The First Hospital at Home Program in South Texas
By Amanda Jepson | Categories: | Comments Off on The First Hospital at Home Program in South Texas
The Hospital at Home program at University Health, in San Antonio, provides hospital-level care in a patient’s home as an option for hospitalization. While COVID-19 catalyzed the program, the emerging interest in acute care at home and its positive effect on patient experience, population, and costs put the program in motion.
Services include: twice daily in person nurse visits, telemedicine provider visits, remote vital signs monitoring, physical and occupational therapy, medical equipment, internet-connected digital tablets for telehealth visits and patient education, labs and intravenous medications, social support and other services. A multidisciplinary team of doctors, nurses, social workers, care coordinators, respiratory therapists, and other specialists is trained to deliver care outside the hospital. The program created a new department and mobile fleet with in-house funding and is now entirely self-sustaining.
Nursing, information technology, and health care innovation staff lead the program, and staff from the pharmacy, laboratory and pathology, operations, legal, and respiratory care, patient care services, food services, medical records, radiology, patient care coordination, and other departments have been involved in program design since inception. Each department created workflows and standard operating procedures outlining their roles in patient support. A specially designed module within the system’s electronic medical records helps coordinate remote patient monitoring, equipment, and provider best practices. Leadership from each department is heavily involved in program evaluation and sustainability. Patient feedback shapes the program by helping staff identify social determinants of health, such as food insecurity and other needs crucial for recovery and staying healthy after discharge.
The program continues to grow. Since the program started in 2021, the Hospital-at-Home program has cared for more than 3,100 patients, corresponding to over 16,400 beds saved for the hospital. The health system reports zero falls with serious injury, medication errors with serious injury, pressure injuries, or zero staff safety incidents. The program has reduced readmission, increased patient satisfaction, and generated significant cost savings; from 2021 to 2024, the program saved University Health more than $17 million. Additionally, the program has retained 100 percent of its staff.