Project to implement virtual care in LTC homes

GUELPH, Ont. – COVID-19 has presented a unique challenge for long-term care and retirement homes. As a leader in specialized geriatric services, St. Joseph’s Health Centre Guelph (SJHCG) is leading a project to implement virtual care in long-term care (LTC) and retirement homes across the Waterloo Wellington region.

Infection prevention and control measures necessary to contain and prevent the spread of the virus in long-term care and retirement homes, includes reducing the number of people coming and going from the home. This may also reduce the on-site presence of physicians or nurse practitioners (NPs) who have been reserving those face-to-face visits for urgent situations.

A solution to this problem is virtual care, which enables physicians and nurse practitioners to continue providing advice and support for residents in long-term care and retirement homes while working off site. Virtual care leverages technology to provide optimal care using chat, audio and/or video.

Working with the eHealth Centre of Excellence (eCE) and the Waterloo Wellington Local Health Integration Network (WWLHIN), St. Joseph’s Health Centre Guelph’s Nurse-Led Outreach Team (NLOT) and Behavioural Supports Ontario (BSO) programs have partnered together to support the implementation of virtual care in both LTC and retirement homes across Guelph, Wellington, Kitchener- Waterloo and Cambridge.

“Arriving at this juncture has entailed months of hard work for our teams, including understanding and appreciating the ever-shifting landscape, the needs of the homes, and barriers and challenges to adopting virtual care,” said Carrie Heer (pictured), nurse practitioner coordinator and clinical lead of the Nurse-Led Outreach Team. “As a clinical leader and direct front line provider, it is imperative that care teams have the tools that will help them provide the very best care.”

The project aims to prevent the need for residents of long-term care and retirement homes to be transferred to the emergency department or admitted to hospital by increasing access to MDs, NPs, emergency and specialist care through virtual care technology. For those residents who need to be admitted to hospital, the aim is to reduce the number of days they are in hospital and help them get home sooner by enabling the right care at home.

Virtual care benefits residents in other ways too. Technology enables the St. Joseph’s Health Centre Guelph teams to share their expertise and build staff knowledge and skill in the homes.

The Nurse-Led Outreach Team routinely supports long-term care homes by strengthening nursing capacity in the homes while providing urgent or emergency care to residents that is collaborative, evidence-based and resident-centred. The Behavioural Support Ontario team, hosted by St. Joseph’s also supports long-term care and retirement homes through education and clinical management for individuals with responsive behaviours.

The Nurse-Led Outreach Team has provided education, coaching, and mentoring to all 36 long-term care homes across the region, as well as offering educational support on infection prevention and control practices to all 52 retirement homes in Waterloo Wellington since the start of the pandemic.

As the St. Joseph’s teams assist homes during COVID-19, they are facilitating the rapid adoption and evaluation of virtual care through a three-month study of up to 10 LTC and 10 retirement homes. The data that will be collected through this study offers vital insights into the needs of long-term care and retirement homes and how best to support them through the pandemic and beyond.

“We have a small window of opportunity to implement virtual care before we experience a projected second wave of COVID-19 and seasonal influenza in the fall,” explained Ms. Heer. “This research is among the first projects in the province and is expected to provide data to inform solutions for delivering care that is effective, safe and resident-centred.”