11:24 a.m.

Helping patients from Hospital to Home

In December, the Osler worked with our partners at the Central West CCAC and Headwaters Health Care Centre – as well as the Ontario Telemedicine Network (OTN) and the LHIN – to launch a new program called Hospital to Home (H2H) designed to help integrate care across the continuum.

H2H is an innovative new model of care that is helping to improve clinical hand offs and information-sharing when patients leave hospital by arranging for patients to receive short-term nursing support from an integrated care team in hospital and at home. Right now, H2H is primarily supporting patients with urinary tract infections and cellulitis but will later expand to help those with more complex needs.

The program was introduced at Etobicoke General Hospital, Headwaters Health Care Centre and Brampton Civic Hospital in stages so we could gather feedback from patients to enhance the program every step of the way. Since the implementation of H2H, the current average hospital length of stay has decreased by two days and unplanned hospital readmission rates have been reduced by more than two per cent.
As one of six integrated programs sponsored by the Ministry of Health and Long-Term Care’s new bundled funding model, H2H is an excellent example of how different organizations from across the continuum of care can work together to improve access to care that truly benefits patients. And it’s proving to be effective.

Patients have 24/7 support and H2H staff are able to seamlessly access patients’ health records. The use of OTN virtual technology has also strengthened the quality of care and enhanced overall communication among health care providers.

In the first four months of the program, H2H nurses have completed over 1,800 visits in the community for approximately 220 patients. We’re encouraged by the early results and will continue to work with Headwaters and Osler to provide access to integrated services that offer safe, quality care to the community.