Holland Bloorview Kids Rehabilitation Hospital recently had a unique opportunity to facilitate the transfer of a client by demonstrating care through a remote communication model they call “bedside videoconferencing.” The virtual knowledge exchange took place with health care providers in the client’s hometown of Thunder Bay where they had never before received a pediatric ventilator-dependent patient.
Zoey Faith Lamarche came to Holland Bloorview as a client at eight months of age. She had a complex diagnosis and was considered a medically fragile technology dependent (MFTD) client requiring round the clock care. Zoey Faith’s parents, Amanda Mintenko and Mathew Lamarche, were committed to learning how to care for their daughter so they could take her home to live in Thunder Bay where son Liam was anxiously awaiting their return.
“I was really scared at first because we thought Holland Bloorview was a long-term stay facility but the hospital had a high level of communication with us and included us in all decision-making,” Amanda says. “They made me feel more like a mom.”
The Holland Bloorview team created a transition plan based on the family’s needs and then worked with health care providers in Thunder Bay to facilitate the transfer. Through the innovative use of Ontario Telemedicine Network’s (OTN) videoconferencing, members in the circle of care in Toronto and Thunder Bay were able to attend family team meetings during Zoey Faith’s entire stay. The videoconferencing was also used to train respiratory therapists and nurses in Thunder Bay on Zoey Faith’s care to reduce the possibility of surprises upon transfer.
Robert Gangnon, a respiratory therapist at Holland Bloorview helped coordinate multiple videoconferencing sessions for the team in Thunder Bay. “The technology was amazing,” says Robert. “I could easily zoom in with the camera and move it around to show detailed equipment examples by myself as I was explaining specifics.”
Amanda and Mathew were trained on all aspects of Zoey Faith’s care by the Holland Bloorview team and then participated in a month of “care-by-parent” at the hospital. During the care-by-parent period that is intended to simulate the future experience at home, Amanda and Mathew provided all care for Zoey Faith with the ability to call a nurse if needed. Equipped with this experience, Amanda and Mathew were then able to help train the remote team in Thunder Bay via videoconferencing on things like tracheostomy care and daily physiotherapy activities.
Maryanne Fellin, a clinical resource leader at Holland Bloorview, was pleased that the parents could demonstrate their comfort level with care and also act as teachers for the Thunder Bay team. “Having the family show Zoey Faith’s care right at the bedside helped the Thunder Bay team visualize what they would need to do,” Maryanne explains. “It also allowed the Thunder Bay team to get to know the family, see how Zoey Faith would react in a real setting and then have a discussion during the videoconference.”
This was the first time that Holland Bloorview had used the OTN videoconferencing technology and the team is excited about future applications. “As respiratory therapists, we do education for community nurses and it’s tough to get on everyone’s schedule,” Robert commented. “This technology could lend itself perfectly for training these kinds of groups.”
Earlier this year, Amanda and Mathew made the journey to Thunder Bay ahead of Zoey Faith to get everything set up at home. Due to an unforeseen delay, Zoey Faith’s transfer took place three weeks later. A respiratory therapist and nurse from Holland Bloorview accompanied Zoey Faith on the flight home by medical transport and provided a comprehensive handover of care to the Thunder Bay team.
Zoey Faith’s family greeted her upon arrival and was thrilled to be reunited. Amanda reports that Zoey Faith’s older brother Liam is now enjoying his little sister. “It was a long hard process but we got through it,” Amanda says. “If it wasn’t for Holland Bloorview we wouldn’t have been able to bring Zoey Faith home.”
The team at Holland Bloorview was pleased to have the opportunity to work with the team in Thunder Bay in such a unique remote communication model. “It was a bittersweet transition,” Maryanne says. “We were sad to see Zoey Faith leave, but we felt like we found a really innovative solution and implemented it well to get this little girl home.”