Getting on board with going off ward

Abstract Off‐ward practices for hospitalized patients vary across medical centers, but many hospitals adopt restrictive policies that prioritize safety and liability over autonomy and dignity. Hospitalists routinely navigate competing priorities and negotiate institutional barriers, positioning them to advocate for patient‐centered interventions. In this Next Steps article, we describe why limiting freedom of movement infringes upon ethical principles and display that practical frontline solutions are possible through a hospitalist‐led off‐ward pilot program at a Veterans Affairs hospital. This experience demonstrated that hospitalists can create safe opportunities for patients to regain meaningful independence during hospitalization.

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Publication Details

Journal
Journal of Hospital Medicine
Published
2026-10-22
DOI
https://doi.org/10.1002/jhm.70523
Primary Topic
Ethics in medical practice
Type
article
Field-Weighted Citation Impact
0.00
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article

Getting on board with going off ward

David Alfandre, Adriana Izquierdo, Satya Patel, Christopher Moriates
Journal of Hospital Medicine
Ethics in medical practice
article

Getting on board with going off ward

David Alfandre, Adriana Izquierdo, Satya Patel, Christopher Moriates
article en

Abstract

Abstract Off‐ward practices for hospitalized patients vary across medical centers, but many hospitals adopt restrictive policies that prioritize safety and liability over autonomy and dignity. Hospitalists routinely navigate competing priorities and negotiate institutional barriers, positioning them to advocate for patient‐centered interventions. In this Next Steps article, we describe why limiting freedom of movement infringes upon ethical principles and display that practical frontline solutions are possible through a hospitalist‐led off‐ward pilot program at a Veterans Affairs hospital. This experience demonstrated that hospitalists can create safe opportunities for patients to regain meaningful independence during hospitalization.

Journal of Hospital Medicine
University of California, Los Angeles (US), VA NY Harbor Healthcare System (US), VA Greater Los Angeles Healthcare System (US), New York University (US)
Openalex Percentile: Top 8%
Ethics in medical practice
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