University Health, San Antonio
University Health in San Antonio was awarded THA’s Bill Aston Award for Quality for its Hospital at Home project, a care model that provides hospital-level of care and addresses patient needs in the comfort of their homes.
When the COVID-19 pandemic left hospitals struggling without beds and people sickened from delayed medical care, University Health provided a new option to help: Hospital at Home. The innovation sparked by desperate need harkens back to an age-old concept: house calls – but now supported by modern technology. University Health began accepting its first patients to Hospital at Home program in July of 2021 to provide acute care to patients in the comfort of their own homes. University Health also became the first hospital in the country to admit postpartum patients to this program. Through the program, University Health addressed health equity by improving patient experience, increased access to care by providing it to those who would otherwise delay, and increased acute bed capacity, in addition to reducing readmissions and increasing Emergency Department throughput.
Hospital at Home is an innovative care model that allows for patients with conditions previously managed only in a hospital to receive compassionate, high-quality virtual and in-person acute level of care in the comfort of their homes. The University Health multidisciplinary care team includes doctors, nurse practitioners, registered nurses, social workers, care coordinators, physical therapists, and other specialists. The program has proven suitable for all ages, several diagnoses, and all-payer statuses. Concierge-level services were delivered to all patients enrolled, including those uninsured, promoting health equity among patients. In addition to high patient satisfaction, this program lowers readmission rates, reduces hospital-acquired infections, leads to improved care transitions to ambulatory care, and provides access to care for those who might otherwise delay it and opt to avoid getting admitted to the hospital, exacerbating their condition.
Since July 2021, over 730 patients have been cared for by the Hospital at Home team. With the average daily census of up to 19 patients and an overall average length of stay of 4.94 days, the program outcomes resulted in savings of over 3,600 Bed Days to the hospital. The payer mix is similar to the overall patient population served by University Health, attesting to equitable access to care. The leading sources of patient referrals include medicine (451 patients, including 109 with COVID-19), Labor and Delivery (46), post-surgical (29), neurology (28), and cardiology (24). Overall, the Hospital at Home 30-day Readmission Rate is 10.3%, compared to the overall hospital rate of 12.8%, and a similar type of patients in the brick-and-mortar hospital in the acute care unit of 12.4%.
The Hospital at Home program has proven to be sustainable and effective for improving patient care, freeing up beds in the hospital for sicker patients while keeping people out of the hospital or reducing their hospital stay. The program has created an innovative approach to health equity and health education through interactive technology, addressing social determinants of health and increasing access to care and acute bed capacity. Patients who received hospital level of care in the comfort of their homes reported feeling better, less fatigued, more engaged in care, and faster on their road to recovery.
Please join us in congratulating University Health for being named the 2022 Bill Aston Award for Quality winner.