The Coming Home Intervention to Enhance Safe Hospital-to-Home Health Transitions: Pilot Evaluation

Area of Science:

• Gerontology
• Health Services Research
• Nursing

Background:

• Hospital-to-home health care transitions pose safety risks for older adults.
• The Coming Home Intervention (CHI) was developed using the Hospital-to-Home Health Transition Quality (H3TQ) index to address these risks.

Purpose of the Study:

• To pilot the Coming Home Intervention (CHI) and evaluate its impact on hospital-to-home health care transitions.
• To assess the intervention's effect on quality of care and patient safety outcomes.

Main Methods:

• A quasi-experimental, before-and-after, difference-in-difference design was used across two home health agencies.
• The Hospital-to-Home Health Transition Quality (H3TQ) index assessed transition quality, while the Outcome and Assessment Information Set evaluated emergency department use and rehospitalization.
• Data were collected from older adults/caregivers and home health clinicians.

Main Results:

• In New York City, older adults/caregivers reported fewer quality issues post-intervention (IRR=0.50).
• Baltimore showed a non-significant decreasing trend in 30-day emergency department use or rehospitalization (OR=0.68).
• Older adults/caregivers in Baltimore rated quality issues less favorably after implementation.

Conclusions:

• The Coming Home Intervention (CHI) pilot demonstrated potential for improving hospital-to-home transition quality.
• Findings support future larger-scale studies of CHI in diverse older adult populations receiving home health services.