Name of the Procedure:

Domiciliary or Rest Home Visit for the Evaluation and Management of a New Patient

Common name(s): Home Visit, New Patient Evaluation

Summary

A domiciliary or rest home visit is conducted by a healthcare professional to evaluate and manage the care of a new patient in their home or a rest home setting. It involves a comprehensive history and examination, and moderate complexity in medical decision-making.

Purpose

This procedure aims to assess and manage the health conditions of patients who cannot travel to a medical facility due to their age, disability, or chronic illness. The primary goal is to provide personalized healthcare and coordinate necessary treatments from the comfort of the patient's residence.

Indications

• Chronic medical conditions that limit mobility.
• Post-hospitalization follow-up.
• Elderly individuals requiring regular health assessments.
• Patients with disabilities that make in-office visits challenging.

Preparation

• The patient should prepare a list of current medications.
• Have any recent medical records or test results available.
• No specific fasting or medication adjustments are typically necessary unless instructed otherwise.

Procedure Description

1. Comprehensive History: The healthcare provider conducts a thorough review of the patient’s medical history, current medications, and any presenting symptoms or concerns.
2. Comprehensive Examination: A physical exam covering vital signs, organ systems, and functional assessment is performed.
3. Medical Decision Making: The provider evaluates the examination findings to develop a care plan, which may include ordering diagnostic tests, prescribing medications, or coordinating with other healthcare services.
4. Counseling and Coordination: The provider offers guidance on managing health conditions and coordinates care with other healthcare practitioners as needed.

Tools and Equipment: Medical bag with diagnostic tools (e.g., blood pressure monitor, stethoscope), patient records, portable lab kits if necessary.

Anesthesia or Sedation: Not usually required.

Duration

Typically, the visit lasts between 60 to 90 minutes.

Setting

The patient’s home or rest home environment.

Personnel

• Primary care physician or nurse practitioner.
• In some cases, a registered nurse or allied health professional may assist.

Risks and Complications

• Minimal risks, primarily limited to potential miscommunications or incomplete assessments if patient history or current status is not fully disclosed.
• Rare risks include missing the nuances that a more controlled examination room environment might reveal.

Benefits

• Personalized and convenient care in a familiar setting.
• Reduced stress and logistical challenges for patients with limited mobility.
• Prompt and coordinated management of health conditions.

Recovery

• No specific recovery period as the procedure is non-invasive.
• Follow-up appointments may be scheduled as necessary.

Alternatives

• In-office visits: More controlled environment but may be challenging for less mobile patients.
• Telehealth visits: Convenient but might lack the depth of physical examination possible in person.

Pros and cons of alternatives:

• In-office visits offer comprehensive diagnostic tools but require patient travel.
• Telehealth is convenient but may not allow for a full physical examination.

Patient Experience

• Patients can expect to feel comfortable being evaluated in their own environment.
• There might be some initial anxiety, but the familiar setting often helps alleviate this.
• Pain management: Not typically necessary as the exam process is non-invasive.