Designing an inclusive Hospital at Home service line
In collaboration with UChicago Medicine’s Center for Healthcare Delivery Science and Innovation (HDSI).
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.
Dr. Cheng-Kai Kao
Chief Clinical Informatics Innovation Officer, UChicago Medicine
James Stroble
Executive Director, Health System Post-Acute Care, UChicago Medicine
Sharon Markman
Executive Director, Clinical Excellence Innovation & Engagement, UChicago Medicine
Kim Erwin
Director, Equitable Healthcare Lab; Associate Professor of Healthcare Design and Design Methods
Marina DePablo
Patient Education Manager, UChicago Medicine
Annie Guinane
Director of Ambulatory Care Coordination at UChicago Medicine
Jon Chapman
Executive Director, Care Coordination, UChicago Medicine
Ben Laughton
Chief Nursing Informatics Officer, Executive Director of Clinical Practice, UChicago Medicine
Urvi Bidasaria
Master of Design Student 2023, Institute of Design
Tomoko Ichikawa
Associate Professor of Practice, Institute of Design
Victoria Williamson
Master of Design Student 2022, Institute of Design
Elizabeth Graff
Master of Design Student 2023, Institute of Design
CHALLENGE
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?
This project was in partnership with the UChicago Medicine Center for Healthcare Delivery Science and Innovation.
APPROACH
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.
OUTCOME
Over 8 months, we iterated and refined a Hospital at Home Service Blueprint that details all the steps, tools, front line and operations staff and practices to deliver the new care model. At over 12 feet long, this blueprint visualizes all aspects of care delivery starting when the patient enters the Emergency Department, to the transfer to inpatient care, to transfer to home, and to discharge. The service blueprint was a novel tool for UChicago Medicine, and it was embraced for use in future service line development.
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.
