Hospital at Home (HaH) at Island Health is an innovative model that delivers acute-level hospital care to patients in their homes. Developed to improve clinical outcomes, enhance patient, family caregiver, and healthcare provider experiences, and alleviate pressure on traditional hospital infrastructure, HaH reflects a strong commitment to patient-centered care. Patients and family caregivers have been involved at every stage of the program’s development and evaluation, ensuring that care delivery meets both medical and experiential needs. The care team includes the full complement of interdisciplinary team members that are present in the brick-and-mortar hospital. Notably, over 97 per cent of patients and caregivers have reported positive experiences, highlighting the value of receiving high-quality care in the familiar setting of home.
Pharmacy services are deeply embedded in the HaH model, with clinical pharmacists contributing to care planning, Best Possible Medication History to support medication reconciliation, and patient education. Pharmacists provide operational support and customized medication dispensing tailored to the home environment, facilitating safe and effective medication management. Their integration into the interdisciplinary team has significantly reduced drug therapy problems and enhanced continuity of care during transitions from one care environment to another. Impressively, 100 per cent of patients and caregivers surveyed recognized the essential role pharmacists played in their care.
As a learning health system, HaH engaged in quality improvement and research activities to evaluate its impact across multiple domains, including clinical outcomes, patient and family caregiver satisfaction, and staff experience. Under the leadership of Principal Investigator Dr. Sean Spina, the “Alternatives to Traditional Hospital Care Offered in Monitored Environments” (ATHOME) program team consisted of an interdisciplinary group of patient partners, academic researchers, clinicians, and program leaders.
This program contributed to the development of the model and supported Island Health’s involvement in this emerging area of care. Launched in Victoria, BC, in November 2020 as a grassroots initiative led by the Hospitalist Program with nine virtual beds, HaH has since expanded to 24 virtual beds and one other site on Vancouver Island and has served over 3,200 patients. The program combines virtual and in-person care, and patients keep the same hospital admission status as those in traditional
hospital settings.
HaH’s success underscores the value of co-design with patients and families and shows how evidence-based, patient-oriented research can transform care delivery. International recognition of the program speaks to its global relevance and potential for scalability. As healthcare systems around the world explore sustainable, patient-centered alternatives to traditional models, HaH stands out as a blueprint for the future: personalized, responsive, and aligned with the evolving needs of communities.
By Sean P. Spina, Tara McMillan, and Winnie Lam
Sean is the Regional Clinical Pharmacy Manager at Island Health and leads the AT-HOME research team as Principal Investigator, evaluating the impact of Hospital at Home (HaH) models on patient care. Tara is the Manager of Research Programs and Facilitation at Island Health and Research Manager for the AT-HOME research team. Winnie is the Pharmacy Operations Manager for the Victoria and Cowichan area hospitals within Island Health. She led the medication management portion of the HaH implementation and introduced the elastomeric IV balls for patient home use.
