Surgeon Knowledge and Perspectives on Hospital at Home for the Surgical Patient

Hospital at home (HAH) enables inpatient-level care at home. However, postoperative patients are a minority of the HAH patient population and there are no evidence-based guidelines for inclusion or care of these patients. We aimed to assess surgeons' baseline HAH knowledge and, following focused education on HAH, evaluate perspectives on integrating HAH into postoperative care at an academic safety net hospital.

We conducted semistructured interviews (May to September 2025) with attending surgeons in general surgery, orthopedic, and urology departments. Following baseline knowledge assessment, surgeons reviewed an HAH information sheet. Interviews were recorded and transcribed. Themes were identified using rapid qualitative analysis.

Ten surgeons were interviewed. All had some baseline HAH knowledge and asked clarifying questions about the program. Those with more HAH exposure prior to the interview reported having attempted HAH use for their patients. Many described patients with protocolized care as ideal HAH candidates. Total parenteral nutrition administration, continuous monitoring technology, and HAH personnel trained in caring for surgical problems were identified as facilitators. Surgeon workflow was identified as a barrier to HAH integration, though surgeons expressed willingness to incorporate HAH into their day and viewed their surgical inpatient teams as resources to help with this.

Surgeons see utility in HAH for their patients, suggesting benefit to engaging surgeons early in HAH program implementation. In the context of HAH's global progress and lessons from enhanced recovery after surgery protocol implementation and adherence, this foundational work can help advance HAH into the perioperative space.