Nominated by Matt Zavadsky, Medstar Mobile Healthcare
VITAS Healthcare of Fort Worth has partnered with MedStar Mobile Healthcare on a hospice revocation avoidance program since 2013.
The partnership is designed to prevent hospice revocations and enhance the experience of patients and families enrolled in VITAS’s hospice program by providing a ‘safety net’ in the event of a hospice-related 9-1-1 activation for the enrolled patient.
Patients/families at risk for a potential 9-1-1 activation are identified by VITAS and referred to MedStar for enrollment. MedStar does an initial home visit for the family and patient to explain the goals of the partnership and explain what might typically happen in the event of a 9-1-1 call.
Enrolled patients are flagged in MedStar’s computer aided dispatch system and if 9-1-1 is activated, in addition to the regular EMS response, a MedStar Community Paramedic co-responds to the call. MedStar’s communications center also notifies the on-call VITAS Hospice nurse of the response.
Once on scene, if the 9-1-1 activation is related to the patient’s hospice plan of care, the on-scene MedStar CP assists the patient and family with comfort measures, such as administration of medication from the patient’s ‘comfort pack’. The VITAS on-call nurse is contacted by the CP for care coordination. Typically, these patients are managed at home, without the need for an ambulance trip to the emergency room. If, in the determination of the on scene MedStar CP, the VITAS nurse, and the family, the patient is not able to stay home, the VITAS nurse makes arrangements for the patient to be transferred to an in-patient hospice unit.
VITAS also has the capability to access MedStar to request an episodic home visit for an enrolled hospice patient to do an assessment, treatment and communication with the VITAS nurse.
This partnership has been profiled in numerous healthcare journals, and the Advisory Board Company.
To date, 462 patients have been enrolled in this program, and 9-1-1 was activated for the patients 208 times. Of these calls, only 108 resulted in a transport from the home, and 17 of these were transported to an in-patient hospice unit.
Of the 462 patients referred who were at risk for revocation, only 89 (19.3%) experienced a revocation.
Nominated Organization Description
VITAS provides coordinated care and offers support to patients and their families with a range of options that corresponds to their specific needs. Guided by an individualized care plan, hospice care often begins with routine home care and includes a number of specialized services.
VITAS offers several key services that support patients and their families as they provide hospice care at home. Our Telecare clinicians are available via phone 24/7/365 to answer questions and dispatch someone to the bedside, if necessary. Medical equipment and medications are delivered to the home a well, and respite care provides up to 5 days of Medicare-certified inpatient care for a hospice patient so that family members can take a break from their caregiving duties to relax, unwind, recharge, travel, recover from an illness or attend other events.
Date of Implementation: 2013
Number and Demographics of Patients
462 patients identified as at-risk for 9-1-1 activation and revocation of hospice status.
Outcomes / Utilization
To date, 462 patients have been enrolled in this program, and 9-1-1 was activated for the patients 208 times. Of these calls, only 108 resulted in a transport from the home, and 17 of these were transported to an in-patient hospice unit.
Of the 462 patients referred who were at risk for revocation, only 89 (19.3%) experienced a revocation.
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