Expanding Care Beyond Walls: Launching Geisinger’s Hospital at Home Program

Authors: Michelle Budzyn, PharmD, BCPS and Kelly Bolesta, PharmD, BCPS

Geisinger’s Hospital at Home program is an innovative initiative that offers patients hospital-level care from the comfort of their own homes. The program allows patients to remain close to family, friends and pets; avoid unnecessary exposure to infection; and continue healing in safety and privacy — all while maintaining regular contact with their healthcare provider.

Since its launch in October 2023 at Geisinger Wyoming Valley Medical Center, the program has expanded to Geisinger South Wilkes-Barre, Geisinger Community Medical Center and Geisinger Medical Center.

To continue delivering hospital-level care in the home, medication access is a critical component of the program. The Acute Care Pharmacy team played a pivotal role in shaping the medication management framework to ensure safety, optimize access and maintain continuity of care. Partnering with other pillars in Enterprise Pharmacy, the acute care team adopted new processes to bridge the gap between traditional inpatient management and current outpatient services. In addition, nursing and physician teams collaborated with pharmacy to establish best practices for medication management, ensuring alignment across disciplines.

Healthcare providers caring for patients in the program can administer medications in any formulation — oral, intravenous, intramuscular, subcutaneous and more. In the hospital, medications are typically dispensed from automated dispensing cabinets. In the home, where this technology is not available, the pharmacy team developed alternative procedures to ensure safe and compliant medication access. For example, the Acute Care Pharmacy team implemented a modified dispensing process that provides a 24-hour supply of medications.

To support timely administration of critical medications, care teams are equipped with a medication “tackle box” containing a selection of commonly needed medications. This mobile solution allows clinicians to administer urgent first doses without delay. Controlled substances follow a revised dispensing protocol to eliminate the need for waste in the home, and insulin pens have been introduced to improve safety and ease of use.

One of the challenges encountered in the Hospital at Home program was the administration of intravenous antibiotics requiring multiple daily doses. To streamline the regimen for both nursing staff and patients, the Acute Care Pharmacy team collaborated with the Home Infusion team to implement the use of elastomeric pumps. These portable, disposable infusion devices deliver antibiotics over a predetermined period and offer the advantages of being simple to operate and requiring no electricity or complex programming — making them ideal for home-based care.

Patients in the Hospital at Home program are encouraged to self-administer oral medications under the direction of the nursing team. This approach fosters autonomy and improves adherence while maintaining safety through clear communication. As-needed medications are dispensed with clear, patient-friendly instructions, helping patients and caregivers understand when and how to use them appropriately. The Acute Care Pharmacy team worked closely with Pharmacy Informatics to develop labeling solutions that support safe, clear and patient-friendly medication use in the home setting.

As with traditional inpatient care, medication reconciliation remains a cornerstone of the process. Pharmacists verify discharge medications to ensure accuracy and appropriateness, maintaining a strong commitment to safe transitions of care. The Meds to Beds service has been adapted for the home setting so patients receive their prescribed medications at discharge without needing to leave their home. This eliminates delays and supports adherence to treatment plans.

Overall, the Hospital at Home program represents a significant advancement in redefining healthcare delivery. Through thoughtful planning, interdisciplinary collaboration and a commitment to patient safety, Geisinger is extending the reach of hospital-level care — without compromising quality. Pharmacy Services is proud to be at the forefront of this evolution, making sure care supports healing at home.

Reference 1. Geisinger’s Hospital at Home program. Accessed August 12, 2025.

geisinger.org/hospital-at-home