Children on chronic home ventilation face an increased risk of hospitalization, and their families often experience high-stress levels.
Arkansas Children's Hospital's (ACH) advanced home ventilator program incorporates telemedicine and multidisciplinary care to provide education, respiratory assessments and coordinated care to patients at the hospital and home. The pulmonology team, one of seven nationally ranked programs by U.S. News & World Report, provides award-winning, accredited care to infants and children with complete diagnosis and treatment of acute and chronic lung disease.
The advanced home ventilator program has three pillars for success: establishing optimal respiratory status at discharge, extensive family education and telemedicine.
The advanced home ventilator expert team at ACH manages the care of children who need various types of respiratory support at home, such as ventilators, bi-level, CPAP, airway clearance devices and/or have a tracheostomy. The team includes:
Some common diagnoses of patients benefiting from the advanced home ventilator program include:
The program can assess patients remotely, reducing emergency room visits and weaning children off ventilators quicker.
First, providers establish the patient's optimal respiratory status at discharge to ensure patients are safe to discharge on the medical equipment. Establishing this status is critical because patients are essentially taking the ICU home.
Extensive family education is the second step, so they can safely care for a child at home. Telemedicine plays a crucial role in the final step toward positive outcomes.
Medical experts assess patients at home to determine if a problem can be solved virtually or if they need to come to the emergency department. Data from the ventilators also helps experts determine how patients are doing.
At ACH, this remote program has reduced the number of ED visits and lifetime ventilator use. Of the 12 patients initially enrolled, eight have been weaned off ventilators within 12-16 months of initial hospital discharge.
Clinical-translational research is vital to advanced home ventilator programs. Our clinicians collaborate in local and multi-center studies to examine the disease mechanisms that result in chronic respiratory failure and identify novel therapies.
ACH measures outcomes and regularly reevaluates and enhances the program by participating in multiple quality improvement projects, including high-fidelity simulation exercises in caregiver training, remote home oxygen monitoring and decreasing the duration of narcotics/sedative use in children. A collaborative leader in pediatric pulmonology care, the advanced home ventilator program extends this leadership through participation in the national bronchopulmonary dysplasia collaborative. The team measures readmissions, emergency department visits and decreased ventilator use to keep track of decannulations and preventable death.