SHM Converge Scientific Abstract ePoster Gallery-Pediatric Hospital at Home: Why We Were Able to Launch the First Us Pediatric Hospital at Home Unit

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Atrium Health Levine Children’s Hospital (AH-LCH) launched the first Pediatric Hospital at Home (HaH) unit in the United States in February 2025 in response to pediatric inpatient capacity constraints. The team used the Consolidated Framework for Implementation Research to identify the main factors that enabled successful implementation.

Key implementation factors included:

- <strong>Strong clinical need:</strong> A pediatric bed shortage created urgent pressure for an alternative care model.
- <strong>Existing HaH infrastructure:</strong> AH-LCH could build on Atrium Health’s established adult Hospital at Home program, which was already viewed as safe, effective, and financially viable.
- <strong>Supportive health system structure:</strong> Being part of a large health system allowed the team to use regulations and reimbursement pathways that supported program development.
- <strong>Trusted leadership:</strong> Respected leaders championed the effort and helped align the program with other departmental needs, such as clinical triage and research capacity.
- <strong>Adaptable, committed team:</strong> The program selected a flexible team for the pilot, which helped with rapid execution.
- <strong>Frequent communication and feedback:</strong> Regular updates on performance helped build staff confidence and buy-in.
- <strong>Regulatory flexibility, but also vulnerability:</strong> External policy changes, such as Medicare waiver disruptions during government shutdowns, affected the pace and structure of care delivery.

Overall, the experience showed that Pediatric HaH is feasible in the U.S. when operational infrastructure, leadership, organizational culture, and policy conditions align. The program has since cared for more than 200 patients in its first year.

Asset Subtitle

Tonya K. Obita

Meta Tag

Author List David Marseille, Douglas A. Dodds, Sara Horstmann, Stefanie Reed, Tonya K. Obita

Category Innovations

Concept Home-Based Acute Care

Concept Hospital Bed Shortage

Concept Virtual Health

Concept Leadership Support

Concept Capacity Constraint

Distinguished Non-Finalist

Presenter Organization Wake Forest School of Medicine, Charlotte Campus

Presenting Author Tonya K. Obita

Track Technology in Hospital Medicine

Keywords

Pediatric Hospital at Home

Atrium Health Levine Children’s Hospital

implementation factors

Consolidated Framework for Implementation Research

pediatric inpatient capacity

health system infrastructure

clinical leadership

regulatory flexibility

care delivery model

hospital at home program

Home-Based Acute Care

Hospital Bed Shortage

Virtual Health

Leadership Support

Capacity Constraint