After one of our readers, Tom Brown, was admitted to the UHD service, he and his wife were so grateful for the care he received that they contacted Tomorrow to tell us about this innovative SNS Care at Home service.
Imagine a hospital ward that exists outside of a hospital, with dedicated health professionals and medicines administered at home. This is the concept of UHD, a home care unit operated by Portimão Hospital. I spoke to specialist nurse Humberto Ferreira to learn more.
Humberto is a rehabilitation nurse who works with seven nurses and four care specialists, whose shared goal is to provide hospital care in people’s homes. Anyone who is registered with the SNS is eligible for this service, but you cannot choose it; they choose you! Humberto explains: “The criteria to be chosen are social, geographical and clinical. So you need to be independent or dependent with a permanent caregiver so that we have support during the home visit. You need to be within a 30 km radius of the hospital and we should be able to meet your clinical needs in your home.”
Dr Nuno Bernardino Vieira coordinates the medical part of the home care unit with the chief nurse, Alexandra Ferreira. They see patients in their care as being looked after in a remote hospital ward. This concept started in Spain and moved to Lisbon before the Portimão team was created two and a half years ago. It took seven months to open this single ward, as all nurses need a lot of experience. It is challenging work for medical professionals as they are working alone and in a home environment. Its experienced team of internal medicine physicians and nursing staff originate from emergency services and intensive care with some experts in rehabilitation.
The nurses rotate in shifts, and there are eight doctors from Portimão hospital who take it in turns supervising a week in the remote ward. UHD works in conjunction with other wards, such as surgery, so that people can recover from the postoperative period, teaching the patient how to adapt to the new conditions after the surgery, medication, and all the inherent care as UHD. The home care team can do blood tests or send an ambulance if the patient needs to go to the hospital for a test or treatment. However, because your house is seen as a hospital wing, you can not go out! So if you are in this care, you can not go out to the supermarket or go for a walk. You’re not allowed to leave your home until you’re discharged. Hospitalisation for UHD is the same as a hospital stay, except you do it at home.
Humberto and the team evaluate the patient daily and bring their medication. They change the pill box and leave the medication for the next 24 hours. They have a machine (Infusion Pump CADD), the size of a bag, which monitors taking antibiotics with an infusion into their vein three or four times a day.
Every day, UHD talks to the doctor in charge who makes a diagnosis and a decision about the treatment and will then discharge the patient when they are ready. They communicate with a family doctor to inform them of the treatment they have undergone.
At this time of year, releasing beds makes a vital difference to the hospital. The unit started with five beds and a car, and was increased to two cars and 10 beds after a year and a half. Humberto admits that in winter, having 10 extra beds in the hospital is hugely beneficial for the health service.
Although Humberto says they don’t “work for medals”, I can tell how much it meant to him and his team that they were awarded Best National Home Hospitalisation Unit in Portugal. “Having had immense success and with very hard work ahead, we hope to continue and maintain the title that was assigned to us.”
The UHD team is part of the army of unsung heroes who work within the SNS to deliver free healthcare with love and dedication and deserve all our thanks and good wishes.
