Background

Same day discharge has been described in bariatric surgery. Our institution implemented a novel Hospital at Home (HAH) program to allow day of surgery transfer to home for select bariatric patients.

Methods

Single-institution, multi-center study for select sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) patients (August 2022-November 2023). HAH patients were transferred to home from PACU with a peripheral IV and remote monitoring equipment. A paramedic performed an in-person 'tuck in' visit the evening of surgery and the morning of postoperative day-1 (POD1) to enable IV administration of fluids/medications and a virtual visit with the treating team. Goal discharge was POD1. Primary 30-day outcomes included readmission and complications.

Results

Overall, 32-patients (11 SG, 21 RYGB) were enrolled. Two patients were admitted to the hospital from PACU (diet intolerance and urinary retention) and did not complete the program. In total, 30 patients (93.75%) completed the HAH program. One patient was readmitted from home on POD1 for abdominal pain and discharged the same day (3.33%). One patient presented to the ED on POD18 for a syncope event and was discharged home (3.33%). Four patients were kept in HAH for an additional day secondary to nausea, vomiting, pain or tachycardia (13.33%).

Conclusions

The HAH program implemented allowed for safe, same-day transfer to home for select bariatric patients.