Campbellford sixth hospital to adopt Home First approach

CAMPBELLFORD - Patients will be discharged sooner and receive enhanced services at home to help with their recovery under a new approach being implemented at Campbellford Memorial Hospital this month.

The Home First philosophy, as it's known, "promotes safe and timely care, services and supports to meet health-care needs of patients and families in the most appropriate setting," chief nursing officer Jan Raine told the hospital's board of directors April 7.

It also frees up hospital beds occupied by alternate level of care (ALC) patients who are either waiting to be placed in a nursing home or are unable to return home because they lack the resources to live independently while recovering.

Returning them as soon as possible to the comfort of their own homes allows them and their family members to "make life-changing decisions related to future living accommodations," such as a long-term care facility, "under less stressful conditions," Ms. Raine said.

"(Their) health, independence and well-being are maintained longer," she said, and the risk of their acquiring an infection while in hospital is reduced.

"Studies have shown that extended periods of time in hospital can have significant negative consequences on patients," Ms. Raine said.

Community Care Access Centres (CCAC) across the Central East LHIN (Local Health Integration Network) have been given $2.2 million* to play the lead role in introducing the Home Care philosophy to the region's seven hospitals. Campbellford will be the sixth one when it goes live on April 26 after nearly two months of extensive preparation.

"The hospitals that have already gone live have seen great results and they're really excited about it," Ms. Raine said. So far, more than 2,200 clients have been discharged following the introduction of Home First last fall.

Ms. Raine explained the CCAC will step in as soon as a person goes to the emergency department for "an acute event." The person will either be admitted to hospital or sent home with a plan for services to be provided if necessary.

Up until now the barriers to a patient's subsequent discharge from hospital have not been addressed in a timely fashion and "deconditioning" can occur, Ms. Raine said. "You don't get better, you get worse."

But with Home First, those barriers will be removed before the patient is discharged with a wide range of services, from physiotherapy to Meals on Wheels, to be provided in the home.

As of last week, nine of the Campbellford's 34 beds were occupied by ALC patients but the number has been as high as 16 at times.

"It just makes the whole system far more efficient," CCAC communications director Gail Scala said in an interview. "We're diverting unnecessary admissions to hospital."

"What Home First has done now is strengthen those relationships we've had in the past with our community support services and with our hospitals."

Community Care agencies across the Central East LHIN have been given $1.2 million to provide enhanced services. Community Care Northumberland is receiving $150,000, with $30,00 earmarked for CMH patients.

"It's a great program," Trish Baird, the executive director of Community Care Northumberland, said in an interview.
Clients usually pay for Community Care programs but if they are assessed in need of enhanced services following discharge from hospital, they receive them free of charge for up to six weeks, "and we try to transition the person from then into our regular services," Ms. Baird said.

Community Care will also provide a one-time intervention, such as building a ramp for a Cobourg man who had an amputation.

The $30,000 earmarked for CMH isn't a huge amount of money, Ms. Baird admitted, "but sometimes you can do a lot ... just being in there and making sure people know about what services are available."

When they realize how much programs, such as Meals on Wheels, help them feel better, they decide "it really isn't that much in the grand scheme of things," Ms. Baird said.

"If they're safe at home and can manage with a few hours of help a day or a week or whatever they require, it certainly is a lot less expensive and better quality of life than sitting in a hospital bed (where) you may not know anybody."

Ms. Baird estimated clients receive between $1,000 and $1,500 of enhanced services during the six weeks they are eligible to receive them.

Reposted with permission from Metroland Group -Durham Division.

* Please note that the Central East LHIN has provided $7.3 million in funding to support the introduction of the Home First philosophy.