{"id":417,"date":"2020-09-08T21:24:17","date_gmt":"2020-09-08T21:24:17","guid":{"rendered":"https:\/\/www.hospitalinnovate.org\/covid19\/?p=417"},"modified":"2021-07-11T15:42:45","modified_gmt":"2021-07-11T15:42:45","slug":"02which-non-clinical-criteria-do-hospitals-use-to-determine-when-to-discharge-covid-19-patients-to-home","status":"publish","type":"post","link":"https:\/\/www.hospitalinnovate.org\/covid19\/2020\/09\/08\/02which-non-clinical-criteria-do-hospitals-use-to-determine-when-to-discharge-covid-19-patients-to-home\/","title":{"rendered":"02. Which non-clinical criteria do hospitals use to determine when to discharge COVID-19 patients to home?"},"content":{"rendered":"

[vc_row full_width=”stretch_row_content_no_spaces” equal_height=”yes” content_placement=”bottom” css=”.vc_custom_1600728674769{margin-top: 0px !important;border-bottom-width: 4px !important;padding-top: 0px !important;padding-right: 20px !important;padding-bottom: 0px !important;padding-left: 20px !important;background-color: #f2f2f2 !important;border-bottom-color: #2c5d73 !important;border-bottom-style: solid !important;}”][vc_column width=”2\/3″ css=”.vc_custom_1599247143020{padding-right: 20px !important;padding-left: 10px !important;}”][vc_custom_heading text=”Discharge Criteria Key Clinical Questions” font_container=”tag:h2|text_align:left|color:%23f7941d” use_theme_fonts=”yes” css=”.vc_custom_1599600251861{margin-top: 0px !important;padding-top: 40px !important;}”][\/vc_column][vc_column width=”1\/3″][vc_column_text]<\/p>\n

Home<\/a> \/ Discharge Criteria Overview<\/a> \/ Key Clinical Questions<\/a><\/p>\n

[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=”stretch_row_content_no_spaces” gap=”20″][vc_column width=”3\/4″ css=”.vc_custom_1599596059091{padding: 20px !important;}”][vc_custom_heading source=”post_title” use_theme_fonts=”yes”][vc_column_text]<\/p>\n

a. HOMERuN institutions<\/strong><\/h3>\n

Where sites provided information, there tended to be agreement, but some sites provided more information than others. The criteria collectively included: 1) suitability of the home for patients to self-isolate from other household members until no longer necessary per CDC guidelines; 2) ability for patients to meet basic needs such as food, medications, durable medical equipment, and ability to carry out activities of daily living while under home quarantine (independently or with available help); and 3) patient and caregiver understanding of when to return if condition worsens. We recommend using these collective criteria.[\/vc_column_text][vc_row_inner gap=”30″ css=”.vc_custom_1599600134655{padding-top: 20px !important;padding-right: 20px !important;padding-bottom: 20px !important;padding-left: 20px !important;}”][vc_column_inner width=”1\/2″][vc_column_text]<\/p>\n

b. What is Known<\/strong><\/h3>\n

Many of these criteria are based on first principles or from the literature on safe discharges in hospitalized patients in general (i.e., without COVID-19). Several sites provide useful algorithms or guidelines for non-clinical criteria, including OHSU<\/a> and Northwestern<\/a>\u2019s links to CDC recommendations such as Discontinuation of Isolation for Persons with COVID-19 Not in Healthcare Settings<\/a> and Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for Coronavirus Disease 2019 (COVID-19)<\/a>.[\/vc_column_text][\/vc_column_inner][vc_column_inner width=”1\/2″][vc_column_text]<\/p>\n

c. What is Not Known<\/strong><\/h3>\n

To our knowledge, there are no studies evaluating the necessity of these criteria in patients with COVID-19 (i.e., that the absence of them being met is correlated with poor post-discharge outcomes).[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner gap=”30″ css=”.vc_custom_1599600134655{padding-top: 20px !important;padding-right: 20px !important;padding-bottom: 20px !important;padding-left: 20px !important;}”][vc_column_inner][vc_column_text]<\/p>\n

d. Spring 2021 Update:<\/strong><\/h3>\n
    \n
  • Ability to discharge patients to home often depends on whether other people living there have already contracted COVID-19 (and thus were no longer susceptible). Families generally became more comfortable caring for loved ones with COVID-19 over time<\/li>\n
  • As with all patients, social determinants of health, including home supports, often determine success of discharge<\/li>\n
  • Some states and communities were able to contract with vendors for durable medical equipment (DME; e.g., home oxygen) for uninsured patients<\/li>\n
  • Some sites used medical students and community health workers to provide continuity of care to underserved patients<\/li>\n<\/ul>\n

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    Nineteen percent of protocols recommended standard pharmacologic VTE prophylaxis dosing for all COVID-19 patients regardless of estimated VTE risk. Ten percent recommended…<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[],"_links":{"self":[{"href":"https:\/\/www.hospitalinnovate.org\/covid19\/wp-json\/wp\/v2\/posts\/417"}],"collection":[{"href":"https:\/\/www.hospitalinnovate.org\/covid19\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hospitalinnovate.org\/covid19\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hospitalinnovate.org\/covid19\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hospitalinnovate.org\/covid19\/wp-json\/wp\/v2\/comments?post=417"}],"version-history":[{"count":6,"href":"https:\/\/www.hospitalinnovate.org\/covid19\/wp-json\/wp\/v2\/posts\/417\/revisions"}],"predecessor-version":[{"id":1311,"href":"https:\/\/www.hospitalinnovate.org\/covid19\/wp-json\/wp\/v2\/posts\/417\/revisions\/1311"}],"wp:attachment":[{"href":"https:\/\/www.hospitalinnovate.org\/covid19\/wp-json\/wp\/v2\/media?parent=417"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hospitalinnovate.org\/covid19\/wp-json\/wp\/v2\/categories?post=417"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hospitalinnovate.org\/covid19\/wp-json\/wp\/v2\/tags?post=417"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}