Guelph General Hospital is looking to free up hospital beds with a new at-home healthcare program.
GGH@Home provides hospital patients with complex needs with continued care after they are discharged from the hospital and are back at home. The program is in partnership with Bayshore Integrated Care Solutions, an integrated healthcare company. It provides personalized healthcare plans with services from its nurses, personal support workers (PSWs), physiotherapists and occupational therapists.
The new GGH program provides care and medical equipment to people at home for up to 16 weeks. There is no cost to patients.
In hospitals where the program exists it has seen decreases in re-admissions, said Jennifer Murphy-Novak, senior director of patient services at GGH. There are also decreased levels of alternate level of care, meaning patients who take up a bed in a hospital who may not need the intensity of care provided in a hospital setting.
Preventing readmissions and freeing up beds are the outcomes GGH wants to see. They are hoping “to get our community members back and home, with a safe envelope around them of services that will help support them,” said Murphy-Novak.
The criteria for the program are wide-ranging and based on individual patient needs. Patients need to be 18 and older and deemed to have complex care needs requiring additional support at home. Complex needs could be a decline in an older adult’s physical health due to being sedentary because of illness who need wound care or IV therapy for antibiotics or additional support after a hip replacement surgery.
Bayshore staff bring equipment, medical devices, and medication to patients' homes. Things like a hospital bed, mechanical lift, commode, or walker are examples.
Medical professionals like nurses and PSWs provide care and, in some cases, light housekeeping. The care is provided during the day.
“Well, the benefits are really more for the patient. So they're in an environment that they're comfortable and they're familiar with. People heal, I think the best at home. It provides them the opportunity, if they need a little extra support, that they can get it while they're healing, said Murphy-Novak.
People are able to rehabilitate at home “and it's all about how they're going to adapt and learn and to live after something as devastating as a stroke,” she said.
As a liaison between GGH and Bayshore, patient navigator Liana Walmsley works with the healthcare teams with eligibility criteria, identifying patients who would be a good fit for the program and speaking with patients and families to get them ready for hospital discharge.
When a patient starts the program Bayshore is in charge of their care and GGH is still involved as the patients progress to see how it's going. If more care is needed patients go through another assessment and connect with Ontario Health for other home care options.
GGH expects the program will treat 174 patients a year.
“I would say that I'm looking forward to the success of it. That we've got some great success stories from the patients that have lived and gone through and experienced the 16-week program that GGH at home is offering,” said Murphy-Novak.