Health News For South West
Monday, October 05, 2015
Huron Perth Healthcare Alliance
A Home For Brian - Collaboration Key in Partnership
On July 31st Jane Moore, Interim Manager Critical Care; Monica Boon, RN and Alexandra Jajesniak, RN, Team Lead made a special house call to a former patient, Brian. The visit was purely social and gave them a chance to visit Brian in his new home.
At this point in time it had been one month since Brian was discharged home after spending over 16 months on the Critical Care Unit of the Huron Perth Healthcare Alliance (HPHA) – Stratford General Hospital Site.
“It is very rare to have a patient stay with us for over a year,” says Moore. “Brian really became like one of the family. He and the staff on the unit really developed a close relationship.”
Brian has a degenerative neuromuscular disease and lives with chronic mechanical ventilation (CMV). Mechanical ventilation is a method to mechanically assist or replace spontaneous breathing which involves a machine called a ventilator.
“When Brian was first admitted he was suffering from pneumonia which compromised his breathing,” adds Moore. “After we were able to stabilize him we moved him over to the telemetry side of the unit and trained our Registered Practical Nurses (RPNs) to care for him. This added additional skills to our RPNs’ scope of practice such as tracheostomy care and ventilation management. Our Respiratory staff along with the Registered Nurses on the unit were instrumental in providing this training.”
As the days and months passed the staff of the Critical Care Unit did their best to provide a home-like and stimulating environment for Brian, celebrating holidays and making sure he had access to a television to watch his favourite wrestling programs but it didn’t compare to the life he could have in a home or community setting.
“Acute hospital care is used for the delivery of temporary care and treatment to stabilize a patient so that they can move to another setting for ongoing living and delivery of daily health and supportive care,” notes Anne Campbell, Vice President Partnerships & Patient Experience. “With a CMV patient that usually means moving to a long-term care home, but that option is not really age appropriate for Brian, who is in his late forties. Some CMV patients end up staying in hospital indefinitely but that is neither patient-centered nor financially sound.”
An alternative to a long-term care home was presented in December 2014 when HPHA was approached by Brian’s Respirologist, Dr. David Leasa of London Health Sciences Centre. Leasa, known in some medical circles as the “home ventilation doctor”, was involved in an initiative to provide care for stable CMV patients by moving them from the hospital environment to other community venues, including home if possible.
This initiative, known as Specialized Assisted Living Housing, is a community option that focuses on supporting people with special needs who require services at a greater frequency or intensity than home care but without the medical monitoring or supervision that would be provided in a long-term
care home. These services as they apply to adults living with CMV are provided in custom-designed homes with around-the-clock supportive care provided by trained specialists.
“Brian was a candidate for this type of living situation and the Critical Care team along with Dr. Leasa began planning for his transition home. Stakeholders involved in this planning included Brian himself, his physicians, nurses, respiratory technologists, dietitians and family along with the Community Care Assess Centre, Horizon Pro Resp, and our newest community partner Participation House,” commented Campbell.
Participation House Support Services is the primary community agency that provides residential support to adults living with chronic mechanical ventilation in the South West Local Health Integration Network area.
Over the course of six months the team assigned to Brian’s transition would create a specialized and individualized care plan as well as train Community Support Workers with Participation House on his personal and medical care needs.
Another aspect of Brian’s care plan involves a course of action that is followed when Brian arrives at the Stratford General Hospital Emergency Room. Due to the complexity of Brian’s condition a care plan was created for the Emergency Staff to streamline the triage process and enable a quick response to his care needs. If an admission is required this care plan follows Brian into the Critical Care Unit.
“To see Brian flourishing in his own home is such a rewarding experience,” comments Moore. “He was eager to give us the grand tour and was so proud of his television and wireless headphones. As we left he was picking a spot on his bedroom wall for his housewarming gift from the unit, a new Wresting Poster.”
“The success of Brian’s move to a home environment is the result of a unique collaboration between HPHA staff and Participation House care providers,” concludes Campbell. “We have a commitment to support the care planning and education of hospital and community care providers to ensure a seamless transition between care environments. Brian’s story will hopefully be the first of many successes.”
Critical Care @ the Huron Perth Healthcare Alliance – Stratford General Hospital Site
The Critical Care Unit is composed of two sections; Intensive Care and Telemetry.
The Intensive Care Unit (ICU) provides comprehensive care for persons who are critically ill and who can benefit from treatment, using an inter-disciplinary approach. Our patients are typically adult medical, surgical and cardiac patients requiring acute and life-saving interventions.
The Telemetry Unit provides continuous cardiac monitoring and specialized care. A majority of the patients admitted to this unit have heart concerns. Others are patients with conditions such as pneumonia or renal failure, or are surgical patients who need heart monitoring.
Patients who are admitted with a primary cardiac focus will be connected to telemetry equipment that monitors the activity of the heart, while permitting freedom of movement around the unit. Registered nurses who are knowledgeable in arrhythmia interpretation view patient heart activity through a centralized computer system. This allows our nurses and physicians to respond immediately to any changes in the patient’s cardiac condition.
Participation House Support Services
Participation House Support Services is a non-profit, community-based organization providing assistance to people with severe physical, developmental or multiple disabilities and/or complex medical needs to reach their full potential and become contributing members within their community. It is committed to encouraging and creating an inclusive community where individuals with disabilities have access to all the community has to offer and are included in a valued and meaningful way. Supported individuals and their families participate in determining the level and type of support they receive, and the type of activities they choose to participate in.
In addition to supporting individuals in over 50 locations throughout London and region, Participation House provides support services, recreation and leisure activities for individuals with disabilities throughout the community. Project Hope (Help with Opportunities for Participation and Enrichment) was established to offer young adults considered medically fragile and/or having high needs, who are no longer eligible for educational support, with day activities for social interaction and community activities while still living at home with their families.
Media Contact:
Anne Campbell
Vice President Partnerships & Patient Experience
519-272-8210 ext 2318
anne.campbell@hpha.ca
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