Profiles in safety: The Hospital From Home Program.

Abstract

Abstract: Although today's health care system has achieved unprecedented advances, geriatric adults remain vulnerable to iatrogenic complications associated with traditional hospitalization, including acute cognitive delirium, rapid functional decline, medical errors, and health care-associated infections. To improve patient safety, an organization initiated an acute hospital-at-home pilot program from June 2023 through February 2024. Building on the removal of prepandemic regulatory and reimbursement barriers, the pilot was formally expanded and rebranded as the Hospital From Home (HfH) Program. An evaluation of 673 patients over 25 months showed an improved safety profile, with zero serious safety events and a 7.47% 30-day unplanned readmission rate. The program achieved a 100% discharge-to-home rate while successfully managing a slightly above-average to moderately complex Case Mix Index of 1.45. Furthermore, standardized patient experience measures demonstrated higher scores across key nursing leadership domains, including nurse-to-patient communication, interdisciplinary care coordination, and overall patient satisfaction.