Montreal’s Hospital@Home continues to grow
August 16, 2023
MONTREAL – As of early July 2023, 410 patients had taken part in the Jewish General Hospital’s Hospital@Home program, which began about 18 months earlier. As a result, more than 2,000 hospital bed days had been saved, creating additional capacity for the hospital with the same resources.
Equally important during the current human resources crisis in healthcare, it has been determined that patients in the program require 46% fewer hospital staff resources while still receiving high-quality care, according to an article in the Montrealer Online.
The program allows some patients to complete their hospitalization at home while being constantly monitored by the virtual care team. Eligible patients include – but are not limited to – those with heart failure, chronic obstructive pulmonary disease, pneumonia, urinary tract infections and cellulitis, as well as those recovering from certain types of surgery.
Not surprisingly, the program is now in the process of being emulated elsewhere in Quebec.
The Jewish General Hospital project is under the direction of Erin Cook (pictured), director of Quality, Transformation, Evaluation, Value, Ethics and Virtual Care, and Dr. Lawrence Rudski, medical director of Virtual Care. Cook credits the virtual care team for helping to make the program a success – as well as readily available funding from donors to the JGH Foundation.
Under the program, eligible patients are not discharged from the hospital but are provided with all the equipment and medications they need to continue their care at home. This includes wireless devices to remotely monitor vital signs such as blood pressure and heart rate – all the patient has to do is wear a wireless chest pad or clip on a finger attached to a wristband.
The patient continues to be monitored remotely by hospital staff and any issues can be promptly managed or, if necessary, the patient transported back to the hospital – a service the JGH provides. Video consultations with the nursing and medical team are also scheduled several times a day and can be attended by family members wherever they might be.
A survey found that eligible patients are embracing the Hospital@Home program: 100% of participants prefer the program to in-hospital care. And with a 93% approval rating, patients are overwhelmingly satisfied.
Hospital statistics show that of the eligible patients who have been presented with the option, only 4% have declined. In patient surveys after recovery, 90% said they believed the program facilitated their recovery.
The program has now been expanded to include a Recovery@Home component for other types of patients, such as those awaiting test results, to do so at home. This, too, is feasible thanks to the resources coming from JGH Foundation donors. “The support of donors has been extremely helpful,” said Cook. “Anything we need, the JGH Foundation has been there to support the growth of our virtual care programs.”
The Quebec government has taken notice. Health Minister Christian Dubé visited the JGH to learn about the program and in May he announced a pilot program to implement it in eight hospitals in different regions next year to evaluate the feasibility of making it available in 34 hospitals throughout the province by 2026. Cook and the team leading the program at the JGH are acting as consultants for the provincewide rollout.
JGH Foundation donors can, with good reason, think of their donations as a gift not just to JGH patients but to patients across Quebec.
The program was developed at the JGH over three days last year. The key reason the Hospital was able to act rapidly to implement the program was due to the funding support of the JGH Foundation, which promptly financed the acquisition of the equipment for remote monitoring. “Donor support was crucial in allowing us to get Hospital@Home off the ground quickly, rather than waiting for government funding,” said Cook.
The genesis of the program came in January 2022 when the fifth wave of the COVID-19 pandemic was on the upswing and hospital staff were nearing exhaustion. Dr. Lawrence Rosenberg, president and CEO of CIUSSS West-Central Montreal, the JGH network of health facilities, challenged JGH leadership to quickly create a virtual “COVID@Home” program so more patients could be cared for without physically being in the hospital, and the hospital could maintain access to key programs such as surgery.
Working very quickly over just a few days, Cook recalled, the team of over 70 people across the organization determined what was needed to effectively and safely select and manage patients remotely. Because of the readily available funding from the JGH Foundation, they quickly acquired the needed remote monitoring equipment, which has been reviewed and approved by Health Canada.
The program rapidly proved feasible and popular among patients and staff and soon evolved into a broader virtual care program that also provides monitoring and care for patients who have been discharged but are completing their recovery at home, those awaiting transfer to another facility, those in need of remote rehabilitation services, and to allow the Emergency Department to conduct “teletriage” to evaluate patients.
John Truss, a patient who was hospitalized with life-threatening sepsis following a case of influenza, was able to do much of his recovery with Hospital@Home. “As nice as they were in the hospital and as caring as they were, it’s just more comfortable at home,” he said. “It takes a lot of the stress away so you can concentrate on just getting better. It’s just amazing.”
Source: Don Sancton, The Montrealer Online