Development of Competency Framework for Nurses in Hospital-at-Home in Singapore

Mobile Inpatient Care at Home (MIC@Home), also known as Hospital-at-Home (HaH), was introduced in Singapore to enable treatment modalities traditionally done in the hospital to be carried out in the comfort of patients’ own homes. Management of higher acuity patients in the HaH setting requires nurses to have a wide range of skills from both inpatient and community. The purpose of the study is to develop a competency framework to guide the training curriculum of HaH nurses to ensure sustained quality and safety of care of patients. The six-step model for developing competency framework was applied and a Delphi process was then employed to ensure the validity of the framework by seeking feedback and consensus from a panel of experts from both clinical and nursing backgrounds. A competency framework was developed, acknowledging the limitations of the small panel of experts surveyed and also the possible overgeneralisation due to the patients’ acuity, complexities and specialties of our HaH team. We have proposed a competency framework that will serve as an important playbook for hospitals in equipping HaH nurses with the necessary tools, resources and knowledge to ensure the standard of care for HaH patients.