Providence’s transformation improves patient flow and access

Listening to the people we care for – and responding to the changing needs of the times – is part of the rich history of Providence Healthcare.  Long before social programs were widely available, the Sisters of St. Joseph established the original House of Providence in 1857 in downtown Toronto, to care for the needs of the sick and the poor, the homeless and the vulnerable.  Providence became an innovative solution to a challenging time in society.

When the residents, Sisters and staff moved to a new location in East Toronto in 1962, the newly named Providence Villa and Hospital evolved.  Programs included rehabilitation and complex continuing care, and residential long-term care was offered in a home-like, modern environment.

This year, Providence Healthcare – as we are now known – celebrates 50 years of service within the east Toronto community.  This milestone anniversary is part of a larger 155-year legacy of city-wide care.  Today, we’re one of Toronto’s leading providers of rehabilitation, palliative care, outpatient clinics and services, caregiver support and long-term care. Providence has endured over time because of an extraordinary capacity to reinvent our programs and services in response to the changing needs of society.  Yet one thing remains constant: our commitment to provide innovative, compassionate care in a Values-driven environment.

As Providence’s President and CEO, I am proud to continue the work of a long line of great leaders who were united in a commitment to keep our Mission and Values alive through time.  One of our most important jobs is to inspire the people who work and volunteer here, so that they can provide the best possible care with the best patient outcomes.  One of the ways we have successfully done this is through an exciting project we call ‘Transformation by Design.’

Two years ago, when Providence began to remodel the aging patient care units in our hospital, we realized we had a unique opportunity to redesign all of the processes associated with the patient care experience.  Transformation by Design was launched as a pilot project with the full support and commitment of the Toronto Central Local Health Integration Network (LHIN).  Our clinical staff members have been engaged and involved in this project every step of the way – listening to patients and families; testing and refining processes; and implementing new ideas in ‘living laboratories’ that replicate patient care experiences in a safe, controlled environment.

We interviewed and received feedback from hundreds of patients and their families; from our own employees, physicians and volunteers; and from our community partners.  These include four acute care hospitals (St. Michael’s Hospital; Sunnybrook Health Sciences Centre; Toronto East General Hospital and The Scarborough Hospital); the Toronto Central and Central East LHINs; as well as local Community Care Access Centres (Toronto Central, Central East and Central).

Together, we’ve learned that one of the best things we can do for patients and their families is to improve timely access to programs and services, and increase patient flow across the system – from acute care to rehabilitation, and from there to home.   We also realize that we need better communication to help our patients understand what is happening at every step of their journey to wellness and recovery.  Transitions and hand-offs from one level of care to another need to be smooth, safe and coordinated.  Timely and appropriate support needs to be available upon discharge home and in the community including outpatient clinics and services; caregiver support and education; and at-home care and assistance.

After one of our brainstorming and engagement sessions with staff, we recognized that one of the best ways to ensure a timely admission to our programs is to reach out to our rehabilitation patients while they are still in acute care hospitals.  Our solution – place a Patient Flow Coordinator from Providence in each of our four partner acute-care hospitals.  The Coordinators liaise with acute care teams so that appropriate patients are admitted to rehabilitation as quickly as possible in their recovery.  Rehabilitation begins 24/7 as soon as patients are admitted.  From day one, the objective is a safe, coordinated and successful return home.  Everything that we do supports this goal – from designing 12 innovative spaces that encourage rehabilitation and replicate the home and community environment, to implementing one central communication point of contact for care planning and discharge arrangements. We call these ‘huddles’, where the physiotherapist, occupational therapist and nurse meet as a team weekly with the patient and family.

Early indicators show that Providence now admits more patients from acute care than it has in the past – and is doing this at an earlier time in the patient’s recovery.  Last year more than 75 per cent of our patients returned home safely with the best possible outcomes and independence and with the crucial at-home support that they need from the Community Care Access Centres to continue their recovery.  Communication is improved, and patients are satisfied with their overall experience of care.

Care for our employees is equally as important as care for our patients.  Our staff health and wellness programs focus on giving them the support they need so they can continue to be engaged, passionate and committed to our Mission.  A new on-site staff gym, employee health and wellness programs, and a full range of communication, recognition, learning and development opportunities show our employees, physicians and volunteers that they are valued and appreciated as much as our patients.

All patient care units – and subsequently the redesign of the patient care experience before, during and after the Providence hospital stay – will be complete within the next two years.  We will continue to measure our progress through key indicators so that we can sustain and refine our contribution to the health-care system ‘solution’.  I’d be remiss if I didn’t mention how the generous support of Providence Healthcare Foundation has ensured that we have the urgently needed capital funds to move forward with this groundbreaking initiative.  This is a project that has inspired and engaged our donors, and they have been excited to be a part of such an innovative transformation.

By continuing our legacy of listening and responding to our patients and families – and the health-care community that cares for them – Providence Healthcare will ensure it remains innovative and responsive well into the future.

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