72 Ward acute care at home with community-based specialist follow-up. Is it virtually possible?

Résumé fourni par la source

Background Heart Failure has an average length of stay (LOS) in Ireland of 10.58 days per admission. As part of Ireland’s Integrated Care (IC) initiative, University Hospital Limerick (UHL) piloted a Virtual Ward (VW) program to support early discharge of HF patients, enabling continued treatment and monitoring at home. Purpose This study aimed to evaluate the efficiency and effectiveness of the VW for HF patients and their follow-up care in a community-based IC cardiology clinic. Method A retrospective review was conducted on 35 HF patients treated through the VW over a six-month period. Key metrics included hospital length of stay, VW LOS, time to community clinic review, and NT-pro BNP levels(a marker of HF severity). Results 35 patients treated on the virtual ward for heart failure,16 of which were HFrEF on all 4 pillars , were followed up in the IC cardiology clinic in Limerick over a 6 month period showing significant reduction in acute hospital LOS to an average of 6.25 days, compared to the national average of 10.58 days. Patients spent an average of 9 additional days on the VW, allowing ongoing treatment and monitoring at home. The reduced hospital stay resulted in an average cost saving of €6,278 per patient, based on an estimated cost of €1,450 per bed day. NT-pro BNP levels decreased significantly from 10,598 ng/L at hospital admission to 5,154 ng/L at VW discharge (P = 0.009), indicating effective clinical management. The median time to follow-up in the IC cardiology clinic post-VW was 1.5 weeks (IQR 0.57–2.5), with 4 patients requiring urgent in patient VW review. Conclusion This study demonstrates that the VW model can safely reduce hospital LOS while maintaining effective HF management. Community-based follow-up supports early intervention during a vulnerable recovery phase, improving outcomes and reducing healthcare system burden.

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