Various perceptions exist of a hospital stay. There’s something that seems reassuring about being in a facility, surrounded by caring professionals, high-tech equipment and clinical hyper-attention.

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But a hospital stay doesn’t always assure perfect outcomes. Patients risk acquiring infections from the patients around them; it can be disorienting and debilitating; and without proper vigilance and ongoing follow-up, there’s a risk of medical errors and potential readmission after discharge. Acute care provided at a patient’s home offers the opportunity to provide care that’s safer and potentially less costly. From the patient’s perspective, it’s a winner, says Colleen Hole, vice president of clinical integration and chief nurse executive for Atrium Health Medical Group. “As you think about the aging population, having to travel 30 to 45 minutes to a hospital is daunting,” she notes. “To ask them to come into an urban area with one-way streets and parking decks is a lot, and it’s daunting to leave a spouse who's 85 years old, worrying about traveling to see their loved one. To be able to care for them in their own home with us there to support them, it’s a win all around.” 

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While there’s growing momentum for the hospital-at-home movement, leading organizations have found logistical challenges in scaling their programs, and concerns abound about how such services will be reimbursed. But acute care in the home has demonstrated many benefits, and more organizations are exploring it as a way to ensure better care, optimize use of inpatient rooms and enhance patients’ experience. 

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• Fred Bazzoli, Editor in Chief

As you read the stories in this package, we hope it will provide: 

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• 1. Background on the emergence and evolution of the hospital at home movement. 
• 2. Details of how leading organizations have developed their strategies and details on how they are pursuing growth. 
• 3. Evidence about the benefits of hospital care at home and the challenges of adopting this strategy. 
• 4. Insight into factors that challenge the growth of the approach, especially regarding how care is reimbursed. 
• 5. Leaders’ perspective on how to begin initiatives, and the importance of executive support of this radical strategic vision.