Hospital’s stroke team begins new ​‘house call’ ser­vice for patients in study

Written by Jennifer Mackenzie

Do you remember the notion of a “house call” – when a doctor or nurse would come to your home to care for you? You might think that’s just a fantasy from dated television dramas like “Little House on the Prairie,” but it was once a real practice. In 1930, about 40 percent of doctor-patient interactions were through house calls, but by 1980, the rate was down to about 1 percent.

The dedicated women of the Onslow Memorial Hospital (OMH) stroke team have decided it’s time to bring the practice back for stroke patients who are part of the North Carolina COMPASS (COMprehensive Post-Acute Stroke Services) study and are discharged to home but not able, for one reason or another, to return to the hospital for crucial follow-up visits. The COMPASS study aims at improving patient functional outcomes and reducing hospital re-admissions for stroke patients.

Beginning June 1, Post Stroke Provider Keltsie Kellum, FNP, and Post-Acute Care Coordinator Lisa Edmundson will alleviate the burden of driving or finding reliable transportation assistance for stroke patients in need of the service. After submitting their driving records and securing administrative approvals, Kellum and Edmundson are ready to roll.

“In recovering from stroke, patients are often not capable of driving and frequently haven’t even been cleared to drive by their doctor or neurologist,” Kellum explains. “Offering follow-up visits to the home can ease this burden for someone who can’t drive and may not have anyone who can help them with transportation.”

“This is a necessary and also very comforting service that we are happy to now be able to provide to these patients,” Edmundson adds.

“North Carolina currently has the 8th highest stroke mortality rate in the country and is part of a region known as the ‘Stroke Belt,’ meaning that our area has a particularly high incidence of people affected by stroke,” says Tonya Whitaker, the hospital’s Stroke Nurse Coordinator. OMH is designated an Advanced Primary Stroke Center by The Joint Commission.

Stroke care is a complex, multi-faceted challenge for patients and their families that doesn’t end at discharge. “We know that treatment and recovery must extend well past discharge to be fully effective,” Edmundson says.

While stroke patients who are discharged to rehabilitation centers or nursing homes have significant challenges to overcome, stroke patients discharged to home also confront a unique and highly stressful situation.

“Stroke patients leave the hospital where they’ve had meals prepared for them, medications brought to them, rehab services provided, and around the clock assistance with self-care, such as dressing and bathing. They return home with new physical deficits, new medications, new expectations to adjust their lifestyles to prevent complications or recurrence, and medical appointments they need to keep,” Kellum explains.

“Giving stroke patients the option of a home visit when needed is one more way OMH is striving to make sure patients keep their important appointments and have the best possible outcomes,” Edmundson says.