Wave Healthcare Eases the Hospital-to-Home Transition for Pediatric Respiratory Disease Patients and Their Families

By Thomas Crocker
Thursday, August 16, 2018

With a team of experienced respiratory care therapists and offices in five locations throughout Texas, Wave Healthcare provides the equipment, expertise and education that infants and children who require respiratory support need to begin life at home after discharge from the hospital.

For families of infants or children who have upper airway or cardiac abnormalities, chronic lung disease, or other medical conditions that require breathing support, the prospect of leaving the hospital and going home with a mechanical ventilator, airway clearance device or other equipment can be daunting. This is especially true of families with children who have a neuromuscular disease.

Ben Castruita, RT, BS 
Director of Respiratory Services

“Children with neuromuscular disease do not have the muscle tone to breathe independently, so they are totally dependent on the mechanical ventilator to do it for them,” says Ben Castruita, RRT, BS, Director of Respiratory Services at Wave Healthcare. “Every patient’s case is different, and it is vital to ensure we adjust the machine appropriately for each patient. That is why we spend a lot of time with patients and their families to ensure the settings we program and the adjustments we make match the physician’s orders and the patient’s medical needs.”

That process of supporting and educating families begins well before patients leave the hospital.

A Critical Juncture

The transition from hospital to home carries significant potential for problematic gaps in communication and families find themselves in an unexpected, challenging position — having to care for a child with a complex medical condition and using equipment that may be unfamiliar to them.

“Wave uses an innovative approach,” Castruita says.

After a referral from a pediatric pulmonologist, hospital case manager, social worker or another source, a Wave Healthcare respiratory therapist meets with the patient and family and the work of having a successful transition to home begins. Many factors must be considered when discharging a child home with mechanical ventilation, including thorough education for all caregivers, parent participation, appropriate space in the home and safety of the child. Wave Healthcare’s goal is to have the whole assessment completed prior to discharge.

Lupe Martinez, BSRC, RRT, RCP, AE-C Director of Clinical Practice

“We bring the equipment the patient and family will use in the home to the hospital,” says Lupe Martinez, BSRC, RRT, RCP, AE-C, Director of Clinical Practice at Wave Healthcare.

Wave Healthcare requires each patient to use its devices prior to discharge so clinicians can verify the equipment can be tolerated and family members can build familiarity with it. On the day of discharge, a respiratory therapist meets the family at home to ensure the child transitions well and to discuss device maintenance and troubleshooting, Martinez emphasizes.

Wave Healthcare educates outside caregivers, such as home health nurses, in the use of mechanical ventilators and other devices. If a child receives mechanical ventilation, regular visits allow a respiratory therapist to check the status of patient and ventilator. If questions arise, families have around-the-clock access to a respiratory care team with extensive experience — clinical leadership at Wave Healthcare has an average of 20 years in the pediatric respiratory field.

“We hire respiratory care practitioners who have worked in a hospital NICU and PICU because experience in an acute-care environment is invaluable,” Martinez says.

Innovative Respiratory Care Solutions

Wave Healthcare offers a variety of inventive services to help patients and families overcome the most significant obstacles of at-home respiratory support. These services include:

  • High-flow nasal cannula — In the hospital, this device has become a staple during the past five years for young patients who require elevated oxygen flow to keep their airways open, according to Martinez. High-flow nasal cannula was largely unavailable to patients in the home. Wave Healthcare consultants worked with neonatologists to develop comparable solutions that now play an integral role in keeping patients from returning to the hospital.
  • Intrapulmonary percussive ventilation (IPV) — “Many patients with neuromuscular disease are unable to cough up secretions from the lungs,” Castruita says. “IPV is a ventilator-like device that sends tiny bursts of air all the way to the alveoli and mobilizes the secretions to clear the lungs so they can be removed via patient coughing or suction.”
  • Noninvasive ventilation compliance monitoring — This service helps ensure very small children can receive continuous positive airway pressure (CPAP) for obstructive sleep apnea safely at home. Three to five days after children receive their noninvasive ventilator at home, a respiratory therapist follows up with their parents to identify any problems related to the mask or pressure settings.

“These are just a few examples of how Wave Healthcare creates solutions for these families while fulfilling our mission of ‘Improving Healthcare for Children,’” Castruita says.

Meet the Program Directors

Lupe Martinez, BSRC, RRT, RCP, AE-C, Director of Clinical Practice at Wave Healthcare, developed a passion for caring for children when she joined the pediatric air ambulance crew near the end of a 20-year career at Methodist Hospital in San Antonio. After earning a bachelor’s degree in respiratory therapy, she worked with a private practice pediatric pulmonologist and helped train home health nurses to care for children who needed respiratory support. She joined Wave Healthcare in 2012. She trains the company’s respiratory therapists in Wave Healthcare protocols and educates community clinicians about new respiratory support products and technology.

Ben Castruita, RRT, BS, Director of Respiratory Services at Wave Healthcare, developed an interest in respiratory medicine during his time in the military and first worked with children in the NICU at a community hospital near Austin. He went on to care for critically ill children and held leadership positions at hospitals in El Paso and at The Children’s Hospital of San Antonio before joining Wave Healthcare nearly two years ago out of a desire to apply his expertise to home care. He supervises the company’s respiratory therapists and ensures they deliver consistent, high-quality care to patients throughout Texas.

For more information about Wave Healthcare’s services and equipment, visit wavehealthcare.com or call 866-935-9283.