Mass Normal Brigham to Take a look at SNF-at-House Mannequin

Boston-based Mass Normal Brigham, one of many leaders of the acute hospital-at-home motion, has acquired grant funding to guage the supply of short-term rehab care at dwelling. 

With a grant of $4.6 million from the Massachusetts Govt Workplace of Well being and Human Companies (EOHHS), the well being system will run a randomized managed trial to check the impact of delivering short-term rehab care at dwelling vs. at a talented nursing facility (SNF).

Nationally, about 40% of older adults discharged from acute care hospitals require some kind of post-hospital care, and about half of these obtain care in an inpatient expert nursing facility. The price of expert nursing amenities is growing, and the COVID-19 pandemic exacerbated the workers shortages and capability challenges these post-acute care amenities face.

Delays in discharging sufferers from acute care hospitals to post-acute care settings have posed a problem that has contributed to capability points nationwide, stopping sufferers from accessing the rehab care they want and stopping open beds for brand new sufferers in want of acute hospital care. 


Hospital sufferers can anticipate weeks or months earlier than discovering a SNF mattress and accessing the care they want. In response to the most recent report by the Massachusetts Well being & Hospital Affiliation, 1,792 sufferers are awaiting to be discharged from hospitals throughout the state.

“If profitable, this care mannequin might lead to an entire transformation of how we ship superior rehab care to our sufferers,” mentioned David Levine, M.D., M.P.H., M.A., scientific director for analysis and growth for Mass Normal Brigham’s Healthcare at House program, in a press release. “There aren’t sufficient rehab beds in Massachusetts, and if we will substitute facility-based care with home-based care, we will assist alleviate the capability disaster that our healthcare programs have been experiencing throughout the state. This is able to have a direct profit for sufferers, household caregivers and clinicians,” added Levine, who’s principal investigator of the trial.

As a part of the research, 300 sufferers will likely be enrolled from 5 acute care hospitals within the Boston space: Massachusetts Normal Hospital, Brigham and Girls’s Hospital, Brigham and Girls’s Faulkner Hospital, Boston Medical Middle and Cambridge Well being Alliance. Of these 300, 150 sufferers will likely be randomized to obtain short-term rehab care at dwelling, whereas 150 will obtain care within the conventional expert nursing facility. 

Sufferers admitted to rehab care at dwelling will see a nurse, licensed nurse assistant, doctor, and residential well being aide upon admission. Subsequent care will embrace every day distant doctor and in-home licensed nurse assistant visits. Bodily, occupational, and speech therapies are additionally obtainable and tailor-made to sufferers’ wants. Sufferers may even obtain 24-hour, in-home responses from cellular built-in well being paramedics and, as wanted, dwelling well being aide care.


Researchers may even consider the experiences of household caregivers and scientific workers, inspecting burden and burnout amongst these teams.

In 2019, Levine and colleagues ran a pilot randomized managed trial of 10 sufferers to check the flexibility to ship SNF-level care at dwelling. Outcomes have been promising and pointed towards decrease value and a greater affected person expertise in comparison with conventional SNF care, Mass Normal Brigham mentioned.. Nevertheless, the small affected person cohort required replication with a a lot bigger affected person cohort.

“Now, due to this monetary award by EOHHS, we will take a look at this progressive care supply mannequin that reimagines how we ship post-acute care,” Levine mentioned. “At Mass Normal Brigham, we’re leaders within the superior home-based care area. Certainly one of our targets is to create the proof base that will likely be a pathway for the nation’s healthcare programs to comply with nationwide.”