Becker's Hospital Review

20 INNOVATION How a former Mayo Clinic leader is building AdventHealth's hospital at home By Giles Bruce A ltamonte Springs, Fla.-based AdventHealth recently brought on a former leader from Rochester, Minn.- based Mayo Clinic to help build its hospital-at- home program. The 50-plus-hospital system rolled out acute hospital care at home in January from its AdventHealth Winter Park (Fla.) facility (patients have to come from the hospital). The initiative has since treated a handful of patients, with a goal of reaching an average daily census of 20 to 30 in the next year. "AdventHealth did a lot of homework," Maura Nazario, MSN, RN, vice president of clinical operations for AdventHealth's home-based services, told Becker's. "They understood from the Mayo Clinics of the world, the Mass General Brighams, what it takes to launch a program like this." Ms. Nazario herself worked for Mayo Clinic's hospital- at-home program, which is also centered in Florida, before joining AdventHealth in mid-2024 to oversee its development of the care model. With hospital at home, patients (after coming from the emergency department or continuing a hospital inpatient stay) get acute care at home upon being outfitted with a tablet, monitoring technology and medical equipment then receiving two visits a day from a nurse or paramedic and a daily virtual appointment with a physician. Nurses, located in a command center, are available virtually 24/7. "For AdventHealth, we really pride ourselves on providing whole-person care," Ms. Nazario said. "Whole-person care is thinking about the patient, not only their physical self but their mental, their social and their spiritual wellbeing. Providing a substitution for their inpatient hospitalizations from the comfort of their home exemplifies our philosophy and treating the patient as the driver of their care plan." AdventHealth partnered with remote monitoring company Biofourmis on the technology but otherwise built the program itself. Coordinating all the logistics was the biggest challenge, Ms. Nazario said. AdventHealth, which also has hospitals in Colorado, Illinois and several other states, decided to unveil hospital at home in Florida because the health system has its largest presence in the central part of the state, which also has a large aging population, and because patients there are familiar with the care model. Florida has become a hub of hospital at home, with big health systems like Mayo Clinic and Cleveland Clinic also largely focusing their programs on the state. But AdventHealth hopes to expand to more states, as well as diagnoses and levels of care (such as skilled nursing). Initially, the program has freed up inpatient space at Winter Park hospital, and patient (and caregiver) feedback has been positive, Ms. Nazario said. "We feel it makes us better clinicians," she said. "When we provide this level of care, it makes us learn more about what's really happening when patients go home. Are their diets too hard to follow? Do they have too many medications?" n patient recovery or to help staff perform functions. e innovation unit also plans to share its findings with the broader healthcare community, and gives vendors direct access to the clinical space to try out their technologies. "I like to use the example of, 'Row the canoe while you're carving it,'" Mr. Raymond said. "So we have the opportunity to do innovation in real time." Or, to use another motto of the unit: Fail fast. "Success is great, and that leads to operations, but failing or bailing leads to innovation and taking the technology to the next level," he said. "We have a really unique opportunity here at Nebraska Medicine," said Kara Tomlinson, DNP, RN, executive director of system delivery and innovation at Nebraska Medicine. "is innovation design unit is going to give us an opportunity to test, trial and innovate around different ways to provide care. is is really exciting stuff." e technology has been "pretty intuitive" for patients and staff alike, she said. "We really tried to keep the people at the center of everything," Mr. Carson said. "So giving patients more control over the space they were in, giving our staff better visibility to the conditions they may be facing as they entered rooms for patients who were fall risks or had other isolation precautions, and then trying to retain our staff in an environment where care dynamics change by allowing them to continue to use their skills in a virtual format." Nebraska Medicine worked with healthcare consulting firm Blue Cottage of CannonDesign on the concept. e health system solicited feedback from staff in designing the unit, asking: What does innovation in healthcare mean to you? Nebraska Medicine plans to continue iterating on the hospital room of the future, even aer its "futuristic" new medical center is built. "is unit, and the philosophy, the vision, will continue on into perpetuity," Dr. Tomlinson said. Ron Carson, Bethany Lowndes, Scott Raymond and Kara Tomlinson of Nebraska Medicine will be giving a presentation on their "innovation design unit" from 10:35-11:15 a.m. Oct. 2 at Becker's 10th Annual Health IT + Digital Health + RCM Conference in Chicago. n

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