Many patients stay in hospital for several weeks because they need intravenous antibiotic therapy. Apart from reducing their quality of life and introducing practical inconveniences, this may increase the risk of infections.
Patients and their relatives contributed to the development
The Medical Department at Kristiansund Hospital has headed the project, which has involved a number of partners. The hospital pharmacy prepares the medication. The home care services in Kristiansund and several surrounding municipalities provide follow-up care for the patients in their own home. The call handlers at the regional emergency response centre provide emergency backup. The Centre for Health Innovation was an important driver for the research and innovation efforts, and for interaction. SINTEF has provided the service design and research.
Sørlandet Hospital and some of the local authorities in Agder county have also developed solutions for home-based intravenous antibiotic therapy and they have shared their experiences with the project team in Kristiansund.
Patients and their relatives have played an important role throughout. And the project has been developed through multidisciplinary collaboration between service providers, service designers and researchers. Based on the scoping phase, the project partners visualised a service pathway proposal. This was then tested in a tabletop exercise and simulated scenarios before it was further developed and tested with patients.
Photo: Kristine Hermstad
Receiving treatment several hours away from the hospital
After several rounds of testing and repeated interviews with patients, relatives and healthcare personnel, the service is now up and running, and suitable patients at Kristiansund Hospital are receiving quality-assured infection therapy in their own home.
A doctor at Kristiansund Hospital starts off the antibiotic therapy, after which the treatment is followed up in the patient’s home under an agreement with the primary health service. The antibiotics are administered via a catheter connected to an electronic pump.
This offer is available to patients whether they live in the vicinity of the hospital or several hours away – the patients receive the same treatment no matter what. This new interaction model lends itself to being adopted by other regional health authorities.
The patients feel free
The relevant patients can now leave the hospital several days or even weeks earlier. In this way, hundreds of bed nights are saved. The health service can release beds, and most importantly: the patients’ quality of life increases. They report better sleep and a greater sense of freedom. Some have even been able to attend school, go to work, take part in leisure activities and keep up a social life.
The project has emphasised the importance of developing a service which is medically safe, but which is also felt to be safe and secure by the patient. The patients play an active part in their own treatment, and this provides a good basis for their coping and reassurance.
Better collaboration has many benefits
It is often challenging to bring about collaboration between the specialist and primary health services. However, the new model introduced in Kristiansund and in the surrounding municipalities in Møre and Romsdal has demonstrated greater exchange of knowledge and expertise between service levels. The patients receive more specialist health services in their own home, which aligns with national strategies.
Thanks to this project, hospitals and local authorities have developed a service they provide jointly, with the hospital doctor in charge of the treatment while the home care services follow up on the patients in their home. Better collaboration and distribution of jobs save the specialist health service both time and resources. This can bring about a more sustainable health service.
Project: New collaborative model that offers patients safe antibiotics therapy in their own home
By: Møre and Romsdal Health Trust, as represented by Kristiansund Hospital, SINTEF AS, Centre for Health Innovation, Kristiansund local authority, Midt-Norge HF hospital pharmacies, Centre for Development of Institutional and Home Care Services, Møre and Romsdal region
Design disciplines: Service design, Systemic design
Recipient of the DOGA Award
This prosject has received the DOGA Award for Design and Architecture fot its outstanding qualities and for showing how strategic use of design and architecture creates important social, environmental, and economic value.
These are three reasons why this is an exemplary project:
- Patients get to go home early
Patients get to (if they want to) leave hospital several days and weeks earlier than before. Since the service commenced, patients have avoided more than 400 days in hospital.
- Better utilisation of resources
The interaction brings better utilisation of resources. The cost of providing intravenous antibiotic therapy in the patient’s home can be as much as 70% cheaper than traditional treatment.
- Greater parity of care provided by the health service
The project helps the health service provide greater parity of care in that patients can access the same treatment irrespective of where they live. It is also beneficial that patients and their relatives are saved from having to travel long distances to hospital.
