The role of nursing in hospital-at-home programs

Hospital at home (HaH) provides hospital-level care in a patient’s home in lieu of traditional inpatient care. HaH developed out of recognition that hospitals frequently aren’t ideal care environments, especially for older frail adults susceptible to hospital-associated complications. Since the COVID-19 pandemic began, interest in avoiding hospital care has increased. Nursing plays an integral role in HaH care, drawing on skill sets from home health, inpatient, and telehealth medicine. In the 1990s, Bruce Leff, MD, introduced HaH to the United States at The Johns Hopkins Hospital. However, the model stalled due to the multi-payer system and the absence of an accepted payment model. Internationally, HaH has scaled in several countries, including Australia, France, and Spain. A few U.S. health systems have maintained HaH programs since the 1990s, most notably at Department of Veterans Affairs hospitals.