There’s no place like home isn’t just a classic line from the Wizard of Oz movie. It’s also a philosophy that has enabled staff to free up acute care beds and reduce wait times at Stevenson Memorial Hospital.
On a typical day just a few months ago, Alternative Level Care (ALC) patients waiting to go elsewhere were occupying up to 30 per cent of the hospital’s 28 beds. Most were frail seniors heading to long-term care homes.
“We felt like we were not able to meet all of our patients’ needs each day,” said Shannon Landry, hospital Vice President and Chief Nursing Officer. “It wasn’t unusual to have nine of our 28 beds occupied by ALC patients and that number went up as high as 14 on a few occasions.”
As a result, the emergency department was often crowded with patients waiting to be admitted to hospital, sometimes lying on stetchers for up to three days.
Today, there is just one ALC patient at Stevenson and the number has remained below 2 or 3 consistently since the “There’s no place like home” approach to discharge patients safely back to their own homes with appropriate services or retirement home as quickly as possible was launched in July.
"Our philosophy has changed,” says Annette Jones, President and CEO. “If you came from home, there's only one place to go - home. We don't talk about long-term-care anymore and that shift in thinking means we don't have sick patients in the emergency department waiting to get admitted to a bed."
The key to success was educating staff and physicians about available in-home services including the "Home First" program run by the Community Care Access Centre, (CCAC) the region's homecare agency providing elderly patients discharged from hospital nursing, therapy and personal support services for two months after discharge. "It’s about ensuring everyone has the care they need in the most appropriate place with the services they need,” Jones said. “These elderly people really want to go home.”
Seniors who end up in hospital because of a fall or pneumonia, for example, quickly lose function, mobility and strength. They are also exposed to hospital-acquired infections.
“Often, an ALC patient can occupy a hospital bed for up to a year, waiting to go to a long-term care home,” Jones explained. “We believe that the best place to make a decision about long-term care and to wait for a placement is at home.”