COVID 19 Hospital In The Home (HITH)
Useful management information
COVID HITH criteria (+/- disease-modifying treatments)
Adult with confirmed COVID 19 and:
- signs or symptoms of only mild disease, and with risk factors for poor outcomes
Risk factors for poor outcomes:
- Unvaccinated or partially vaccinated patients with specific comorbidities and within 5 days of symptom onset
Specific comorbidities:
- Age 55 years and older, or age 35 years and older if Aboriginal and Torres Strait Islander
- Obesity (BMI > 30)
- Diabetes (other than diet controlled)
- Cardiovascular disease (including congenital heart disease)
- Chronic obstructive pulmonary disease (history of chronic bronchitis, chronic obstructive lung disease, or emphysema with dyspnoea on physical exertion)
- Moderate to severe asthma (requiring an inhaled steroid to control symptoms or prescribed a course of oral steroids in the previous 12 months)
- Chronic kidney disease (eGFR < 60 mL/min)
Immunocompromising conditions (irrespective of vaccination status or day from symptom onset)
- Primary or acquired immunodeficiency:
- Haematologic neoplasms – leukaemia's, lymphomas, myelodysplastic syndromes
- Post-transplant – solid organ on immunosuppressive therapy, haematopoietic stem cell transplant within 24 months
- Immunocompromised due to primary or acquired (HIV/AIDS) immunodeficiency or Down syndrome
- Other significantly immunocompromising conditions:
- Chemotherapy or radiotherapy
- High-dose corticosteroids (≥ 20 mg of prednisolone/day, or equivalent) for ≥ 14 days
- All biologics and most disease modifying anti rheumatic drugs (DMARDs)
Signs or symptoms of mild disease
- Mild symptoms and signs (fever, cough, sore throat, malaise, headache, muscle pain, nausea, vomiting, diarrhoea, loss of taste and smell)
- No new shortness of breath or difficulty breathing on exertion
- No evidence of lower respiratory tract infection during clinical assessment or on imaging (if performed)
- with signs or symptoms of moderate disease and without risk factors for poor outcomes.
Signs or symptoms of moderate disease
- A stable patient with evidence of lower respiratory tract disease during clinical assessment, such as:
- Oxygen saturation 93 to 94% on room air at rest
- Desaturation or mild breathlessness with mild exertion
- Evidence on imaging of pneumonitis or pneumonia
Referral
- Ensure the patient consents to treatment occurring in the home via daily contact with the Hospital in the Home (HITH) team.
- Mark the request as "Urgent" and contact the service using one of the following referral processes. Using a process outside those listed below may delay processing of the referral. Additional referral processes will be listed here as soon as they become available.
- Smart Referrals using the condition "COVID-19" (Strongly recommended if available in your practice to ensure secure, faster, and streamlined referral for care)
- Faxing a written referral to Metro South Health Community Referral Service (07) 3156 4382. Save time by using a prepared template in your Practice software. Your Practice Manager can download and install COVID-19 templates from Brisbane South PHN – Forms and Referrals.
For administration enquiries, phone the Metro South Health GP Liaison Officer (GPLO) program 1300 364 155 (*select option 2) during business hours.
For clinical enquiries, phone the Princess Alexandra Hospital (PAH) switchboard (07) 3176 2111 and ask to speak to the infectious diseases registrar:
This is for clinical advice only. For referrals, see above.
The PAH is experiencing a high volume of calls at this time. If your patient is unwell and requires immediate hospital management, assessment in the emergency department is recommended.
Minimum referral criteria (Does your patient meet the minimum criteria?)
Does your patient meet the minimum referral criteria?
Category 1
For clinical enquiries, phone the Princess Alexandra Hospital (PAH) switchboard (07) 3176 2111 and ask to speak to the infectious diseases registrar: The PAH is experiencing a high volume of calls at this time. If your patient is unwell and requires immediate hospital management, assessment in the emergency department is recommended. |
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| Category 2 (appointment within 90 calendar days) |
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| Category 3 (appointment within 365 calendar days) |
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Assessment and management information can be found on a range of conditions at SpotOnHealth HealthPathways
Standard referral information (To be included in all referrals)
Reason for request
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can't order, or the patient can't afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
Relevant clinical information about the condition
- Presenting symptoms (evolution and duration)
- Physical findings
- Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
- All conservative options that have been pursued unsuccessfully prior to referral
- Body mass index (BMI)
- Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
- Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
- Current medications and dosages
- Drug allergies
- Alcohol, tobacco and other drugs use
- A comprehensive capture of information in relation to MSH Referral Criteria
Clinical modifiers
- The presence of clinical modifiers may impact the categorisation of the patient.
- Impact on employment
- Impact on education
- Impact on home
- Impact on activities of daily living functioning – low/medium/high
- Impact on ability to care for others
- Impact on personal frailty or safety
- Identifies as Aboriginal and/or Torres Strait Islander
Patient's Demographic Details
- Full name (including aliases)
- Date and country of birth
- Residential and postal address including whether patient resides at an aged care facility
- Telephone contact number/s – home, mobile and alternative
- Medicare number (where eligible)
- Name of the parent or caregiver (if appropriate)
- Name of delegate and contact details (Department of Corrective Services)
- Preferred language and interpreter requirements
- Identifies as Aboriginal and/or Torres Strait Islander
- Any special needs, access requirements and/or disability relevant to the referral
Referring Practitioner Details
- Full name
- Full address
- Contact details – telephone, fax, email
- Provider number
- Date of referral
- Signature
- Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner
Other relevant information
- Willingness to have surgery (where surgery is a likely intervention)
- Choice to be treated as a public or private patient
- Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
Essential referral information for COVID 19 Hospital In The Home (HITH) referrals (Referral will be returned without this)
- Date of positive test
- Type of test (PCR or RAT)
- Presenting symptoms - evolution and duration
- Physical findings
- Medical history
- Current medications and dosages
- Immunisation history
- Drug allergies
- Patient must have consented to treatment occuring in the home via daily contact with the Hospital in the Home (HITH) team
Additional referral information for COVID 19 Hospital In The Home (HITH) referrals
- Alcohol, tobacco and other drug use
Emergency
If a patient is unwell and requires immediate hospital management, assessment in the emergency department is recommended.
Out of catchment
Metro South Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro South Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.