Situation:
Patient has a years-long history of noncompliance, a complicated medical situation, and a lack of transportation options. This has resulted in a pattern of erosion at home leading to 911 calls, ER visits, and hospitalizations.
Patient was found to have an acute urinary tract infection in the ER, and was discharged with orders for ten (10) days of IV medication via home infusion.
Case Summary: Due to social issues, patient would likely delay or skip care scenarios, in-person or virtual.
Due to the frequency of therapy and patient’s poor vasculature, a traditional IV catheter is a bad choice. Prior treatments have failed for this patient due to inability to get a catheter into a vein. Therefore, a midline catheter, placed using ultrasound guidance, was ordered.
Problem:
The patient is unable to travel to the local hospital for this outpatient surgical procedure, and home care companies do not have the capability. Without it, no medication and no healing will be possible.
Action:
On a same-day basis, a midline was placed, first dose administered, the patient was instructed on how to self-infuse and care for the catheter, and provided key resources for follow-up contact.
Results:
Patient was able to receive the procedure at home and the therapy on a timely basis.
Discussion:
The patient was amazed by how convenient this service was, having experienced the all-day wait at the hospital for line placement many times.
For the payor, the cost was 60% less than having the line placed at a hospital, in addition to the values of patient satisfaction and compliance.
