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Transforming care with hospital at home in British Columbia

Posted on Apr 22, 2025

An innovative health initiative is reshaping patient care in Victoria, reducing hospital stays while delivering equal or superior medical outcomes. Launched in 2019 by Drs Shauna Tierney and Elizabeth Crisci, the Hospital at Home (HaH) program provides comprehensive hospital-level care directly to the homes of low-risk adult patients, offering the comfort and convenience of receiving medical services in a familiar environment.

Island Health, in collaboration with health care providers and the Ministry of Health, has successfully expanded the physician-led initiative across the province. Cities like Duncan, Vancouver, and Prince George have embraced this approach, which was recognized as a finalist in the 2024 Premier’s Awards for Innovation.

The initiative’s success was catalyzed by essential funding from the Joint Collaborative Committees (JCCs), including the South Island Medical Staff Association Facility Engagement and the SSC Health System Redesign. This financial support was pivotal in fostering the extensive engagement and collaboration needed to transform Hospital at Home from a concept to a reality.

Dr Tierney, the current medical lead for Hospital at Home in Victoria, cites the COVID-19 pandemic, advancements in virtual care, and growing pressures on hospital beds as significant drivers behind the rapid adoption and expansion of the program. With executive sponsorship from Marko Peljhan, Island Health played a key role in uniting multidisciplinary teams to effectively implement the Hospital at Home service model.

"Hospital at Home is redefining how we deliver acute care, ensuring patients receive high-quality treatment where they feel most comfortable—at home," says Dr Tierney. "By integrating virtual care, in-home physician visits, and acute nursing support, we’re not just improving patient outcomes; we’re also alleviating pressure on hospital resources and enhancing the overall efficiency of our health care system."

The program is praised for its dedication to treating patients with stable conditions who opt to receive treatment in the comfort of their own homes. Given the option, about 75% of eligible patients choose this model, as it provides comprehensive daily care, including virtual and in-home physician visits, acute care nursing, and essential services like IV therapy and blood work. Patients maintain full access to hospital services whenever necessary.

In its first year under Island Health’s management, 99% of Hospital at Home participants recommended the program. An upcoming cohort control study indicates that clinical outcomes meet or exceed those of traditional inpatient care, underscoring its effectiveness and patient satisfaction.

Dr Tierney emphasizes the shift toward a more patient-centered approach in medicine. This shift is evident in the quicker recovery times and fewer hospital readmissions experienced by participants. Despite its challenges, this approach offers significant benefits—providing personalized care that enhances patient satisfaction and improves clinical outcomes.

Looking forward, Dr Tierney envisions Hospital at Home as a fundamental component of acute care across British Columbia. She advocates for the creation of dedicated units in every hospital to ensure its continued expansion and success. “It’s a fascinating project,” she says. “Whenever I get discouraged, I think of my patients who have urged me not to give up; just keep going.” This commitment underlines the transformative potential of Hospital at Home in revolutionizing health care delivery.

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