The North East Local Health Integration Network (LHIN) is gearing up to promote a Home First mindset to help reduce the number of Alternate Level of Care patients at hospitals in Sault Ste. Marie, Sudbury, Timmins and North Bay.
The initiative came about as a result of some success that several LHINs in southern Ontario have had, said Terry Tilleczek, senior director, planning, integration and community engagement with the North East LHIN.
According to Tilleczek, the percentage of ALC patients occupying hospital beds in the Hamilton-Niagara region fell from 25 per cent to 12 or 13 per cent last year as a result of a Home First initiative as well as other programs, "so we sat down with the North East CCAC (Community Care Access Centre) and representatives of the four major hospitals to see how we can roll it out here," he said.
"It's really a change in culture, a shift in thinking for caregivers, physicians and other hospital staff," added Ann Matte, senior director, strategy, planning and integration with the North East CCAC. The idea is to send elderly patients home after an acute episode in hospital instead of jumping to the conclusion that long-term care is the only option.
The objective is to keep the patients and their families from making life-changing decisions to sell a home or give up an apartment while under the stress of an acute episode.
By going home with the necessary support and taking time to understand the implications of a move to a long-term care facility, elderly patients and their families will be in a better position to judge what's best for them, said Matte.
"If more services are needed, we'll bring them in until it can be decided where you go next. That's the philosophy. Now, what happens is that someone ends up in hospital and they're identified as someone who will be going to a long-term care facility."
Their acute phase may be over, but owing to the shortage of long-term care beds, they remain in hospital waiting for a place to open up. However, a prolonged stay in hospital as an ALC patient increases the risk of becoming less and less mobile.
"Hospitals are good for acute care, but they're not a place where you want an elderly person to linger," said Matte. "The hospital's mandate is fixing people, getting them better and sending them home. Somehow, over the years, we got away from that."
Home First complements the Ministry of Health and Long-Term Care's Aging at Home program, which focuses on providing transportation services, home care, meals-on-wheels and other supports in the community.
Sault Ste. Marie
The North East LHIN and the CCAC launched Home First in Sault Ste. Marie because of Emergency Room and ALC challenges confronting Sault Area Hospital.
"We're on the ground in Sault Ste. Marie working with front line staff, the people responsible for discharge planning, Emergency Room staff and CCAC case managers," said Matte. Sudbury is next in line, to be followed by North Bay and Timmins.
ALC patients currently occupy 25 per cent of hospital beds in the North East LHIN - the highest percentage in the province.
The LHIN's 21 small, rural hospitals have high ALC numbers, but aren't operating at full capacity, so it's less of a problem, said Tilleczek. The problem is more severe in the four urban hospitals because most of them are operating at close to 100 per cent capacity.
