SHM Converge Scientific Abstract ePoster Gallery-Leveraging Hospital-at-Home to Address Community Dialysis Discharge Barriers

Pdf Summary

Oregon Health & Science University created a Hospital-at-Home (H@H) program in November 2021 to relieve inpatient bed shortages, initially driven by COVID-19 pressures. In January 2022, the program expanded to include dialysis-dependent patients who were medically ready for discharge but had to remain hospitalized while waiting weeks or months for an outpatient hemodialysis chair. This expanded model, called HD@Home, allowed patients to receive care at home while continuing to use the hospital’s brick-and-mortar dialysis unit on scheduled times three times per week.<br /><br />The model uses a “virtual unit” supported by technology, in-home clinicians, home-based services, a 24/7 command center, and paramedic transportation to and from dialysis. The program limits enrollment to four HD@Home patients at a time and includes routine COVID screening and ongoing case management for chair placement.<br /><br />To date, 43 dialysis-dependent patients have been treated through HD@Home. Their average length of stay was 25.3 days, with a range of 2 to 89 days, reflecting severe community dialysis access shortages. Altogether, the program accounted for 1,090 dialysis patient-days and freed capacity equivalent to 167 additional brick-and-mortar admissions, based on OHSU’s average inpatient length of stay of 6.5 days.<br /><br />The program demonstrates that Hospital-at-Home can be used not only for acute care, but also as a creative discharge solution for chronic dialysis patients. Key success factors include careful coordination, dedicated dialysis scheduling, and transportation support. Patients generally appreciated being able to return home, though longer stays could feel isolating, especially for those without strong social support. OHSU is now considering extending the model to partner hospitals facing similar dialysis-related discharge barriers.

Asset Subtitle

Ayako Mayo

Meta Tag

Author List Angela Alday, Ayako Mayo, Matthew Richards, Matthias Merkel, Stephanie Halvorson

Category Innovations

Concept Hospital-at-Home

Concept Home Dialysis

Concept Dialysis

Concept Community Dialysis Chair Placement

Concept Command Center

Distinguished Non-Finalist

Presenter Organization Oregon Health & Science University

Presenting Author Ayako Mayo

Track Transitions of Care

Keywords

Hospital-at-Home

HD@Home

Oregon Health & Science University

dialysis-dependent patients

outpatient hemodialysis

inpatient bed shortages

virtual unit

paramedic transportation

discharge planning

healthcare access shortages

Hospital-at-Home

Home Dialysis

Dialysis

Community Dialysis Chair Placement

Command Center