Sample tools, forms, and technical assistance for hospital at home service delivery.
Staffing the Hospital at Home Program: Roles, Staff Criteria and Training, and Team Communication
Last Updated: January 31, 2021
A profile of the Mount Sinai Hospital at Home staffing model, with guidance for designing staffing roles and hiring an effective team.
Webinar: BUILDING YOUR DREAM TEAM: STRATEGIES FOR STAFFING YOUR HOSPITAL AT HOME PROGRAM
Last Updated: February 22, 2022
This webinar addresses the issues crucial to successfully staffing a hospital at home program.
Webinar: ARE WE READY?: PREPARING YOUR CLINICAL TEAM FOR DELIVERING HOSPITAL AT HOME CARE
Last Updated: May 24, 2022
In this webinar, presenters from a wide range of backgrounds discuss the unique education and preparation needed to help your staff deliver a successful hospital at home program.
Sample HaH Competency Checklist for Nurses [Mount Sinai]
Last updated: June 23, 2022
This sample clinical competencies checklist lists all the skills and workflows that nurses serving patients in a hospital at home program should be familiar with. Courtesy of the Mount Sinai Hospitalization at Home program.
Sample Mobile Integrated Health Clinical Training Schedule [Medically Home]
Last updated: June 23, 2022
This sample training schedule for mobile integrated health (MIH) professionals ensures that MIH staff as part of a hospital at home program are are well-equipped as possible before beginning to serve patients. Courtesy of Medically Home.
Nurses at the Forefront: Essential Clinicians in Hospital at Home Programs
Recorded: June 20, 2023
The Hospital at Home Users Group, in partnership with the American Academy of Home Care Medicine, is pleased to present our latest webinar for hospital and system leaders interested in learning about the opportunities and challenges associated with providing acute care in the home.
Webinar: Efficient, Effective, Excellent: Issues in Hospital at Home Logistics and Operations
Recorded February 9, 2021
Drawing from examples at Huntsman in Utah and in other locales, this webinar will examine best practices for ensuring that hospital at home programs can organize and manage the service and staffing needed to deliver high quality acute care. Presentation recording and slides by the Hospital at Home Users Group™.
Webinar: On Time, Every Time: Delivering Hospital at Home Ancillary Services
Recorded February 16, 2021
Delivering a variety of ancillary services is a key requirement of the CMS Acute Hospital Care at Home waiver program, and new and existing programs must ensure that a whole range of services — from labs and imaging to food and durable medical equipment — are available when hospital at home patients need them. Presentation recording and slides by the Hospital at Home Users Group™.
Policies Checklist for the Hospital at Home Program
Last Updated: March 5, 2021
Sample list of hospital policies to review and adapt for the hospital at home program.
Sample Patient Non-Medical Transport Consent Waiver [Beebe Health]
Last Updated: April 18, 2022
Sample consent waiver for hospital at home patients to sign off on using non-medical transport, ie. for family or friends to drive the patient to and from the hospital instead of an ambulance. Courtesy of Beebe Healthcare.
Sample Protocol for Death of HaH DNR/DNI Patient [UMass Memorial Health]
Last Updated: May 13, 2022
Sample protocol for the death of Hospital at Home patient who is of “Do Not Resuscitate” or “Do Not Intubate” Status at home. Courtesy of UMass Memorial Health.
Always Prepared: Ensuring Your Hospital at Home Program is Ready for Any Emergency, Large or Small
Recorded May 2, 2023
The Hospital at Home Users Group, in partnership with the American Academy of Home Care Medicine, is pleased to present our latest webinar for hospital and system leaders interested in learning about the opportunities and challenges associated with providing acute care in the home.
Webinar: Mastering Meds: Exploring Approaches to Pharmacy in Hospital at Home
Recorded March 30, 2021
This webinar focuses on a topic raised time and again by Hospital at Home Users Group™ members — how to best structure and integrate pharmacy services into a hospital at home program.
Hospital at Home Pharmacy FAQ
Last Updated: October 26, 2021
This resource addresses many of the questions raised about Hospital at Home pharmacy processes, including decision points about using an inpatient or outpatient pharmacy or private vendor.
Sample Pharmacy Department Policy for Hospital at Home
Last Updated: October 26, 2021
A Sample Hospital at Home policy from the perspective of the Pharmacy Department.
First-Dose or Urgent Provider Pack/Kit: Medication Inventory
Last Updated: October 26, 2021
Here are two examples of “first-dose” or “urgent” medication lists carried by Hospital at Home MDs of APP’s.
Home Hospital Pharmacy Playbook
Last Updated: November 2022
From the Mayo Clinic and the American Society of Health-System Pharmacists, a comprehensive guide to designing Home Hospital pharmacy services.
How Are We Doing? Evaluating Hospital at Home Quality and Safety
Last Updated: March 3, 2021
Webinar presentation by the Hospital at Home Users Group™ on how to measure, evaluate, and improve upon hospital at home care quality.
Webinar: How Are We Doing? Evaluating Hospital at Home Quality and Safety
Recorded February 23, 2021
Drawing from the experience of Brigham Health’s Home Hospital program and others around the country, this webinar examines a range of quality and safety measurement issues and how these data are essential to generating better outcomes and recruiting institutional funding and support. Presentation recording and slides by the Hospital at Home Users Group™.
Tech Matters: Building the Right Digital Platform for your Hospital at Home Program
Recorded February 2, 2021
Presentation from the Hospital at Home Users Group™ on the relationship between technology decisions and hospital at home program efficacy and quality. Topics include remote patient monitoring, EHR, telemedicine requirements, team communications, Smart Home applications, and ensuring equity. Webinar recording and slides are available.
Using Epic for Hospital at Home
Last Updated: March 19, 2021
White paper developed and continuously updated by Epic, including workflows, system configuration, and reporting. Requires Epic UserWeb login.
Webinar: HaH for Epic Users
Last Updated: March 19, 2021
Operational guidance and system demo for hospital at home programs using Epic. Requires Epic UserWeb login.
Epic for Hospital at Home: FAQ and Resource List
Last Updated: March 19, 2021
Developed by Epic for Epic users designing or delivering hospital at home services. Requires Epic UserWeb login.
Clinical Command Centers and Care at Home [Current Health]
Recorded Aug 2, 2022
Presentation from Current Health on the purpose, impact, and role of a Clinical Command Center. The webinar walks through the process of designing and building a team of digital nurses, and shares some of the lessons learned for your care-at-home journey. Courtesy of Current Health. Webinar recording available.
A look at the essential role that caregivers play in hospital at home care, with thoughts on how to develop solutions to support them more effectively.
Next Step in Care: Doctor Visits
This guide provides practical tips in multiple languages to help patients and family caregivers coordinate agendas before an appointment and to communicate effectively together during the doctor visit – tips that will help avoid conflict as well as get the most out of the encounter with the doctor. Created by the United Hospital Fund. The United Hospital Fund is not responsible for information or advice provided by others, including information on websites that link to Next Step in Care and on third party sites to which the Next Step in Care links.
Next Step in Care: Hospital-to-Home Discharge Guide
A guide to help caregivers prepare for a loved one’s return to home from the hospital, including considerations related to equipment and supplies, environment, and caregiving tasks. Translated in multiple languages. The United Hospital Fund is not responsible for information or advice provided by others, including information on websites that link to Next Step in Care and on third party sites to which the Next Step in Care links.
Next Step in Care: A Family Caregiver’s Planner for Care at Home
A form to help caregivers understand the kinds of home care services their loved one will be receiving, and the schedule of these services. Available in English, Spanish, Russian, and Chinese. The United Hospital Fund is not responsible for information or advice provided by others, including information on websites that link to Next Step in Care and on third party sites to which the Next Step in Care links.
Next Step in Care: What Do I Need as a Family Caregiver?
A form to help caregivers and health professionals plan for services provided to patients in the home, and to discuss caregiver capacity/availability to perform caregiving tasks. Available in multiple languages. The United Hospital Fund is not responsible for information or advice provided by others, including information on websites that link to Next Step in Care and on third party sites to which the Next Step in Care links.
The Care Act: Implementation and Progress (AARP Public Policy Institute)
March 2019
Care Giving in the US 2020 (National Association of Caregivers and AARP)
What Can Hospital at Home Programs Do To Support Family Caregivers
June 3, 2021
How Health Systems Can Care for the Caregiver (NEJM Catalyst Innovations in Care Delivery)
July 2021
Caring for Those Who Care — Resources for Providers: Meeting the Needs of Diverse Family Caregivers
July 7, 2021
Information for Family caregivers
Last updated: December 6, 2023
This informational resource is specifically designed for caregivers. It provides answers to frequently asked questions, clarifies the caregiver’s role and available assistance, and encourages two-way communication between the caregiver and care team. Though this guide is designed as a Users Group resource, we encourage folks to adapt the resource (and use their own branding) as they see fit. This resource was presented at the caregiver innovation session at the 2023 Hospital at Home Users Group Annual Meeting.
webinar: family first: prioritizing family caregivers in hospital at home
Last updated: February 20, 2024
“Family First” explores the implications of the HaH model from the perspective of caregivers, clinicians, researchers, and advocates. It highlights what we are learning from the science, as well as new tools and approaches that improve the experience of family caregivers and ensure HaH is appropriate for the broadest group of patients who need and want it.
Sample caregiver Information handout [texas health]
Last updated: April 15, 2024
Example informational handout for Hospital at Home caregivers that discusses caregiver responsibilities and what to expect. Courtesy of Texas Health.
Sample caregiver Information handout [indiana university health]
Last updated: April 15, 2024
Example informational handout for Hospital at Home caregivers that discusses caregiver responsibilities and what to expect. Courtesy of Indiana University Health.
Sample COVID-19 Patient Clinical Pathway: Current Health
Last Updated: December 20, 2021
This Clinical Pathway guide from Current Health details at-home care for COVID-19 patients. It includes patient inclusion criteria, health data collection & monitoring, in-home services, assessment & escalation, EHR documentation, and an example patient workflow.
Sample COVID-19 Patient Clinical Pathway: Health first
Last Updated: December 20, 2021
This Care Planning guide from Health First at Home describes at-home care for COVID-19 patients. It includes patient inclusion criteria, admission guidelines, remote health data collection & monitoring, home visit schedules, isolation precautions, discharge & post-discharge guidelines, and more.
Webinar: HOSPITAL AT HOME FOR COVID: WHAT WE’VE LEARNED AND WHAT WE’RE LEARNING
Last Updated: March 22, 2022
In this webinar, speakers reflect on the lessons learned from treating COVID patients in the past, how they are implementing these lessons into their programs, and how they are preparing for the future.
Measuring Up: Meeting Program Standards for Hospital at Home
Recorded: September 20, 2022
The Hospital at Home Users Group, in partnership with the American Academy of Home Care Medicine and the American Hospital Association, is pleased to present our latest webinar for hospital and system leaders interested in learning about the opportunities and challenges associated with providing acute care in the home.
Webinar: Hospital at Home for Cancer Care
Recorded December 14, 2021
In this webinar, representatives of five launched or planned programs focused on cancer patients across the country discuss their programs and share their results to date.
HaH Cancer Program Comparison Grid
Last updated December 20, 2021
This Comparison Grid was assembled as part of the December 14, 2021 HaH Users Group webinar, Hospital at Home for Cancer Care, which featured five oncology programs from across the country that utilize hospital at home care, and captures the commonalities and differences between these diverse programs.
Oncology Program Marketing Brochure: Mount Sinai Hospital At Home
Last updated December 20, 2021
A marketing brochure from the Mount Sinai Hospital at Home Oncology program laying out the program’s benefits, care plans, and enrollment options for patients.
Oncology Caregiver PocketCard: Mount Sinai Hospital at Home
Last updated December 20, 2021
This sample pocketcard is intended to help train nurses and caregivers to conduct in-home assessments of patients enrolled in the Mount Sinai Hospital at Home Oncology program.
Webinar: CAN WE DELIVER SKILLED NURSING FACILITY CARE AT HOME? SHOULD WE?
Recorded: December 5, 2023
This webinar examines three systems’ experience creating SNF/Rehab@Home programs as adjuncts to their Hospital at Home offerings. Speakers explore the benefits and challenges of starting and operating these care lines and how Hospital at Home leaders and clinicians can evaluate whether SNF/Rehab@Home makes sense for their health system or hospital.
SNF/Rehab@Home Program Comparison Grid
Recorded: December 5, 2023
This Comparison Grid was assembled as part of the December 5, 2023 Users Group webinar, Can We Deliver Skilled Nursing Facility Care at Home? Should We?, which featured three systems that developed SNF/Rehab@Home programs as adjuncts to their Hospital at Home offerings, and captures the commonalities and differences between these programs.
Offering Observation at Home Services: Payment Pathways and Feasibility
Last updated: March 2024
In January 2024, members of the HaH Users Group assembled to discuss Observation at Home. Dr. Anthony Wehbe of SENA Health described how they are implementing Observation at Home for their health system partner, Inspira Health.
As of this writing, there is no waiver or Medicare payment for Observation care at Home. A few hospital systems and implementation partners have negotiated with commercial payors for an Obs at Home rate. Others, including SENA Health, have navigated a path to operationalize Obs at Home without a direct Obs at Home payment. Typically, it involves treating the patient in the brick-and-mortar through workup and Observation status determination, and billing for an Observation stay. While undergoing Observation care, the patient is discharged from the facility and moved home, where the necessary equipment and supplies are delivered, medications are provided, and ongoing in-person (and, if available, virtual) care continue, as with any HaH episode. Certain elements of the care, such as provider visits (in-person or virtual), are billable to insurance. Costs for care that cannot be billed and that are not covered by the Observation rate would be covered by the hospital or health system, which benefits from additional bed capacity, less burdened brick-and-mortar staff, and satisfied patients. If the patient ultimately requires inpatient admission after their Observation stay, that can potentially occur in the home if the patient is otherwise eligible for HaH care; note that the CMS waiver requires an in-person admission H&P be completed for all HaH waiver episodes.
Offering Observation care at Home at your institution may make sense if:
- You already have the infrastructure (staffing, operations, in-home service providers, etc.) in place to provide acute care in the home – e.g. an existing Hospital at Home or ED in the home service.
- Your institution’s observation unit is consistently at or over capacity, with negative downstream effects on other units and the patient and staff experience.
- You have outlined a workflow to admit patients who may need ongoing inpatient care after an Observation episode, including steps to ensure that there is an in-person H&P before a HaH episode, or transfer back to the facility if necessary.
Updates:
- In February 2024, Marco Rubio (R-FL) and Tom Carper (D-DE) proposed legislation (the At Home Observation and Medical Evaluation – HOME – Services Act) to expand HaH waivers to include Observation patients.
OBSERVATION AT HOME MARKETING BROCHURE: INSPIRA HEALTH HEALING AT HOME
Last updated: March 15, 2024
A patient-facing marketing brochure from Inspira Health’s program laying out the program details and benefits.
OBSERVATION AT HOME INTERNAL BROCHURE FOR PROVIDERS: INSPIRA HEALTH HEALING AT HOME
Last updated: March 15, 2024
An internal marketing brochure from Inspira Health’s Observation at Home program directed at healthcare providers.