A $10 million philanthropic gift is helping Dartmouth Health in Lebanon reimagine health care delivery at home.
The gift from Dartmouth emeritus professor Kenneth R. French established the Vickie French Hospital at Home program, named in honor of his late wife, and launches a new model of care designed to deliver hospital-level treatment to patients throughout rural northern New England in their homes. The initiative is part of Dartmouth Health at Home, a broader effort to expand healthcare beyond the hospital’s walls.
Unlike conventional home health services, which typically provide nursing visits for wound care or medication management, the Hospital at Home program is designed for patients who would otherwise require inpatient admission.
“We bring the fullness of the hospital to patients’ homes,” says Dr. Nathan Goldstein, chair of Dartmouth Health’s Department of Medicine. “Instead of bringing the patient to the hospital, we bring the doctors and the nurses and the medicines and the labs and the monitoring equipment to their home.”
Patients with conditions such as pneumonia, heart failure and other illnesses requiring intravenous medications and close monitoring can receive the same level of treatment they would in a hospital, provided they are medically stable enough to recover safely at home.
“We know that particularly for older adults, bad things can happen in the hospital,” Goldstein says. “They get confused. They might fall. Sometimes people get infections there. The site of care changes all of that. It’s safer. And [at home is] where they want to be.”
The program is expected to initially maintain an average daily census of about 10 patients. While that number may seem modest, Goldstein says it frees the equivalent of 10 hospital beds each day for patients with more critical needs.
Dartmouth Health plans to begin with post-operative patients who can safely leave the hospital earlier than usual before expanding to emergency department admissions and other qualifying patients. The French gift provides financial flexibility to build the program gradually, an advantage many hospital-at-home programs lack.
Because NH, Vermont and Maine are among the nation’s oldest and most rural states, Dartmouth leaders believe the initiative could become a blueprint for healthcare systems nationwide.
“The ultimate goal is to create a playbook,” Goldstein says. “If you live in rural Nebraska, Idaho or Utah, we want to be able to hand you a manual and show how this model can work.”
In addition to improving patient outcomes, Goldstein says the program, which expects to begin enrolling patients next March, could create new career opportunities for experienced nurses while easing hospital crowding, a combination Dartmouth Health hopes will help establish a new standard for rural healthcare. For more information visit, dartmouth-health.org.
