What Makes Hospital Care at Home Nursing Different

When thinking about the role of nurses, we often default to thinking about what happens within the hospital. With new modalities of care in new environments, however, today’s nursing jobs can take many different forms. At Contessa, we recognize that many nurses are seeking an alternative to hospital-based roles. Contessa’s nurses enjoy an experience that’s unique in three key areas:  

  1. Physical environment 
  1. People, knowledge, and training 
  1. Patient interaction and care plans 

Physical Environment 

The most obvious difference between types of nursing jobs is where the patient care takes place. The site of care delivery changes the way care is delivered. For home-based nurses, the start of a care visit often illuminates the patient’s living situation and offers vital information about their patient’s quality of life. For example, hospital at home nurses and home health nurses can better personalize care when they can see what is in a patient’s medicine cabinet and refrigerator.  

They can also assess whether the home is secure and appropriate for care, determining if it is a functional space with basic infrastructure, running water, electricity, and some level of connectivity, such as a phone line or internet access. Contessa nurses work with our patients and their families to ensure a safe environment and a general level of comfort with others entering their home. Put together, these pieces help create the home as an ideal setting for patient care. Ensuring the home environment is appropriate for care has the bonus effect of optimizing it for daily life after discharge.  

People, Knowledge, and Training 

While home health nursing is focused on chronic condition management, hospital care at home is truly specialized towards acute conditions. True to its moniker, it brings the same quality and acuity level of hospital nursing to the home. The people, knowledge, training, and teamwork needed to make that happen, and in a highly coordinated way, looks very different from hospital or standard home health settings.  

Home health often starts with less immediate connections to physicians and other clinicians, who have less information and less control over the situation. Hospital at home nurses, by design, are connecting with a clinician at least daily if not more frequently. 

Home health nurses are also very accustomed to thinking about chronic condition management and to regularly listening to and counseling patients. They care for patients with situations such as high blood pressure and COPD. By contrast, Contessa nurses care for a broader range of more acute conditions, such as pneumonia, urinary tract infections, congestive heart failure, and more. Many Contessa nurses are ICU nurses who still practice in the ICU part time.  

With their on-the-ground experience and training, Contessa nurses enhance their skills of asking targeted questions around care plans, driving consistency between drug regimens, making sure their diets match their needs, and much more. This training and mindset add key facets to equip our nurses with the right skills and tools, helping round out the care experience and improve our ability to deliver highly coordinated care.  

Patient Interaction and Care Plans 

Contessa’s nurses typically work within care plans measured in days, not months. As a result, the care episode is usually more intense than home health and brings a higher degree of personalization and coordination to the patient.  

On top of that, Contessa’s nurses often visit patients’ homes at least twice a day, rather than once every few days, and most of their visits last about an hour and a half. This varies considerably from the roles of hospital nurses, who often run from patient to patient, spending less time with each while trying to manage the needs of a higher number of patients in a setting that most patients want to leave as soon as possible. Some hospital nurses don’t even have a moment to go to the bathroom.  

Contessa nurses, on the other hand, have opportunities for longer visits with patients and a less hurried flow with fewer task interruptions. As a result, hospital care at home nurses develop much deeper relationships with patients and their families, plus the patients report a much better experience.  

Nurses are heroes, no matter where they decide to apply their skills. But as the world changes, and healthcare evolves with it, it’s important to remember that not all hospital nursing happens in the hospital. Today, it can happen at home at the same level as it does in the hospital. Learn more about what it’s like to be a nurse at Contessa here. 

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Meet Our Expert

Michael Nottidge, MD, MPH, MBA, Senior Vice President & Medical Director

Michael Nottidge, MD, MPH, MBA, understands that optimal health outcomes start with patient-centered care. As a practicing critical care and emergency physician with a passion for public health and safety, he brings a unique perspective to Contessa, where he’s served as Medical Director since 2021. His leadership ensures that Contessa’s integrated care at home model delivers high-quality patient care and seamless processes for providers, all while creating value for health systems and health plans.