Expanding and Advancing Hospital Services in the Wellbeing Services County

As of last year, the home hospital services in Lohja and Raseborg transitioned from the HUS Helsinki and Uusimaa Hospital District to the Western Uusimaa Wellbeing Services County. The home hospital services in Espoo, Kauniainen, and Kirkkonummi were already integrated into the operations of the Western Uusimaa Wellbeing Services County. Now, the services offered by the Lohja and Raseborg units have expanded to cover additional areas within Western Uusimaa.

Carita Niemi, a nurse at the Lohja home hospital, explains that the primary objective of the home hospital is to deliver hospital-grade care in home settings.

“Our home hospital services now extend to all residents within the Western Uusimaa Wellbeing Services County, excluding individuals under 16 years old who are still under the care of HUS. We conduct home visits to patients, regardless of whether they reside in a nursing home, a residential service unit, or with their family,” Niemi says. 

Niemi asserts that, fundamentally, the care provided by the home hospital does not significantly differ from that of a traditional hospital, with the exception that the patient remains at home.

“Patients can receive treatment at home, even if they require specialized care such as intravenous medication. This also allows them to avoid potential hospital-acquired infections. A doctor’s referral is always necessary for home hospital care. The doctor will evaluate each patient individually to determine if home hospital treatment is a viable option.”

However, the home hospital cannot provide highly demanding treatments. 

“These include medical treatments that require monitoring or procedures that necessitate special equipment only available at hospitals or health centres.”

The home hospital also encompasses an infusion outpatient clinic, which is located within the hospital premises. Here, patients can receive treatments such as blood products, intravenous antibiotics, or other specialized medications.

“The palliative outpatient clinic is another integral part of the home hospital. The doctor and nurse from the palliative clinic conduct consultations either at the hospital or at the patient’s home, depending on the patient’s condition. In early February, the mobile hospital LiiSa commenced operations in Lohja, Raseborg, and Kirkkonummi, working in close collaboration with the home hospital,” Niemi informs us. 

The mobile hospital, known as LiiSa, is a highly regarded concept that has been successfully operating in Espoo for the past five years. The transition of the home hospital has enabled LiiSa to extend its services across the entire Western Uusimaa region.

LiiSa primarily serves elderly individuals residing in 24/7 residential care facilities, as well as other clients who require home care support. It specializes in addressing somewhat urgent situations and is prepared to visit patients at any time of the day or night. 

In LiiSa’s operational model, a nurse from the home hospital visits the patient at their home or nursing home to evaluate their care needs. Treatment can be initiated on-site, eliminating the need to transport the patient to the emergency department first. LiiSa is summoned by a professional from a nursing home or a home care specialist. 

Susanna Vanhanen, the head nurse at the Espoo home hospital, underscores that LiiSa’s operational philosophy always places the patient at the forefront.

“The mobile hospital offers a range of benefits to patients. Rehabilitation and healing can commence more quickly in a home setting due to the lower risk of infection. It’s also crucial that LiiSa’s services are accessible 24/7.”

In the past, if a nursing home resident’s condition suddenly deteriorated, they would have to be transported to the emergency department. 

“Now, we can summon LiiSa to the site to conduct blood tests and further examinations on the patient. Based on these examinations, we might suspect a certain infection. After consulting with a doctor, LiiSa can initiate treatment, such as intravenous antibiotics, right on site. The home hospital then seamlessly continues the treatment. This approach helps us avoid unnecessary emergency room visits, and hospital-grade follow-up treatment can be administered at the patient’s home. If it becomes apparent that the patient requires more comprehensive examinations, we will arrange for their transfer to the hospital.”

Many issues can be resolved during a phone call when a nursing home or home care employee contacts LiiSa.

“Many practical nurses are employed within home care, and there may not always be medically trained nurses available for consultation during a work shift. Employees have expressed that LiiSa provides an added layer of safety to their work, knowing that the support of an experienced LiiSa nurse is just a phone call away.”

Studies have confirmed that the availability of LiiSa has led to a reduction in non-urgent needs in nursing homes.

“In the elderly population, the deterioration of conditions typically occurs over an extended period.  Often, there isn’t a single, identifiable event that prompts staff to consider transferring the patient to the emergency department. As a result, patients rarely have an urgent need for first aid. When LiiSa is readily available, paramedics can focus on urgent cases, freeing up their time from non-urgent tasks.”

Vanhanen also highlights the exceptional end-of-life care provided by LiiSa.

“Specialized expertise in palliative care significantly enhances the level of care. Since LiiSa’s staff are nurses from the home hospital, they possess a broad range of specialized skills. They excel in assessing and managing pain effectively, ensuring that patients do not suffer unnecessarily. In my view, this is one of LiiSa’s most crucial roles.” 

Vanhanen states that LiiSa’s operations demand competence and decision-making skills from its nurses.

“The work is both fascinating and rewarding. The greatest satisfaction comes from doing one’s job well and prioritizing the patient. This approach minimizes value conflicts in daily work. Our nurses are deeply committed to providing high-quality care for mobile hospital patients.”

The nurses at LiiSa receive full support from their supervisors, who share the same commitment to patients.

“I take great personal satisfaction in knowing that our unit shares multidisciplinary goals centred on the patient’s wellbeing This collaborative approach benefits all healthcare professionals and the entire Wellbeing Services County.” 

Mikael Eklund, 57, speaks highly of his experiences with the home hospital. He has received care from the home hospital numerous times due to erysipelas, a bacterial skin infection.

“Over the years, I’ve had erysipelas around 15 to 20 times. Initially, each infection meant spending at least a week in a hospital bed, as the treatment requires the administration of intravenous antibiotics every 8 hours,” shares Eklund.

He felt it was unnecessary and frustrating to be confined to a hospital bed when there was no other treatment required between the medication administrations.

“In my experience, recovery is significantly faster and more effective at home. The mind stays active, and I can sleep in my own bed,” he adds. 

Eklund has nothing but praise for the Kirkkonummi home hospital.

“The staff are splendid people, an absolutely great bunch! Over the years, I’ve been visited by over 10 different home care nurses, and I’ve gotten to know them well. When I have erysipelas, they come marching in and commence treatment. The medical treatment is administered three times a day, and they also monitor my overall condition.” 
 

According to Eklund, the suitability of home hospital care depends on the patient’s functional capacity.

“For instance, for the elderly who are in good shape, this is a far better treatment method compared to lying in a hospital bed. Of course, it’s necessary to first determine if the individual can manage their daily life at home.”

Eklund likens the hospital bed to a couch: it’s easier to lie down than to get up.

“When you’re lying there for a long time, it can be difficult to get up. It’s so easy to just get stuck there. I think it would be beneficial to encourage seniors to exercise, go outside, and engage in activities. Being active enhances energy and liveliness.

Eklund admits to being a satisfied taxpayer.

“The cost of a clinic-at-home visit is very reasonable. To my friends who complain about taxes, I have to say that at least I’m getting full value for my money. In the end, we have it pretty good in this country,” he concludes.