Multidisciplinary approach for the patient on a home ventilator.

HFH has had an evolving home ventilator program since 1976 with the greatest growth in organization and volume since 1979. Technical advancements have made long-term home ventilator use a feasible, manageable, adjunctive, therapeutic modality in the care of patients with chronic respiratory failure. It appears to have more potential benefit for patients with sleep apnea and kyphoscoliosis than for persons with COPD. Many questions still are not answered regarding its use in patients with progressive nonrehabilitative neuromuscular disease. Critical components that must be included in all home ventilator programs include: (1) development of a "team" to train patients, families, and staff; (2) development of a standardized method of communication between the hospital personnel, family, durable medical equipment company, and home care agencies; (3) development of a screening mechanism to evaluate patient's/family's self-care potential in the use of home ventilators; (4) development and refinement of networks between acute care settings and the community agencies; and (5) development of clear channels of communication between patients and health care providers.