Designing an Equitable, Inclusive Hospital at Home Service Line

Over 40 UChicago Medicine team members were involved in developing the Hospital at Home service line. The people listed below routinely engaged in design-led components.

How can we design an efficient, effective and equitable new service line fit for the home?

Accelerated by COVID-19 and emergency waivers from Medicare, Hospital at Home is a service that moves hospital-quality care to the comfort of a patient’s home. This requires sending everything a patient would receive in the hospital — nurses, physicians, medications, equipment, food and labs — to the home setting and maintain patient safety and quality care. How might such a massive move of resources to the home be coordinated and designed to optimize human experience and equitable access?

We joined UChicago Medicine’s Hospital at Home team to help design an end-to-end service model for this new service line. We engaged over 85 patients, community members, frontline providers, and community health workers to understand their concerns and goals. We conducted bedside interviews, group sessions, staff intercepts on hospital floors, and concluded with a co-design session with 19 community members in UChicago Medicine’s service area. Collectively, we identified best practices and tools within the hospital; captured preferred service experiences from patients and providers; and identified service requirements and touchpoints that needed special attention to ensure the service was culturally competent and inclusive.

ID graduate students, under the guidance of professor Tomoko Ichikawa, integrated patient and community guidance into a suite of patient and caregiver education materials.

These components were designed so as to introduce the right information at the right time in the patient journey, and meet health literacy guidelines. Lastly, we proposed an Equity Roadmap that depicted how to build inclusive capacities into the service over time. The Roadmap also highlighted how these new approachs could be retrofitted to existing hospital care.

The first Hospital-at-Home patient was enrolled February 2023.