St. Joseph’s Health System, Niagara Health launch new innovative care model COVID Care @ Home

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Niagara Health press release – COVID Care @ Home is a new model of care delivered by St. Joseph’s Home Care (SJHC), in partnership with St. Joseph’s Health System (SJHS), Niagara Health and community partners that connects patients to care wherever they are, whenever they need it.

Starting at St. Joseph’s Healthcare Hamilton and Niagara Health, with rapid expansion to Kitchener, this new model of care for COVID patients will provide 24/7 access to high-quality care from one integrated team in the home and in community settings like retirement homes, shelters and hospices.

COVID Care @ Home is a uniquely designed program intended for those with a confirmed COVID diagnosis who do not require hospitalization. Complimenting existing local COVID initiatives, the program will support integrated care at home, early discharge from hospitals with supports and help to prevent hospitalization. It will also help to prevent outbreaks by providing Infection Prevention and Control (IPAC) and coaching support for community congregate settings.

Patients will be assessed to determine what level of service will be provided. Vulnerable patients who are at risk of hospitalization and who require additional supports and services will have access to an integrated clinical care team, remote monitoring and at-home and virtual visits to support a safe recovery at home. This same model of care will be available to patients discharged from hospital so they can safely return home sooner.

This innovative, flexible model would provide COVID patients access to services that may not typically be within the scope of traditional home and community care supports. Patients will be cared for by one integrated team representing a variety of providers whose clinical decisions are empowered through the use of a single electronic patient record to support patients in the following ways:

  • Virtual Care (phone, video and remote patient monitoring)
  • One number to call 24/7
  • One clinical team
  • One electronic record
  • System navigation/connection to social supports
  • Access to specialists
  • IPAC Support

St. Joseph’s Home Care will lead this innovative transformation to connect home care to a broad range of services for COVID patients and work in collaboration with other service provider organizations and primary care.

SJHS is one of the largest healthcare organizations in Canada, and the only system in Ontario delivering a full continuum of integrated health care services.

“We’ve learned a tremendous amount about COVID-19 over the last several months,” said Tom Stewart, St. Joseph’s Health System President and CEO and CEO of Niagara Health. “This new program builds on partnerships and learnings by increasing our focus on virtual care and specialized COVID care teams that crosses normal silos of care. This will help us through the second and future waves of the pandemic as well as prepare us for system transformation needed in healthcare.”

The program is designed to support older adults who are at greater risk of physical and mental health decline. Patients will be enrolled by the clinical teams at the time of their COVID 19 diagnosis.

The new model will also help to protect capacity in hospitals by expanding supports and services in the community through a dedicated team that will facilitate care at home, support safe discharges from the hospital and limit unnecessary Emergency Department visits. This will help hospitals to maintain capacity and services during a second wave as well as continuing scheduled surgeries to reduce waitlists and backlogs.

Learn more about COVID Care @ Home at: https://sjhs.ca/integratedcare/covid-care-at-home

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