Hospital in the Home - video transcript
Joel Ryan 00:00
Have we got enough time. Pretty much was born with cystic fibrosis. At maybe half an hour old in the surgery had to do a bowel resection. Then just grown up with CF been a bit of time in hospital, a lot of time in hospital when I was young, going through teenagers years wasn't too bad with it all sort of just mainly alot of physio. Then at age 26, I was pretty much breathing, my lung capacity was at 14%. So they got me on the list for double lung transplant 26 of Feb 2012 I got that transplant then I have worked up ever since I had a bike crash. Pretty bad put me in hospital, then they had to pull my stomach out and repack it because it got a bit knotted up inside. And then it was smooth sailing until November sort of last year, had steak and veggies I think for lunch, got home and said to Amanda my stomach's a bit sore. She tried to make me go to hospital, as normal, I refused. And then by about 2.30 the next morning I was in an ambulance going to hospital. My stomach blocked up that was put down to the bowel resection when I was born, scar tissue where that was, had just eventually clogged up over time, which resulted in a stoma bag was sent home from the hospital with Hospital In The Home they will come out every day, pumping up four liters of fluid in a day. Kidney function wasn't getting any better. So after two months of that they put me in for a stoma reversal rejoin it all, that went on for four days and then the join leaked, which sent me septic because it leaked inside. Yeah, that was a bit bit wild. So then, after that operation, I was hospital there for 34 days. Then I was discharged again, back into HITH care came home. And it was still going to this date. So yeah. It's a bit of a lengthy process, but we're getting there.
Theodore Chamberlain 02:55
My name is Theodore Chamberlain. I'm the Clinical Director for the Hospital In The Home program for the Sunshine Coast University Hospital. This means I have the privilege of allowing Queenslanders to receive hospital level acute care in their home an environment they're familiar with and among people that love them. This is an amazing privilege. This means that they receive the services and treatment that they would normally receive in a hospital, but in their home environment. Now not every patient in a hospital is suitable to receive that same treatment at Hospital In The Home the main aim is to provide a surface that is beneficial for the patient and provides high value clinical care.
Amanda 03:41
When Joel's in Hospital his biggest concern is probably the dogs and making sure they're fed and walk second concerns probably the children and then I'm a close third. But it's been all hands on deck. We've had a lot of family help us when Joel is in hospital as well which is just been amazing neighbors, colleagues, all that sort of thing. And then when he does come home and having HITH and just having that reassurance that we're not alone, and if something does go wrong, we do have a second opinion just around the corner. And that they're always pretty close by, a phone call away if we need them.
Joel Ryan 04:19
At the start when I first come home, they were coming out daily. And then me being me I'm quite self sufficient. I used to do a lot of this care at home with my CF pre Hospital In The Home. When they eventually started coming. The nurses, are great, more than accommodating and it's everything comes to your house, it's more comfortable being in the home.
Mel Maliwanag 04:49
Hi, my name is Mel and I'm a registered nurse from Hospital In The Home. When we go to the patient's house we have them first and foremost we have to wear PPEs is just because because it's not only for the safety of the nurses, but most importantly it is for the safety of the patient. Hi Joel Oh, yeah. Good. Good. How are you?
Joel Ryan 05:10
Yeah. not too bad, come on in.
Mel Maliwanag 05:11
yeah. Thank you. So you know what we're going to do today? Yes, I'll take the blood pressure first. And the pulse rate and how's work good?
Joel Ryan 05:23
Yeah. not bad day in the office
Mel Maliwanag 05:30
I like to see the patients that they're happy because they're in their own comfort set up at home, and not in the hospital where they are doing thier recovery. And also the communication, the interaction I love. The first and foremost is patient centered care is what we're really focusing. Yeah. And also, I love traveling as well as it's good to travel. 176 so that is good.
Amanda 06:06
It was almost a shock for me to come out with him because I wasn't used to their care. Like, who are these people? I don't need them. And then when I eventually started coming, the nurses are great Yeah, then, like Mel said more than accommodating. And it's everything comes to house. It's more comfortable in the home Hi Mel,
Mel Maliwanag 06:32
Hi Amanda, how are you? I'm good. Hi Seth how are you?
Amanda 06:34
Good thanks how are you
Joel Ryan 06:36
Got soccer this affie. Yeah,
Seth 06:36
yeah good I'll be going, heading off to training. Pretty big the game on the weekend.
Joel Ryan 06:44
Yeah, sweet. Yeah. be riding your bike down?
Seth 06:46
yeah, training again, See ya
Mel Maliwanag 06:51
That's good. Enjoy, enjoy. See, you Seth, oh, by the way, Joel, I've got your medication there as well yeah. Yeah, the pharmacy asked me to drop it to you. So it's there. Just setting up everything.
Theodore Chamberlain 07:13
It's better for consumers. because by definition, it's patient centered care. It is giving the patient high quality care in an environment that they're familiar with, that they're comfortable with, and that they have control over. So in the tertiary system, there are things that just cannot be done at home. Large amounts of high technology, large amounts of high input. Those patients obviously are better looked after within the tertiary system. By looking after patients that are better able to safer looked after at home, we free up space for that high end stuff and improve the care of Queenslanders across the system.
Amanda 07:57
It's it's been a huge help to have them. Joel's are very stubborn patient. And when he did get sick, I knew that he needed a hospital. But he knows his body's been doing dealing this for a whole life. So for me, I actually said to him, it's gonna be a long night, I'm going to go to bed and have a nap and wake me up. When we need to go with HITH, I don't have to worry about that. It's not me trying to make that call. I can ring them explain a situation, they can get back to me ASAP. Or they can say look, we're going to do this. Send someone out if they need to. So it's not now us making the judgment call on his health. We've got professionals that are able to do that for us, which has been a huge, huge help.
Joel Ryan 08:48
Recovering at home, it's definitely a lot better. It's leaps and bounds compared to what you would achieve in hospital.
Mel Maliwanag 08:55
Once you're a nurse you always a nurse. And the most important part of being a nurse is you don't compromise the health and safety of the patient because it's good to have interaction. I think it's quite of my quality is more of building rapport with the patients. I want to have an interaction with them. So travelling is just a bonus. But it's more of your passion of seeing the patients and how you can help them the best of your ability. Do you need that slips again? I have my bag.
Joel Ryan 09:29
I've some spares
Mel Maliwanag 09:30
Are you sure.
Joel Ryan 09:30
Yeah. Okay. Yeah. So
Mel Maliwanag 09:32
we get the spares
Joel Ryan 09:33
rolls.
Mel Maliwanag 09:35
Lovely. Any question?
Joel Ryan 09:36
Nah, it's all pretty good. Yeah.
Mel Maliwanag 09:40
Yeah it's good, just is a long wait, isn't it?
Joel Ryan 09:43
Yeah.
Mel Maliwanag 09:44
For the procedure, to hopefully it will be coming very, very soon.
Joel Ryan 09:49
Yeah. Can only hope.
Theodore Chamberlain 09:51
The most important thing is most people don't like being in hospital. You know, we are in hospital because we need to be in a hospital. If we can provide hospital level care in an environment that is patient centric, that is a beneficial to the patient, then we greatly improve the outcome for the patient. So the major advantage of hospital and home is actually we're treating the patient safely in an environment that is suitable for them.
Amanda 10:20
It was quite overwhelming opening your home up and to those people every single day. But after a very short time, they just become friends. Yeah.
Theodore Chamberlain 10:33
Now I would encourage health services to expand HITH. HITH is a patient centric safe model that improves flow. You know, to expand HITH though requires cultural change and requires engagement with consumers. It requires engagement with the invest invested interests within a tertiary system. But as a patient centric, safe, economically efficient service HITH is the way of the future.
