SHM Converge Scientific Abstract ePoster Gallery-Fighting Covid on the Homefront: A Model for Hospitalists to Infuse Monoclonal Antibody Against Covid-19 in Patients' Homes

Fighting Covid on the Homefront: A Model for Hospitalists to Infuse Monoclonal Antibody Against Covid-19 in Patients' Homes

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The document describes a pilot hospital-at-home program that delivered COVID-19 monoclonal antibody (mAb) therapy directly to patients’ homes. The program was developed by DispatchHealth Advanced Care in Denver and used hospitalist physicians, advanced practice providers, hospital-trained nurses, and EMTs to provide in-home evaluation, IV access, infusion, and monitoring for infusion reactions.<br /><br />The main motivation was that access to mAb therapy was often delayed or limited by testing turnaround time, patient mobility, transportation barriers, and insufficient infusion-center capacity. By using an existing mobile care infrastructure, the team created a process to identify eligible patients quickly and treat them within the therapeutic window under FDA emergency use authorization criteria.<br /><br />During the pilot phase from October 1 to December 16, 2021, 45 potential patients were identified, and 24 patients (44%) were successfully infused at home. One patient (2%) was sent to the emergency department for a possible mild infusion reaction. The most common reason patients were not infused was newly discovered hypoxemia, which made them ineligible. The program was later suspended when the Omicron variant became dominant and the available monoclonal antibody treatment was less effective.<br /><br />The program concluded that monoclonal antibody therapy can be safely and effectively administered in patients’ homes by interprofessional hospitalist teams. It also showed that successful implementation required rapid iterative improvement using PDSA cycles to develop clinical workflows, logistics, medication handling, documentation, and emergency response tools.

Asset Subtitle

Manuel J. Diaz

Meta Tag

Author List Candace Bromley, Courtney Banks, Hannah Hodges, Lindsay McGuiness, Manuel J. Diaz, Megan Faga, Paige T. Redifer, Patrick P. Kneeland

Category Innovations

Concept Monoclonal Antibody Therapy

Concept COVID-19

Concept Patient Selection Criteria

Concept Home-Based Care

Concept Home-Based Acute Care

Distinguished Non-Finalist

Presenter Organization DispatchHealth

Presenting Author Manuel J. Diaz

Track Other

Keywords

hospital-at-home

monoclonal antibody therapy

COVID-19

home infusion

DispatchHealth

pilot program

infusion reactions

PDSA cycles

mobile care

emergency use authorization

Monoclonal Antibody Therapy

COVID-19

Patient Selection Criteria

Home-Based Care

Home-Based Acute Care