Original Title: Hospitalisation à domicile dans les établissements de santé au Québec : considérations pour soutenir le déploiement des programmes

Authors' objectives: The Ministère de la Santé et des Services sociaux (MSSS) is aiming to implement hospital at home (HAH) services in all regions of the province by 2026. To achieve this goal, the MSSS has launched the pre-deployment of HAH with several pilot projects in 2023, with financial support from the Institut de la pertinence des actes médicaux (IPAM). In this context, the MSSS wishes to be informed on the aspects to be considered to promote the sustainable implementation of HAH for the adult population requiring physical care in Québec's health and social services institutions. The MSSS has therefore mandated the Institut national d'excellence en santé et en services sociaux (INESSS) to draw up a portrait of the HAH situation in Québec.

Authors' results and conclusions: RESULTS (#1 DEFINITION AND AIM OF HOSPITAL AT HOME IN QUEBEC): The implementation of HAH in Québec is primarily aimed at improving the experience and optimizing the care pathway for patients with acute and stable conditions. (#2 OVERVIEW OF HOSPITAL AT HOME EXPERIENCES): The pre-deployment of HAH is underway in Québec through several pilot projects. Given such recent development, few scientific publications report on the Québec HAH experience. Two programs differing in their level of maturity and geographical location are presented in this report. (#3 CONSIDERATIONS FOR OPTIMAL DEPLOYMENT OF HOSPITAL AT HOME IN QUEBEC): The technologies chosen to assist HAH must meet specific needs and consider the intended user (patient, family caregiver or healthcare staff) to ensure ease of use and plan appropriate technical support. • Clear, appropriate and comprehensive communication of the process, potential benefits and risks of HAH must be provided to the patient and family before admission. Support measures (e.g., financial assistance, respite care, home support) for the patient and family caregiver must also be in place. • Establishing, at the provincial level, a standardized and secure medication pathway that is adapted to virtual care, would mitigate issues associated with handling and delivering medications in these care and service models.

Authors' methods: In order to describe the scope of HAH in Québec, explore pilot experiences and share challenges and possible solutions adapted to the provincial context, a scoping review of the scientific and grey literature was complemented by consultations with various stakeholders. This approach included a public call for contributions to identify key informed parties, a meeting with the users' and caregivers' panel of the INESSS Direction de l'évaluation et du soutien à l'amélioration des modes d'intervention - services sociaux et santé mentale, ad hoc meetings with various stakeholders such as HAH program managers, a meeting with a multidisciplinary advisory committee, and an online questionnaire for citizens, users and caregivers.

Project Status: Completed

URL for project: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/hospitalisation-a-domicile-et-objets-connectes.html

Year Published: 2025

URL for published report: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/hospitalisation-a-domicile-et-objets-connectes.html

English language abstract: An English language summary is available

Publication Type: Other

Country: Canada

Province: Quebec

Organisation Name: Institut national d'excellence en sante et en services sociaux

Contact Address: L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: L'Institut national d'excellence en sante et en services sociaux (INESSS)