SHM Converge Scientific Abstract ePoster Gallery-Turning Up the Volume on Value: Leveraging Elastomeric Pumps to Expand Hospital at Home Access

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<strong>Summary (300 words or less):</strong>

Hospital at Home (HaH) delivers inpatient-level care in patients’ homes, but most programs under the Medicare ACAH waiver require two in-person visits per day. This creates a barrier for patients needing IV antibiotics more frequently than twice daily. To address this limitation, the Mount Sinai team implemented <strong>elastomeric infusion pumps</strong> to enable high-frequency IV antibiotic delivery in the home.

A multidisciplinary clinical pathway was developed with HaH, Home Infusion, Infectious Diseases, and Pharmacy teams. The team created an antibiotic library based on infusion pharmacy literature, reviewed medications for compatibility and stability, and built electronic medical record ordering workflows. Infusion Pharmacy prepared the pumps for home use. Of 35 formulary IV antibiotics reviewed, 23 were excluded because they did not require more frequent than q12h dosing, were incompatible with elastomeric technology, had limited stability, or had better alternatives. The final library included <strong>12 antibiotics with 26 dosing options</strong>.

The elastomeric pump pathway launched in <strong>December 2023</strong>, and utilization and safety were retrospectively reviewed through <strong>July 2025</strong>. Results showed that the workflow integrated smoothly into existing HaH operations and expanded patient eligibility for home-based care. Importantly, <strong>no clinically significant adverse outcomes</strong> were reported, and therapy was successfully delivered in the home setting.

Overall, elastomeric pumps proved to be a feasible and scalable solution for expanding HaH eligibility, improving access to acute care at home, and supporting patient-centered treatment.

Asset Subtitle

Tuyet-Trinh Truong

Meta Tag

Author List Brittany Jackson, Jeffrey D. Epstein, Lucia Wang, Tuyet-Trinh Truong

Category Research

Concept Infusion Pump

Concept Home-Based Acute Care

Concept Intravenous Antibiotics

Concept Eligibility

Concept Antibiotic Library

Distinguished Non-Finalist

Presenter Organization Division of Hospital Medicine, Mount Sinai Hospital

Presenting Author Tuyet-Trinh Truong

Track Value in Hospital Medicine

Keywords

Hospital at Home

elastomeric infusion pumps

home-based IV antibiotics

acute care at home

Medicare ACAH waiver

inpatient-level care

home infusion

infectious diseases

antibiotic stability

patient-centered treatment

Infusion Pump

Home-Based Acute Care

Intravenous Antibiotics

Eligibility

Antibiotic Library