Home Hospital team members Helen Le, PA-C (left) and Amy Costa, RN (right) checking on a patient at home
Mass General Brigham Healthcare at Home is expanding the home-based care continuum by growing its Home Hospital service to reach even more patients across the region. The MGB Home Hospital was formed in 2022, combining the successful hospital at home efforts in operation at Massachusetts General Hospital and Brigham and Women’s Hospital since 2016. Home Hospital care gained momentum in 2020 when the Centers for Medicare and Medicaid Services (CMS) launched the Acute Hospital Care at Home waiver that provided federal regulatory and financial authorization for these programs to combat the COVID pandemic. Since then, Mass General Brigham has provided Home Hospital services to over 3,000 patients, shifting in-hospital care equal to 15,000 days into the homes of patients. In 2023, the MGB Home Hospital has facilitated nearly 1,000 admissions to date and currently has a capacity for 33 patients.
In August, Home Hospital hit an important milestone in its evolution—approval by CMS and the Massachusetts Department of Public Health—to expand operations to Brigham and Women’s Faulkner Hospital, as well as Newton-Wellesley Hospital and Salem Hospital beginning this September. Home Hospital’s growth is a testament to how well-received it is by patients, and the real impact to recovery times and length of stay that patients experience when admitted to Home Hospital. More broadly, this new milestone reflects how critical it is to drive this model across the system to ensure we are delivering improved access and quality of care as an integrated healthcare system.
At BWFH, where patients have previously been admitted to the program under Brigham and Women’s Hospital’s license, the program has been a success and providers look forward to offering the service to even more patients. “In the Emergency Department, most of our patients are evaluated for a potential Home Hospital admission,” explains Emergency Department Nurse Director Robin Powell, MSN, RN, CEN. “We take into account a patient’s medical condition, where they live and their enthusiasm for the program. By admitting a number of patients to Home Hospital we can comfortably provide care for patients in a familiar setting at home while preserving critical inpatient spaces for other patients that may not fit the criteria for a Home Hospital admission.”
Powell continues, “Patients often are transferred from the ED directly to their home after an evaluation with the Home Hospital team. We have had many patients describe their Home Hospital stays as very positive and say they would opt for a Home Hospital admission if needed again.”
Heather O’Sullivan, MS, RN, A-GNP, President of Healthcare at Home adds, "We are incredibly proud of the impact the Home Hospital has had on its patients, as well as our care teams across Mass General Brigham. This expansion is an exciting opportunity to provide greater access to the integrated, high-quality care we offer to even more patients in our surrounding communities."
The care patients need in the comfort of their home.
Home Hospital provides a home-based alternative to a facility-based inpatient hospital stay by maximizing care and recovery time within the comforts of a patient’s home. More advanced than traditional home health services, Home Hospital offers daily visits from healthcare providers (physicians, nurses, therapists, home health aides, and more) and provides services such as intravenous fluids, medications, lab draws, oxygen therapy, x-rays, electrocardiograms and ultrasounds directly in the home. All of this is supported by a 24/7 continuous remote patient monitoring platform that transmits a patient’s vital sign readings to their clinicians as well as a two-way text and video communication pathway to ensure continual access to a patient’s clinical team.
Candidates for Home Hospital care must meet specific criteria: they need to be sick enough to require hospital-level care, but stable enough to receive that care at home. Patients are admitted into Home Hospital from the Emergency Department or an inpatient floor. Common conditions treated include heart failure, COPD, pneumonia, urinary tract infections, and skin infections. However, other conditions can be managed by the Home Hospital, as each care plan is tailored to the individual patient, their unique medical needs, as well as the patient’s home environment. Patients must also live in Massachusetts in a town identified as having adequate proximity to care providers and services.
Improving patient satisfaction, while reducing burden on capacity constraints.
Home Hospital has delivered strong patient outcomes over the years such as greater patient satisfaction and lower hospital readmissions, mortality, total costs and average length of stay. A 2018 study by hospital researchers found that patients in home hospital care were more physically active, got more sleep, and used fewer health care services without significant safety or quality differences. The program also provides greater visibility into a patient’s socioeconomic needs and offers additional resources to support their care. Stephen Dorner, MD, chief clinical and innovation officer for Mass General Brigham Healthcare at Home said, “Being able to have that kind of vantage point, you can ensure greater health and safety of a patient as you’re tailoring their care plan to their personal environment.”
As the current capacity crisis continues to put strain on healthcare providers and facility-based hospitals, Home Hospital offers a care delivery model that increases facility hospital bed availability to treat the sickest patients requiring more complex care. Growing the Home Hospital will continue to be a strategic priority for Mass General Brigham as it exemplifies the value of well-integrated and patient-focused care. Over the next five years, we expect to shift 10% of our inpatient care at Brigham and Women’s, MGH, Newton-Wellesley Hospital, Salem Hospital and Brigham and Women’s Faulkner Hospital to patients' homes.
Learn more about Healthcare at Home on its newly launched website and in a recent Q&A with President of Healthcare at Home, Heather O’Sullivan, MS, RN, A-GNP.
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