‘Home First’ priority for Central East LHIN patients

Initiative helps people return home sooner, reduces ALC rates

There’s no place like home to recover from illness, regain strength and make important lifestyle decisions.

That’s the philosophy and purpose behind Home First, an initiative which has been rolled out across the Central East Local Health Integration Network (Central East LHIN) and that helps patients in hospital return to the community in a timely manner with the appropriate supports to remain at home.

According to the Home First philosophy, every patient admitted to the hospital should expect to be discharged home at the end of the acute period of care.

By working together, hospitals now have processes in place that engage the Central East Community Care Access Centre (Central East CCAC) in a timely fashion to discuss, with a patient and their caregivers, their destination after discharge, often before they are even admitted.

And even if the ultimate destination is not the patient's current home, it will be the first stop from hospital.

“People now have an option to go home and make longer-term decisions in the comfort of their own home,” says Jean Kish, Central East CCAC program director. “Home First is a philosophy, it’s about supporting people to return to the community. It helps patient flow in the hospital and gets patients back where they should be -- in their home.”

"We're giving them the opportunity to stay at home longer," Kish says.

Patients benefit psychologically from being in the place where they want to be and it helps them to be able to maintain their health, well-being and independence for a longer period of time.

Home First is having a dramatic impact on Central East LHIN hospitals. The initiative is reducing the number of patients occupying Alternate Level of Care (ALC) beds in the 15 hospital sites.

“In 2010, the Central East LHIN was getting quite concerned about the ALC rates in all of our hospitals,” says Sally Davis, senior director of client services at the Central East CCAC. “A high percentage of people, who had been successfully treated for the illness or injury that had brought them to the hospital, were spending unnecessary days in hospital waiting to be discharged to what we call an alternate care setting such as back to their home or long-term care.”

The Central East LHIN was tasked with implementing a solution to decrease the ALC rates in Central East hospitals and preventing early admission to long-term care.

Home First is a partnership between the Central East LHIN, the Central East CCAC, the Central East LHIN hospitals and Community Support Services (CSS) agencies. “It’s really a collaborative effort,” Kish notes.

The Central East CCAC, CSS agencies and hospitals use an inter-professional approach to engage patients and families in the discharge discussions early so they can be ready to transition back to their homes successfully at the end of their acute care stay.

Through the project leadership of the Central East CCAC and by working together, the CCAC and partners from the hospitals and community support services organizations successfully rolled out Home First across the LHIN’s 15 hospital sites within a year.

“It was quite a challenge but we all stepped up and it was very successful,” Davis says. “It was really about having the right people at the table planning and having a significant sustainability structure.”

The results are impressive. Since the initiative was first introduced there have been 482 fewer ALC patients in Central East LHIN hospitals between 2010-11 and 2012-13 and 573 more patients have been discharged home.

Engaging community care agencies throughout the process was key, Davis adds. These agencies received additional funding from the Central East LHIN to provide enhanced services to help patients transition home. Support ranges from additional homemaking services such as Meals on Wheels to snow plowing services and even funding for the rental of specialty equipment.

“The agencies were funded to address barriers to discharge that may have previously impacted a patient’s ability to return home,” Davis says.

Previously, the Central East CCAC care co-ordinators became involved with patients after receiving referrals. Now with Home First, care co-ordinators are brought into the care process by the hospital team early in the patient’s hospital stay and complete a first contact with the patient or family within 24-48 hours.

If the patient is already known to the Central East CCAC, the care co-ordinator receives an electronic alert within 15 minutes of a client’s arrival in a Central East LHIN emergency department.

“Hopefully we can even prevent them from being admitted and send them back home with those enhanced services where appropriate,” Davis says.

“We’ve adopted a process that allows patients and families the opportunity to make life-changing decisions related to future living accommodations in the comfort of their own home,” says Kish.

Click here to learn more. http://healthcareathome.ca/centraleast/en/care/Pages/home-first-philosophy.aspx#sthash.oxl8h6n0.dpuf

The Central East LHIN is currently implementing its third Integrated Health Service Plan (IHSP), setting out a shared goal for the local health care system to help Central East LHIN residents spend more time in their homes and their communities.

Improving health care for seniors is a top priority of the Central East LHIN.

Together with the Central East Community Care Access Centre, the hospitals and local community-based health service providers in Scarborough, Durham and the North East Clusters, the LHIN is actively working on the “Community First - Seniors Aim.”

To learn more about the Home First philosophy please click on “Get Connected With Care – Home First.”

For more information on how the Central East LHIN is building a system of care for frail seniors, please visit the Central East LHIN website Seniors Care Network/Regional Specialized Geriatric Services.

Submitted by Natalie Hamilton, Axiom News. To contact Natalie, please email natalie@axiomnews.ca.