Hospital-At-Home: What Nurses and Nursing Students Need to Know

• Hospital-at-home services can reduce costs, improve outcomes, help solve hospital overcrowding, and improve patient satisfaction.
• Existing care models are changing to incorporate more hospital-at-home.
• The nursing community can shape optimal hospital-at-home models for nurses and patients.

Hospital-at-home programs can reduce healthcare costs by as much as 30% and provide better outcomes, especially for patients at risk of hospital-acquired infections or who find the hospital setting highly stressful. In a 2022 survey, 80% of hospitals have plans for offering hospital-at-home services.

So what do nurses need to know about this burgeoning and effective new model of care?

This guide explains hospital-at-home for nurses, how it can affect nursing education and careers, and what you need to know today to be ready. Explore more about this potential transformation today.

Hospital-at-Home: How It Works and the Nursing Role

Hospital-at-home provides care for patients with conditions serious enough to require professional treatment and monitoring without the need to be physically present in a hospital. Typical use cases include recovering from a procedure, accident, or conditions such as dehydration, deep-vein thrombosis, or urinary tract infections.

While the technology and tools for hospital-at-home care delivery are ready for many conditions, legislation and payment systems are lagging, delaying full adoption. Still, many hospitals and a growing number of new providers are moving ahead with hospital-at-home services. The many benefits they see include:

• Lowered cost of care due to shorter hospital stays
• More convenience for family and friends who want to visit patients
• Higher satisfaction among patients and family
• Less risk of hospital-acquired infection and other risks
• Patients can more easily follow their own cultural or religious diet traditions
• Less distress for patients with mental health conditions who find it difficult to be outside their home environment
• Less patient depression and anxiety

What are the implications of hospital-at-home for nurses?

Nurses can provide ongoing monitoring and communication with patients through technology, checking vital signs, addressing questions or needs, or instructing home health aides, family or friends, or others in providing necessary care. There may also be growth in home nursing jobs for nurses who are willing to travel to do initial setup or follow-up visits.

If hospital-at-home can significantly shorten hospital stays, it may also help address nurse burnout. However, it is unclear what the emotional and psychological aspects of providing remote nursing care are, either positive or negative.

Another possible change in hospital-at-home for nurses may be a growing role for venture capital in establishing new hospital-at-home service providers. InsightAce Analytic projects a 47% global compound annual growth rate for hospital-at-home for 2023-2031. McKinsey reports digital health investments from venture capital of $29.1 billion in 2021, up from $14.9 billion in 2020 and $8.2 billion in 2019. These investments may also create a cultural shift for nurses.

How Can Nurses Get Involved in Hospital-at-Home?

Analysts have noted three main challenges to effectively scaling hospital-at-home models. These include building enough patient volume to make programs and infrastructure sustainable, delivering on the promise of cost savings, and ensuring that the right patients are referred to hospital-at-home. If U.S. hospitals, payers, legislators, and clinicians can effectively address these issues, hospital-at-home could benefit patients and nurses alike.

Nurse leaders can play a vital role in representing nursing and nurses in discussions and planning for hospital-at-home services. They can also advocate for patient interests and equitable access to hospital-at-home, especially for marginalized patients and communities.

Some ways to prepare for this possible future of care include:

• Nurses discussing the implications of hospital-at-home for nurses with staff, administration, and nursing associations, such as your state association
• Nurses advocating for themselves and patients when government agencies and payers develop policies and procedures
• Nurse educators analyzing the new learning needs for nurses and developing new resources for practicing nurses, continuing education, and new nursing school curriculum
• Nurse researchers studying outcomes and developing evidence-based care standards
• Clinical nurse specialists identifying the ways to identify effective approaches to hospital-at-home for nurses

There is tremendous potential in hospital-at-home for nurses. It can address some of the most problematic aspects of nursing, including overwork and burnout. It can also deliver better patient experiences and outcomes, reduce moral harm and stress for nurses, and provide more cost-efficient care, possibly passing the savings on to nurses in higher salaries. But for these to happen, nurses must become active and involved in shaping the future of hospital-at-home.

Sources

Arsenault-Lapierre, G et al. Hospital-at-Home Interventions vs In-Hospital Stay for Patients With Chronic Disease Who Present to the Emergency Department. (2021). JAMA Network

Bestsennyy, O et al. From facility to home: How healthcare could shift by 2025. (2023). McKinsey & Company

Global Hospital-at-Home Market Research Report. (2022). InsightAce Analytic

Klein S. “Hospital at Home” Programs Improve Outcomes, Lower Costs But Face Resistance from Providers and Payers. (2023). The Commonwealth Fund

Krumholz, Harlan. Post-Hospital Syndrome — An Acquired, Transient Condition of Generalized Risk. (2013). The New England Journal of Medicine

Pelizzari, P et al. Hospital At Home Is Not Just For Hospitals. (2022). Health Affairs

Why Hospital at Home, and Why Now? Lessons Learned from the Rise of Ambulatory Surgery. (2022). Chartis