Mobile hospital LiiSa brings help to you

Mobile hospital LiiSa has been up and running in Espoo from the beginning of 2019 and has been a great success. This clinic on wheels goes wherever it is needed.

The idea of a mobile hospital is simple: bringing care to a patient rather than vice versa. It is particularly advantageous for elderly patients not to have to be transported to an emergency clinic but instead have a mobile hospital arrive on site at care home or the patient’s residence.

Mobile hospital LiiSa is a joint project of HUS Emergency Medicine and Services and the City of Espoo. It is being piloted in Espoo with a view of later expanding its domain to cover the Helsinki metropolitan area.

Help around the clock

LiiSa is on call on a 24/7 basis. It is technically a unit of Espoo Hospital. Registered Nurse Risto Saariala, having arrived for the morning shift, answers the phone at the hospital office. The call is from the Suvela unit of Espoo home care services. An elderly man living at home with his spouse is presenting symptoms of a severe allergic reaction.

At the beginning of summer, LiiSa operations were extended to part of Espoo’s home care services. The idea is that eventually all home care clients in Espoo will be covered by LiiSa services. LiiSa has more than 200 contacts per month, most of them from the 42 care homes or assisted living facilities covered by the service.

“Some cases can be resolved by phone, but in this case, there is a clear need to see the patient on site,” says Saariala.

Hospital in miniature

After finishing the phone call, Saariala heads out to a specially equipped van – a hospital in miniature. It has equipment for taking standard blood samples and tools for quick sample analysis.

There is also equipment for measuring vital signs, oxygen bottles, drugs and implements for a variety of procedures such as inserting a suprapubic urine catheter. Also, the nurse may begin administering intravenous fluids or medication on site if necessary.

“I can connect to the patient information systems of basic health care and specialist medical care, which is useful particularly at night,” says Saariala.

Saariala makes use of the NEWS (National Early Warning Score) classification when examining a patient on site.

The most common types of call for LiiSa are situations where a resident of a care home has a fever or excess phlegm or has trouble breathing. In most cases, patients can be treated on site; fewer than 9% are taken into the emergency clinic.

Physician always on call

The registered nurses of the mobile hospital work closely together with physicians. LiiSa nurses consult physicians at care homes during the day and physicians at the emergency clinic at HUS Jorvi Hospital in the evening, at night and on weekends.

“We work well together. We diagnose the situation and consult a physician who then decides on how to treat the patient,” explains Saariala.

Saariala says that he enjoys the responsibility inherent in his work.

“I get to decide things and have a sense of achievement. You must have the right work ethic for this job. I want to be loyal to customers and help them get better as well as I can.”

LiiSa received with rejoicing

LiiSa has been much commended by patients, their family members and care home personnel.

“Family members are happy that they don’t have to transport the patient,” says Saariala.

Sanja Sädevirta, Specialist in Internal Medicine working at the emergency clinic at Jorvi, also has kind words to say about LiiSa.

“Care homes rarely have people with competence to deal with acute situations, so their solution tends to be to call an ambulance to bring the patient in to the emergency clinic. Now it is possible to deal with a lot of things on site, and that puts much less of a strain on elderly patients,” says Sädevirta.

“The best thing about this is that we can take help to where it is needed,” says Saariala.

The article was originally published in Husari 5/2019.