In May and June this year I visited Boston to undertake a face to face visit at Ariadne (a joint venture institute between Harvard School of Public Health and Brigham and Women’s Hospital) and the Massachusetts General Brigham Home Hospital. This allowed me insight into the current clinical and organisational development of the MGB Home Hospital through direct observation of its clinical work and meetings with its leadership group. I also involved myself in the academic work of Ariadne through its Home Hospital (HH) stream. 

It is important for Hospital in the Home clinicians, academics and policy analysts to gain a deeper understanding of the US HH system as a way of interpreting the research work that will soon dominate the HH literature. The following discussion paper draws from the major observations of the Fellowship visit. ...

As a rotational physiotherapist I had the opportunity to spend 8months working with the hospital at home team. On my arrival, I was welcomed with open arms by an incredibly supportive and friendly team. Not really knowing what to expect, I initially found the thought of leaving the wards and venturing out into the community daunting; however, a part of me was intrigued and excited to see a different aspect of the patient pathway.  ...

I would like to share my positive experience and my observation. Firstly, throughout my placement, the HAHT staff were so helpful, supportive and friendly. I had a fantastic time and learnt so much along the way. I felt entirely part of the team, which was nice, and the teamwork is great.

During my visits to patients’ homes, I got the opportunity to learn how each patient is unique, and how the nurses were doing everything they could to put the patients’ needs first ...

I first started seriously considering a career in geriatrics when I was in third year of medical school. I was on a general medical ward, and I went with a geriatrics registrar to see a lady in her late 80s with dementia who was a ‘social admission’. Although it would have been easy to have just written ‘medically fit for discharge’ in her notes and moved on, the doctor I was with helped her sit up in bed, refilled her water jug and drew her attention to the beautiful view out of the window. This was the first time I had seen that medicine could be like this and it excited me about medicine in a way that I had not experienced since I started university. ...

Starting my first shift in community geriatrics, I was unsure what to expect. Outside the familiar sterile walls of the hospital and without the reassurance of imaging, bloods and regular observations, I initially felt out of my depth. However, I quickly adapted: learning both clinical and non-clinical tips and tricks ...