Patients want timelier, smoother transition from hospital to home: study
Project leaders target reducing unnecessary time spent in hospital
Wednesday July 23, 2008 -- Natalie Miller
Many patients in Ontario spend too much time hospitalized while waiting for the supports necessary to return home or to another residential setting.

It's a province-wide issue that impacts patient quality of life and satisfaction. It also puts pressure on the Ontario health system as these patients occupy acute-care beds which could be used by people who actually require acute care.

The Change Foundation, in partnership with the Ontario Association of Community Care Access Centres and three hospital sites, are conducting a three-year study aimed at finding solutions to this significant healthcare challenge.

Results from phase one of the project, involving the South East Community Care Access Centre (SE CCAC) and Quinte Health Care's (QHC's) Trenton Memorial hospital ultimately show patients want a smoother, timelier transition from hospital to home.

Katherine Stansfield, vice-president of patient services and chief nursing executive at the hospital, tells Axiom News the results of the study weren't "necessarily surprising" but highlighted "the magnitude of the issues" for QHC.

For instance, the local project group discovered the move from hospital to long-term care home involved 160 total steps including 69 handling steps, 36 forms, four (often long-distance) family trips to the hospital, and 15 delays.

They also learned the process for making a bed offer was quite complicated: a total of 53 steps involving five separate staff members entering client information into nine different forms and five other patient tracking tools, a news release from The Change Foundation states.

“We need to continue to work with our health care partners to ease the transition from hospital to home, particularly since South Eastern Ontario has one of the highest percentages of people over 75 years of age,” Stansfield says.

The project began in February and was aimed at pinpointing problems in the transition and finding solutions. Project participants worked with consultants to map out the steps and decisions patients and caregivers make during the transition with the different service providers, whether the patient is returning to his or her home, a retirement home, long-term care home or supportive housing.

They consulted patients and caregivers about their needs, perspectives and placement preferences to help develop recommendations for changes to processes, policies and practices.

Cathy Fooks, CEO of The Change Foundation, says phase one of the project, 'Having their Say & Choosing their Way: helping patients and caregivers move from hospital to home,' was a success.

“This project is an excellent start in better understanding how to improve this critical healthcare transition for Ontarians," says Fooks in a news release.

"We know that some of the communication and co-ordination problems raised here are not necessarily unique, and we will continue to learn more and compare at two other regional sites. This work will point to systemic ways to improve patient experience, decrease unnecessary hospital stays, reduce community-based adverse events and eliminate confusion about health care roles and responsibilities."

The Change Foundation, a health policy think-tank, says findings from the project show what delays patients from being discharged and the impact that has first-hand from the perspective of patients and caregivers interviewed.

Change Foundation research shows thousands of patients remain in hospital when they should be receiving care elsewhere.

In Ontario in 2005-2006, there were 600,000 days patients spent in hospitals when it was medically unnecessary for them to be there.

That rate for South East Ontario exceeded 20 per cent during 2006, while the provincial rate was 14 per cent.

“The findings of this project will help the CCAC and our partners as we work together to better serve our population,” says David Marshall, SE CCAC's executive director.

“We will be better positioned to serve our clients in the way they want to receive service."

Local project leaders are already making specific changes to streamline and improve the process for patients and their families.

Read more about these changes in an upcoming article.

If you have feedback on this article, e-mail natalie(at)axiomnews.ca or call the newsroom at 800-294-0051.