjustment tools such as Charlson and Elixhauser Indices or Diagnoses Related Groups. On average, the presenters found that Queralt System offers better outcomes than previous mentioned tools in the following exercises:

  • As a measure of risk adjustment.
  • As a measure of comorbidity in order to predict critical outcomes in patients with COVID-19.
  • As a tool for resource allocation.