Clinician satisfaction with hospital at home: A multilevel framework.

BACKGROUND

Hospital at Home (HaH) programs provide acute inpatient-level care, can expand the capacity of traditional hospitals, and help address ongoing inpatient bed capacity issues while maintaining quality of care. While prior studies have explored patient satisfaction with HaH, scholars highlight a need for research into clinician satisfaction with HaH.

PURPOSE: This study identifies factors that influence clinician satisfaction with the HaH model and suggests an approach for effective program design and implementation.

APPROACH: This study takes a qualitative approach, examining the perspectives of twenty clinicians, including hospitalists, advanced practice providers (defined as nurse practitioners and physician assistants), and registered nurses who treated patients in the HaH program of a mid-sized hospital between August 2023 and June 2025.

RESULTS

We developed a multilevel framework, identifying satisfaction factors at the micro (individual), meso (team, patients, and families), and macro (hospital processes and technology) levels.

CONCLUSION

Our findings suggest that HaH may be a pathway to address clinicians' satisfaction (e.g., need for achievement) and shield from dissatisfaction factors (e.g., variety as a pathway for preventing burnout). We also identify opportunities for further development for the HaH model that may improve satisfaction.

PRACTICE IMPLICATIONS: Health care leaders should consider implementing HaH models, provided they remain supported by legislation, as they may offer a positive team-based care experience for clinicians and patients alike while delivering high-quality acute care and leveraging technology to extend capacity for health systems.