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County’s Hospital @ Home program first in province

A new Hospital at Home program was welcome relief for Prince Edward County’s Gail and Ed White.
Ed had been battling a serious infection in hospital for nearly three months, including a month-long stay at Belleville. Gail was unable to visit him every day and missed having her husband close.

The couple was one of the first participants in the program. Hospital @ Home is designed to provide in-home hospital care, support and resources to patients like Ed, allowing them to leave the hospital and recover in familiar surroundings. The Hospital @ Home team also provides support to the friends and relatives of patients, like Gail, who often take on a caregiver role when a loved one is sick, injured or recovering.

“The first day [the coordinator] came in to explain it to Ed, all I heard was you’re going home. I was so thrilled he was coming home… I just wanted him home!”

The Hospital @ Home team got to work immediately, they said, setting up services and arranging for equipment deliveries right to their doorstep.

“What I think that they are trying to do is free up hospital space, cut back on the budget from a meal standpoint, extra nursing or whatever, and make the patient feel more comfortable and capable by sending them home. That’s what I think. And it’s working from my perspective,” said Ed. “They talked to me one day and the next morning I was out of the hospital by 11.”

The Prince Edward Family Health Team officially launched the program Friday, with collaborating partners, South East Community Care Access Centre (SE CCAC) and Quinte Healthcare (QHC). The pilot program is aimed to avoid hospital admissions and improve healthcare for PEC residents.

“The strength of this, the first rural Hospital at Home program in Ontario stems from the commitment of our family physicians to provide top rate healthcare to our patients no matter where they are,” said Dr. Elizabeth Christie, lead physician with the program. “Our physicians have long worked closely with the local CCAC Care Coordinators as well as PEFHT and QHC clinical staff.  The Prince Edward County Memorial Hospital Inpatient Ward was recently identified as the number one Community Hospital Inpatient Ward in Ontario, and our physicians are committed to working with the Hospital at Home Team to ensure that it maintains that standard of care.”

Hospital @ Home is on the Ministry of Health and Long-Term Care’s radar – it is being evaluated as a program with the potential to be rolled out across Ontario.  Queen’s Centre for Studies in Primary Care is on board to provide the necessary structure and expertise to fully evaluate the pilot program.

While on the program, a personalized team of professionals visited the couple’s home to administer treatments and therapy, monitor Ed’s progress and provide support to both Ed and Gail.  Though a variety of team members, including registered nurses, physiotherapist, occupational therapist, personal support workers, social workers and a nurse practitioner visited their home during their time in the program, Gail never felt like they were an inconvenience. The team worked with the couple to schedule home visits, taking into consideration Ed and Gail’s preferences.

“They’re very conscious of our time. I’m not a morning person so they try to do 11 or after,” said Gail. “I like it because I know. They phone every day to set a time that they’re going to come the next day. I like that…We have a life, and if we’re out, I know the time we have to be home…I know when they’re coming.”

The hospital is the standard setting for treating acute illness, however research has shown that most of us would prefer to stay in our own homes, said Brad Gunn, Nurse Practitioner with the program.

“Patients are “admitted” to Hospital at Home for up to seven days while community resources are mobilized,” said Gunn. “As with a hospital admission, patients receive daily visits from a primary care provider–one of the PEFHT’s family doctors or nurse practitioners.  The only difference is that we provide this care in the home instead of the hospital setting.”

Reflecting on his experience, Ed is impressed. “How it’s helped me in the last month, I would recommend it to other people.”

Ed and Gail are still in contact with his Hospital @ Home team, and are grateful for the help and support they have received.

“The follow through has been great,” said Ed, “When they said something was going to happen, it happened.”

“We are very pleased with the results so far,” said Stephanie MacLaren, PEFHT executive director. “At six months into the pilot, preliminary evaluation data is showing that the program is meeting its goals both of keeping people out of hospital, and providing a high degree of patient and caregiver satisfaction.  We are confident that our ground-breaking program will provide the same high quality of care but at a lower cost to the system.”

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  1. Marnie says:

    Not always the case, Marc. I had first-hand experience with a family member who was ill this winter. I drove in white-out conditions to the ER and a certain patient procedure requiring follow-up was postponed because a doctor advised that ambulances could be taken off the roads in the storm. It was better to wait for a break in the weather to do what was needed because there might be no way of getting the patient back to hospital. Even if patients are carefully chosen a power outage would still cause distress. Hospital@Home is a download in which the spouse becomes the caregiver. It is the spouse who must remain alert to the patient’s needs at night and gradually grow more and more tired while playing nurse.
    It’s interesting that this system is supposed to place the patient in a safer environment in regards to contracting a virus or other infection. Several years ago I had home care services for an elderly parent.Twice, caregivers with colds were sent to provide services to a frail 90-year-old who incidentally caught one of these bugs and became very ill. These people were sent out by the Red Cross and the VON – agencies that should have known better. In the good old days operations were performed on the kitchen table. We seem to be moving back to those times. Why is there talk of a new hospital? Who would ever be admitted to it?

  2. Doris Lane says:

    This home care program puts a lot of stress on the family.
    In my case there would be no one at home to look after me

  3. Marc says:

    Hi Marnie,

    My guess is that a lot of your concerns would be taken care of by careful selection of patients. No one is suggesting that Hospital @ Home is for every patient. I would assume that anyone who needs contestant care would simply not be a good candidate.

    If worst came to worst, any of these patients could be returned to hospital by ambulance or air ambulance, even during terrible weather.

  4. Pamela Stagg says:

    This is welcome news to people with compromised immune systems and environmental illnesses, for whom hospital is a dangerous place. I applaud this initiative.

  5. Wolf Braun says:

    Good questions Marnie !

  6. Marnie says:

    Given the weather we have experienced this winter how would this program have worked? There were days when it was unsafe for anyone to be on the roads and times when it was impossible to keep driveways plowed so that a caregiver could reach the patient. A patient in Cressy or at Long Point would have been isolated from care. There were also power outages that would have caused hardship for any sick person hospitalized at home.

    If the patient needs someone with him or her at all times how is this requirement addressed? Does the patient’s spouse have to hire a sitter while he or she shops and runs errands? Instead of allowing the patient to see the family doctor throughout an illness Hospital@Home apparently offers a doctor a day. Given the number of professionals involved and the mileage entailed one wonders how this program could possibly translate to a savings. It sounds like the hype surrounding the move to one-tier government. There was going to be a big savings. But we all know how that turned out.

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