Bringing Acute General Internal Medicine Outside of Hospital Walls

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Michelle Grinman
Ryan Kozicky
Michele Smith
Kirsten Proceviat
Laura Bettcher
Shy Amlani
Vivian Ewa
Mary-Jane Shankel
Jason Goertzen
Lindsay Wodinski
Azadeh Motehayerarani
Ghazwan Altabbaa
Jolene Haws
Colin DelCastilho
Leanne Reimche
Bhavini Gohel


Hospital at Home


International Home Hospital (HH) programs have been shown to be safe and cost-effective. They are associ-ated with lower risk of morbidity and mortality than conventional hospitalization for patients requiring lower acuity hospital-level care. However, there is a paucity of Canadian HH examples in the medical literature. To address this, the Complex Care Hub (CCH) program was created in Calgary, Canada. CCH is an adaptation of international HH models within the Canadian context. This program is unique because of its collabo-ration between General Internal Medicine physicians, Nurse Navigators, and Community Paramedics, while leveraging a robust technological infrastructure. While the preliminary data suggested that CCH is a viable Canadian HH model for a general medical population, this evaluation did not have a control group. There-fore, further studies are planned to evaluate the program’s quality and cost-effectiveness with control groups to enable direct comparison between CCH and conventional hospitalization.

Les programmes internationaux d’hospitalisation à domicile (HAD) se sont révélés sécuritaires et rentables. Ils sont associés à un risque de morbidité et de mortalité plus faible que l’hospitalisation traditionnelle chez les patients nécessitant des soins hospitaliers de faible acuité. Toutefois, on trouve peu d’exemples canadiens de programmes d’HAD dans la documentation médicale. Pour remédier à cette situation, le programme Com-plex Care Hub (CCH) a été créé à Calgary (Canada). Ce programme est une adaptation de modèles interna-tionaux d’HAD dans le contexte canadien. Ce programme est unique, car il s’agit d’une collaboration entre les internistes généralistes, les infirmières pivots et les ambulanciers paramédicaux communautaires, tout en tirant parti d’une infrastructure technologique robuste. Bien que les données préliminaires semblent indiquer que le programme CCH est un modèle canadien viable d’HAD pour une population médicale générale, cette évaluation ne comporte aucun groupe témoin. Par conséquent, d’autres études sont prévues pour évaluer la qualité et le rapport coût/efficacité du programme en utilisant des groupes témoins pour permettre une comparaison directe entre le programme CCH et l’hospitalisation traditionnelle.

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