Guidance on designing patient eligibility criteria, including sample inclusion and exclusion criteria, screening guides, and patient consent forms.
Sample Screening Form: Avera Mckennan
Last Updated: April 22, 2022
Sample Hospital at Home initial patient assessment form. Shared by Avera McKennan.
Webinar: Who’s In? Who’s Out? Deciding which Patients are Right for your Hospital at Home Program
Recorded: January 28, 2021
1/28 presentation from the Hospital at Home Users Group™ on setting eligibility and exclusion criteria for your HaH program, including examples to illustrate key design principles and strategies for educating referrers on eligibility criteria. Webinar recording and slides are available.
Hospital at Home: Patient Eligibility, Referrals, and Intake Processes
Last Updated: January 27, 2021
Guidance on implementing patient eligibility and exclusion criteria, evaluating admissions to the Hospital at Home program, and intake protocols.
Sample Criteria: Presbyterian Healthcare Services
Last Updated: January 27, 2021
Inclusion and exclusion criteria, including geographic radius. Shared by Presbyterian Healthcare Services.
Sample Criteria: Brigham Health
Last Updated: January 27, 2021
Sample Hospital at Home patient eligibility criteria. Shared by Brigham Health.
HaH Referral Workflow: Sample Algorithm
Last Updated: February 8, 2021
Decision-making, handoffs, and communication protocols when a patient has been identified as a candidate for Hospital at Home. Note: this resource is a sample; referral workflows should be adapted to meet the needs of each HaH institution.
Sample Screen for Hospital at Home: Mount Sinai Health System
Last Updated: January 27, 2021
Screen for logistical criteria and hard exclusion criteria for patients who otherwise meet clinical criteria for the Hospital at Home service. Sample shared by the Icahn School of Medicine at Mount Sinai, 2018.
Sample: HaH Bedside Patient Screening Guide for Admitting Provider
Last Updated: January 27, 2021
Safety screening guide for use by the admitting provider for Hospital at Home. Sample shared by the Icahn School of Medicine at Mount Sinai, 2018.
Sample 1: Hospital at Home Consent Form
Last Updated: January 31, 2021
Sample patient consent form form Hospital at Home – any consents should be reviewed by the legal counsel and compliance teams at your institution.
Sample 2: Hospital at Home Consent Form
Last Updated: January 31, 2021
Sample patient consent form form Hospital at Home – any consents should be reviewed by the legal counsel and compliance teams at your institution.
Patient Acquisition/Average Daily Census (Integris OK/Medically Home)
Last Updated: March 28, 2022
Webinar slides on Integris OK/Medically Home’s Hospital @ Home’s program startup and patient acquisition process, with a focus on average daily census. Originally presented to Hospital at Home Users Group Members in a webinar on March 23, 2022.