Getting on board with going off ward.

Abstract

Off-ward practices for hospitalized patients vary across medical centers, but many hospitals adopt restrictive policies that prioritize safety and liability over autonomy and dignity. Hospitalists routinely navigate competing priorities and negotiate institutional barriers, positioning them to advocate for patient-centered interventions. In this Next Steps article, we describe why limiting freedom of movement infringes upon ethical principles and display that practical frontline solutions are possible through a hospitalist-led off-ward pilot program at a Veterans Affairs hospital. This experience demonstrated that hospitalists can create safe opportunities for patients to regain meaningful independence during hospitalization.