Nurse Practitioners save time

The staff at the local Long Term Care Home (LTCH) knew that Mr. Webster* (* not his real name) was in distress.  He had just been transferred back from one of the LHIN’s regional hospitals, outside his immediate community, after having a special catheter inserted and now the catheter was blocked.  Unblocking it would mean sending him back to his local hospital and, since a specialist was not on-call, probably another transfer back to the regional centre.  Everyone agreed that this was not the best care for Mr. Webster, a frail senior in his early 80’s. 

A quick call to the Nurse Practitioner (NP) Outreach Team, NPSTAT, resulted in NP Linda Dacres working with the local hospital to get the necessary supplies and doing the procedure in the long term care home rather than unnecessarily transferring Mr. Webster from the home, to the local hospital and perhaps onto the regional hospital.  

This type of patient-centered care is exactly why the Central East LHIN, working with the Ministry of Health and Long-Term Care, has invested in three new NP outreach teams – in Scarborough, Durham and the North East cluster, which includes Peterborough, Northumberland, Kawartha Lakes and Haliburton.

In the Central East LHIN, the NP-led LTC outreach teams are collectively referred to as NPSTAT: “Nurse Practitioners Supporting Teams Averting Transfers”   The NPSTAT program was developed to address the health risks of transferring frail seniors to emergency departments for visits which could be avoided if treated in the long-term care home. Reducing avoidable hospital visits and admissions will improve the health profile and health care experience of long-term care home residents, while maintaining or reducing the cost of providing appropriate care.

When LTCH residents are hospitalized, NPSTAT can also help facilitate earlier discharges back to the LTCHs which can decrease hospital length of stay (LOS), enhance continuity of care and communication between acute and LTC sectors, and provide support and resources to LTCH staff to help manage repatriated LTCH residents.

Recent comments from health care partners show the key role that NPSTAT nurse practitioners have in caring for patients:

"Thank you to Diane and all the other NP's for their on-going commitment to us as senior providers but most important to their patients, families and community EMS partners that we so rely on for any of our life and death situations we need help with."

Rose Lamb, General Manager, Village of Taunton Mills

"On Monday July 5, 2010 Pickering Fire Service Station 6 responded to an alarm at a Nursing Home in Pickering for the report of a male difficulty breathing.  Very shortly after our arrival and patient assessment we were greeted by Diane MacEachem and her co-worker.  Immediately she gave us the patient information, nature of the emergency, event history, past medical history, assessment findings, vitals and patient care that they had been providing.  Upon the arrival of the EMS crew her information she provided to them expanded, she was now talking to an Advance Care Paramedic. The level of knowledge and information that was shared between the Fire  and  EMS crews was as if we walked into an ER.  In previous experiences with alarm calls at that location the information received by Fire and EMS was not always as in-depth and forthcoming. During the time  EMS was attending to the patient  I spoke to Diane and thanked her for what she had provided. Diane spoke of the Team she and her co-worker are a part of.  The CE LHIN NPSTAT team provided great assistance to both Fire and EMS, being greeted with the knowledge and in-depth patient information at this call allowed us to be able to provide a valuable service to that member of our community. I would like to thank Diane for her work and look forward to seeing more members of her Team in the future."

Mike Palachik
Acting Captain, B2 Platoon
Operations and Emergency Services Department Fire Services Division 
City of Pickering

Since 2008, the LHIN, with the support of the MOHLTC has invested over $2 million in this program.  Between October 2009 and March 2010 alone, NPSTAT team members were involved in over 500 patient care episodes in local LTCHs and were able to affectively avert visits to the Emergency Department 78% of the time – saving over 400 ED visits.  

Teams are located at The Scarborough Hospital, The Village of Taunton Mills in Whitby and in local CCAC offices in east Durham and the North East and support LTCHs across the entire Central East LHIN region.