Hospital at Home

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Hey Everyone,
Just looking for some guidance from some of you that already implemented hospital at home type program and how you are doing blood glucose testing. Currently CMS require glucose checks 2x/day but pharmacy is pushing for 3x/day. The plan would be to have nursing visit the home 2x/day and perform glucose testing and insulin treatments during that time. The issue is with this 3rd or 4th check and the limited staff to be visiting 3 or 4 times per day. How are other facilities handling the CAP and CLIA requirements regarding testing using patients own meter or their sensors. Is there some way that a patient could do their noon check but still be following accreditation standards from CAP and CLIA that the hospital follows?

Thanks,
Brian

4 Replies

Miranda Cotter

Tue Jul 09, 2024 at 4:36PM

I don't know the answer to the CMS glucose checks 2x a day. However, patients with their own meters situation - no we do not allow those values to recorded as a laboratory testing under our CAP/CLIA. Last I heard, the HAH program was trying to figure out how to get the patient's own meter values into the Epic chart somehow, but it would not be charting with the Glucoses done on the Hospital meter.

Brian Wittkop

Tue Jul 09, 2024 at 5:28PM

Thanks Miranda for your reply. Just to clarify, do you know if your HAH program allows nursing/Providers to utilize results from patient's own meter for treatment decisions or for a patients insulin dosing?

Miranda Cotter

Fri Jul 12, 2024 at 4:13PM

I do not know that, sorry!

Christina Schleich

Thu Jul 25, 2024 at 12:20PM

Our HaH program issues hospital approved meters to the patients that need to record their own sugars. The RN also carries one of our POC Accucheck glucometers as well for those who do not have the issued one. The RN/Command Center of the HaH program enters the patient's issued meter values in a flowsheet area of Epic that clearly distinguishes the value coming from the patient's meter. Any testing run on the POC Accucheck meter is logged in Epic as an actual manual edit/entry resulted laboratory test. We have all the Accuchek values coming from HaH program flagged as Do Not Upload in RALS.
The RN is also required to take a picture of the result on the Accuchek machine that then gets uploaded as a media scan onto the patient's chart.

Very confusing, and they are still working out all the bugs.

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Hospital at Home