ED ADMIN & CLINICAL OPERATIONS
Bringing Hospital Care into the Home
SAEM PULSE | JANUARY-FEBRUARY 2022
By Yosef Berlyand, MD; Ryan Thompson, MD, MPH; and Brian J. Yun, MD, MBA, MPH, on behalf of the the Boarding and Crowding Subcommittee of the SAEM ED Administration and Clinical Operations Committee
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Hospital overcrowding and boarding in the emergency department (ED) are major challenges facing hospitals in the U.S. and can negatively impact many aspects of care, from patient experience and quality of care to staff experience and operational efficiency. We’ve all felt this recently with hospitals shattering admission records and both hospitals and clinicians feeling stretched thin like never before. Driven by high volumes and boarding of patients in the ED for hours and sometimes days before receiving their inpatient bed, significant efforts have emerged to find alternative pathways to hospital admission, including Home Hospital. Home Hospital is defined as the community-based provision of services usually associated with acute inpatient care. In practice this means mirroring
“Home Hospital works particularly well for patients who do not anticipate the need for an inpatient procedure and are at low risk for decompensation necessitating critical care.” services delivered in a physical hospital, including therapies such as IV medications and oxygen, daily lab monitoring, and continuous cardiac monitoring in the comfort of a patient’s home. This model has been successfully implemented in Australia and Spain, and has recently gained traction in the United States with innovative Home
Hospital programs established at several academic medical centers including Massachusetts General Hospital, Brigham and Women’s Hospital, Mount Sinai, and Johns Hopkins. Home Hospital works particularly well for patients who do not anticipate the need for an inpatient procedure and are at low risk for decompensation
