By Sara McCloskey-Nieves 

Ericka Akoto’s home is her safe space. It’s where she finds peace and quiet; except when her 2-year-old Silky Terrier Hazel gets excited. 

But in March this year, Ericka had to leave her sanctuary in Hopewell to go to the hospital. Fluid was building up in her leg and foot, a symptom of her congestive heart failure. 

In the past, Ericka went to a hospital that’s a quick drive from her home but says she “was still struggling” with symptoms when she was discharged. That’s why her neighbor suggested heading to VCU Medical Center in Richmond. 

“Even while being physically in the hospital, communication was better. [The doctors and nurses] took their time to explain to me what was happening,” Ericka said. “Then they explained the Hospital at Home program. I was actually shocked. I said, ‘oh, really? That's neat.’” 

VCU Health Hospital at Home (HaH) brings hospital-level care to the homes of patients who are admitted to VCU Medical Center. Research shows that patients, especially those who are immunocompromised or are at risk of developing other infections while hospitalized, do better with these types of programs. 

“Patients sleep better, eat better and move more when they are at home compared to a regular hospital stay,” said Julia Breton, M.D., co-medical director of VCU Health HaH. “These components are critical to recovery but are often in short-supply during a brick-and-mortar hospitalization.”

Julie Breton, M.D., is the co-medical director of VCU Health Hospital at Home. (Dean Hoffmeyer, VCU Marketing and Communications)

The hospital staff approached Ericka about the program because her on-going hospital treatments could be safely and effectively managed outside of the traditional brick-and-mortar hospital. 

Needless to say, Ericka was a bit skeptical about letting strangers in her home. But she was open to the idea after learning about the quality of the care that would come right to her doorstep.  

“Being in a hospital can make you anxious, just because everything seems so fast,” she explained. “The Hospital at Home program was more intimate.
It made me feel like it was all about me. There was no distraction. There was no rushing.
They came in. They took their time.”

The one-on-one aspect of VCU Health HaH is what makes it unique. Since launching in 2023, HaH has brought hospital-level care to the homes of over a thousand people in the Richmond region.  

This model of care has been practiced internationally for decades and more recently in the United States. VCU Health is the first hospital in Central Virginia to offer this type of care at home.   

With Hospital at Home, patients receive expert care at home in a setting that supports healing

Hospital at Home is a program through VCU Medical Center that allows you to be treated for certain medical conditions at home instead of at the hospital. Patients enrolled in this program have daily virtual doctor visits and two in-person home visits from the medical team each day in addition to 24/7 virtual nursing support. 

The home visits are a special part of the program for both patients and their care team. Chris Walker, R.N., one of the HaH nurses, said he enjoys spending individual time with his patients and their families. 

“When you work on the floor, you are being pulled in different directions and care for multiple patients. When you are in someone’s home, you focus 100% of your time with  one patient,” he said.

Being in their living space also helps the HaH team come up with a care plan specifically tailored to the needs of the patient that can also involve the whole family. This makes it easier to help the patient successfully recover and heal after they leave the hospital. 

“You work with [patients and their families] to come up with solutions so they can have a successful discharge. It’s like being part of the family. You get to have an impact on them and see the results right away,” Walker said. 

“The nurse doesn’t just review a list of your medication changes. They can actually help you organize them; they can help set up equipment and teach you how to use it in your own home,” Breton added.

Ericka experienced this firsthand. 

“When you're in someone's home, you see what their environment is like,” Ericka explained. “They can help you with the treatment and getting you better because they're seeing what you deal with on a daily basis.” 

I don't even know how many more words I can use to say just how great this program is. It just made me, as a patient, feel valued and that my healthcare was truly important.

Ericka Akoto, VCU Health patient

On top of the fluid buildup in her legs from congenital heart disease, Ericka had two strokes in recent years. Since then, it’s been a little harder for her to move around her home. 

A HaH physical therapist saw that Ericka was having trouble getting up from her favorite spot on the couch. A quick recommendation — a cushion to help her sit up better and some handles to hold onto near the armrest — has made Ericka’s daily struggle a thing of the past. This was just one example Ericka shared about the ways the HaH team helped her feel more comfortable in her space. 

“If we were in a hospital, I can try to describe a problem, and they can give me suggestions as best as they can. But to actually see it and then they can physically show you what you need to do and how you do it — I don't even know how many more words I can use to say just how great this program is,” Ericka said. “It just made me, as a patient, feel valued and that my healthcare was truly important.” 

Breton sees how creating this unique environment fosters strong relationships based on good communication and compassion for the patients they are serving. 

“Providing care in the home builds a sacred bond of trust between the patient and the clinician,” Breton said. “We are guests in their home and are so thankful for their trust in our care. Our job is not to make their home more like a hospital, but to make the hospital more like home.”

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VCU Health patient Ericka Akoto and her dog Hazel. (Dean Hoffmeyer, Enterprise Marketing and Communications)

Hospital at Home: Common questions about care, services and how to enroll

What is Hospital at Home and how does it work?  

Hospital at Home is a program through VCU Medical Center that allows you to be treated for certain medical conditions at home instead of at the hospital.

Patients enrolled in this program have virtual doctor visits and two in-person home visits from the medical team each day in addition to 24/7 virtual nursing support. They receive all the same care they would get in the brick-and-mortar hospital, but at home. 

What services are included in Hospital at Home?

The services offered to you through Hospital at Home will depend on your medical condition and individualized needs. 

Some of the services you may receive through Hospital at Home include:

• Imaging services, like X-rays and ultrasounds
• Laboratory tests
• Meals and nutrition services
• Oxygen therapy
• Medication support, including IV treatments
• Physical and occupational therapy
• Skilled nursing
• Transportation

Our care coordinators will help with scheduling and arranging additional services, such as pharmacy drop-off and visiting nurse appointments. 

After your discharge from our program, our Hospital at Home team will check-in to ensure your recovery is going smoothly and that you are getting the follow-up care you need. 

How can I qualify or enroll in the Hospital at Home program?

If you are an inpatient at VCU Medical Center or in the emergency department awaiting admission, our care team can meet with you to see if the Hospital at Home program is the right fit.

To qualify for Hospital at Home, you must:  

• Have an illness or symptoms that can be safely and effectively managed outside the hospital by our HaH team.
• Need active hospital-level care.
• Have a low risk of complications.
• Must be in stable condition.
• Live within 25 miles of VCU Medical Center.

What are the benefits of Hospital at Home for patients?

Inpatient hospital stays often mean time away from home and family as well as added stress. Research shows that healing at home has a lot of added benefits for patients and their caregivers. Not only do patients have fewer infections and return visits to the hospital, but they also tend to be less anxious, sleep better and are not in as much pain.