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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

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Published on: September 30, 2020

Practice Standards for Acute Hospital Care at Home.

David M Levine^1,2, Linda V DeCherrie³, Albert Siu^4,5

¹Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Journal of the American Geriatrics Society

|March 29, 2025

Summary

This summary is machine-generated.

National standards for Hospital at Home (HaH) were developed and assessed. Most HaH practices met or exceeded these new standards, indicating high-quality home-based hospital care.

Keywords:

acute hospital care at home home care services home hospital hospital at home hospital‐based practice standards

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Area of Science:

Healthcare Management
Quality Improvement
Health Services Research

Background:

Hospital at Home (HaH) offers hospital-level care in patients' homes, demonstrating safety, quality, and cost-effectiveness.
Existing HaH practices lack national standards, leading to varied care delivery approaches.
The development of national practice standards is crucial for consistent, high-quality HaH services.

Purpose of the Study:

To establish the first national practice standards for Hospital at Home (HaH) programs.
To assess the performance of HaH practices against these newly developed national standards.

Main Methods:

The HaH Users Group (HaHUG) convened a Practice Standards Council to develop evidence-based standards.
Standards were informed by international guidelines and Medicare waiver requirements, with iterative development and public comment.
A survey assessed HaHUG practices' self-reported performance against each standard (meeting, exceeding, or not meeting).

Main Results:

Thirty-one national practice standards were finalized across seven domains, including leadership, quality, and clinical protocols.
The majority of HaH practices self-reported meeting or exceeding the standards, with a mean performance score of 9.75.
The survey response rate was 23.0% (49 of 213 eligible practices), with most respondents being large, nonprofit, teaching hospitals.

Conclusions:

The study presents the inaugural national practice standards for Hospital at Home (HaH) care.
Self-assessment indicates that most HaH programs meet or exceed these new national standards.
Performance variations highlight opportunities for continued development and quality improvement in HaH services.