Home Hospital patients get inpatient care where they are most comfortable—in their homes.
Published by
Jim Milke
on
There’s an old saying among doctors about patients recovering in hospitals, “The longer you stay, the longer you stay.”
Since 2016, Mass General Brigham’s Home Hospital has tackled this challenge with a set of innovations that bring acute inpatient care to the home, where the patient is most comfortable.
The success of the Mass General Brigham Home Hospital, one of the oldest and most established in the nation, is supported by research done by David Levine, MD, MPH, clinical director of research and development for Mass General Brigham Healthcare at Home, associate professor at Harvard Medical School, and a physician at Brigham and Women’s Hospital. Levine’s research, published in the Annals of Internal Medicine in January 2024, documents over 5,000 patients treated in hospital at home programs across the country. The results of his study reveal favorable outcomes.1
On average, Home Hospital patients need less physical therapy, use less skilled nursing rehabilitation, report greater patient satisfaction, have an easier transition to life after discharge, and have better clinical outcomes.
So how does it work? What’s the care team like? In Mass General Brigham’s Home Hospital, admitted patients receive care from the same types of Mass General Brigham physicians and nurses in the brick-and-mortar hospitals, enabled by the latest innovations in remote patient monitoring, mobile imaging, and lab work conducted in the home.
To start, patients meet with a clinician in the facility, for example the Emergency Department or inpatient unit, and are set up with everything necessary for a successful care experience, including monitors that allow your care team to follow your vitals remotely and a tablet to connect to your team via video 24/7. Clinicians, such as nurses, paramedics, OT, PT, nurse practitioners, physician assistants and doctors, visit 3-4 times a day, and patients are never out of touch with their providers.
Home Hospital is ideal for patients with certain conditions, including congestive heart failure, COVID-19, sepsis, kidney and urinary tract infections, and cellulitis. Not all patients or conditions qualify, but many do. Home Hospital is only offered to those patients for whom it is a safe and desirable alternative. And it is completely voluntary.
Below we answer some common questions that many patients have about recovering at home. The answers here are specific to Mass General Brigham’s Home Hospital only.
How does Home Hospital differ from a traditional hospital stay?
Home Hospital differs from traditional by offering care in the patient’s home, creating a more comfortable and familiar environment. This model emphasizes personal care plans and flexibility in visitation and routines while ensuring that the safety and quality of care remain the same as in a traditional hospital setting.
How do I become a Home Hospital patient?
Patients must be seen in a Mass General Brigham hospital in the Emergency department or as an inpatient before they are eligible for Home Hospital. If you and your provider decide Home Hospital is the right choice for you, your provider will refer you to Home Hospital. They will only recommend Home Hospital to you if it is clinically appropriate.
Who will be on my Home Hospital team?
Just like in the hospital, your team will consist of Mass General Brigham doctors, nurses, nurse practitioners, and physician assistants. You may also be visited by Mass General Brigham paramedics during your admission at home.
Will caregivers assume more responsibility for a loved one’s care if they are at home?
Our aim is to alleviate the burden on caregivers, allowing them to focus on their loved one’s emotional well-being and their own self-care throughout the healing process. A caregiver’s level of responsibility can vary based on the patient’s needs and the caregiver’s capabilities. In Home Hospital, medical care is managed solely by the Home Hospital team, similar to an inpatient stay. However, caregivers play an important role in the decision-making process regarding whether Home Hospital is the right choice for their loved one. While caregivers are not expected to handle medical tasks, they can provide vital support in activities such as helping the patient stay hydrated, change their clothes, shower, and go to the bathroom, all within the familiar environment of home. This familiarity often contributes significantly to faster healing and recovery for patients.
Do you work with my current doctors?
Yes. We communicate with your doctors and value their input.
Is it safe for me to be treated at home?
If you have been approached about Home Hospital, you have been identified as someone for whom we believe we can safely provide care at home. Keep in mind, you are being monitored remotely 24 hours a day by a team of nurses, and help can be rushed to you. If you ever want or need to return to the hospital, our home hospital team will coordinate a safe transfer to the hospital for you.
Has this been done before?
Mass General Brigham has been running Home Hospital for more than eight years. Since January 2022, we’ve served over 2,400 patients. Nationwide studies have proven favorable outcomes such as better clinical outcomes, a shorter length of stay, improved patient satisfaction, and an easier transition to life after discharge.
How long can I expect to be treated at home?
How long you’ll be treated depends on your condition and needs. For most patients, it’s usually five to six days. When you’re ready to be discharged, your team will evaluate whether you need ongoing nurse visits, physical therapy, or other services. Your primary care physician will also be involved in this conversation.
What are the plans for follow-up care after the home hospitalization period?
The goal is to facilitate a smooth transition from Home Hospital to continued care. After discharge from Home Hospital, we will create a follow-up care plan that is tailored to your specific needs and recovery progress. These plans often include scheduled visits from our providers, such as nurse or therapists, to monitor your health status, assess progress, and adjust treatment as necessary. Additionally, if needed, you may be referred to outpatient services or rehabilitation programs to continue your recovery journey and ensure ongoing support and medical supervision.
Are there any limitations to who is eligible for Home Hospital?
Every adult patient with an eligible diagnosis has equitable access. Your doctor will recommend Home Hospital to you if it is appropriate for your condition and needs. Home Hospital is a geographically based service. Eligible patients must live in towns within a 3—minute drive time of a participating Mass General Brigham facility.
Who pays for my Home Hospital admission?
There is no additional cost for Home Hospital care other than expenses you would normally have when hospitalized. We accept all patients regardless of insurance. n
What if I feel uncomfortable getting care at home?
Home Hospital is entirely voluntary. It will be offered only if your medical team believes it is a good option for you, and you can choose to be admitted to the traditional hospital if that makes you feel more comfortable.
What if I have an issue overnight or between visits?
During your Home Hospital admission, you’ll be seen at least twice daily in person in addition to your virtual visits with doctors and caregivers. If you need any help between visits, you can contact the Home Hospital team 24/7, and they can arrange for urgent or unplanned visits. You are never out of touch.
How quickly can medical help be summoned in case of an emergency?
We will provide you with instructions on how to reach your team if you have questions or concerns. In the case of an emergency, you should always call 911.
Can I leave my home during the admission?
Admission to Home Hospital is the same as being admitted to a regular hospital. You should not be leaving your home while admitted unless it has been discussed in advance with your care team. This is important as the Home Hospital team would want to know where you are and be able to get to you quickly in the unlikely event of an emergency.
How is my condition monitored between visits?
The Home Hospital team will decide with you whether your medical condition requires continuous monitoring of your vital signs. You may be given an oxygen level test or a blood pressure cuff that you put on, which sends results to your monitoring team. If necessary, you’ll be given a device that monitors and sends your vitals continuously.
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