The Hospital @ Home Model of Care: A Novel Healthcare Solution for the Management of Decompensated Cirrhosis
M
Miranda Stovall
Primary Investigator
A
Archita Desai, MD
Primary Investigator
Enrolling By Invitation
18 years - 100 years
All
Phase
N/A
100 participants needed
2 Locations
Brief description of study
What is the purpose of this study?
The purpose of this study is to work with patients diagnosed with end-stage liver disease to understand their perspectives on the Health at Home (H@H) Program, including desired outcomes and expectations, perceived barriers and drivers. H@H is an emerging model of home-based care, designed to extend traditional, inpatient hospital care which may address these needs. Through H@H, acute medical care services as well as ancillary care such as rehabilitation therapy can be delivered in the home.
The purpose of this study is to work with patients diagnosed with end-stage liver disease to understand their perspectives on the Health at Home (H@H) Program, including desired outcomes and expectations, perceived barriers and drivers. H@H is an emerging model of home-based care, designed to extend traditional, inpatient hospital care which may address these needs. Through H@H, acute medical care services as well as ancillary care such as rehabilitation therapy can be delivered in the home.
THIS STUDY IS ENROLLING BY INVITATION ONLY - Prospective participants will be recruited from among the inpatient census of adults diagnosed with late-stage liver disease at IU Health University and Methodist hospitals. Participants who enroll in this research study will be asked to identify a primary caregiver who is at least 18 years old to participate in the study. Caregivers who self-identify as one who provides care for the afflicted person will be asked to participate as well and will be recruited while the person who has chronic liver disease is an inpatient. Prospective participants, including those affected with chronic liver disease and their caregiver, will be approached by study staff during the inpatient stay in a private room about study participation. If the caregiver is not available to be recruited in person, we will ask the patient to provide contact information so that we can reach out to the caregiver to recruit them in the study.
Detailed description of study
What will happen during the study?
The study is divided into three phases:
- Phase 1 occurs while the participant is an inpatient. Participants will be asked to complete two questionnaires and an open-ended interview (approx. 90 min) with CTSI Research Jam staff.
- Phase 2 is conducted solely at the home of the H@H participant as part of clinical care. The Hospital at Home program (H@H) is an innovative care delivery method that aims to provide hospital-level care at home and facilitate the transition care from the hospital to the home. The IUH H@H program allows patients to complete their hospitalization at home using remote patient monitoring (RPM) devices, laboratory services and both in-person and virtual rounding by the H@H team. The team includes registered nurses (RN), APP and hospitalist physician. Care at home is divided into 4 consecutive phases after initial hospitalization: (1) evaluation/planning, (2) acute, (3) recovery, and (4) rehabilitation. The (1) evaluation/planning phase occurs in the 24 hours after enrollment.
- Phase 3, at which point the participanthabilitation phase to transition the patient to self-management, involves a research jam session, conducted by staff in the Patient Engagement Core (PEC) in the Indiana CTSI, with the participant and caregiver to assess the value of the program. The research jam will take place at a location of the participant's/group's choosing or online. PEC staff will engage participants and caregivers to complete in person or virtual interviews to learn more about their actual experience, outcomes and challenges. These will be semi-structured interviews about their perspectives on the program, including desired outcomes and expectations and perceived barriers and drivers and will last about two hours.
Eligibility of study
You may be eligible for this study if you meet the following criteria:
- Conditions: Chronic liver disease, Cirrhosis
-
Age: 18 years - 100 years
-
Gender: All
Inclusion criteria
• Enrolled into IUH’s H@H program
• At least 18 years of age
• Chronic liver disease/cirrhosis based on characteristic clinical, laboratory, and imaging findings
• English speaking
• Able to provide consent
• Caregiver able to be present during the acute phase of care (first 48 hours post-hospital discharge)
• Able to perform activities of daily living independently
• Lives within IU Health Home service area
• At least 18 years of age
• Chronic liver disease/cirrhosis based on characteristic clinical, laboratory, and imaging findings
• English speaking
• Able to provide consent
• Caregiver able to be present during the acute phase of care (first 48 hours post-hospital discharge)
• Able to perform activities of daily living independently
• Lives within IU Health Home service area
Exclusion criteria
• Unable to complete study questionnaires due to neurocognitive disease, legal blindness or hearing loss
• Transplant of organ other than liver
• Pregnant
• Incarcerated
• New hemodialysis
• Blood pressure < 90/60, Pulse > 120, O2 > 3L
• HIV+/CD4 count < 200
• Receiving hospice services
• Concurrent enrollment in a related research study
• Transplant of organ other than liver
• Pregnant
• Incarcerated
• New hemodialysis
• Blood pressure < 90/60, Pulse > 120, O2 > 3L
• HIV+/CD4 count < 200
• Receiving hospice services
• Concurrent enrollment in a related research study
Updated on
05 Apr 2025.
Study ID: GI-IIR-HOSPITAL-AT-HOME, 21905
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