Hoffer and Roth: Ottawa tries a 'SAFE' way to address hallway health care

Patients in this special program had shorter lengths of stay, were more likely to return home and not require additional supports, and were no more likely to visit a hospital emergency room than others.

The main entrance to the Perley and Rideau Veterans' Health Centre. Partnering with the Ottawa Hospital and the Champlain LHIN, it is trying innovative ways to help the frail elderly after a hospital stay. Tony Caldwell / Postmedia Network

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A pilot project of the Perley and Rideau Veterans’ Health Centre, the Ottawa Hospital and the Champlain Local Health Integration Network is helping to ease the thorny problem of too many patients and not enough hospital beds – so-called hallway health care. The project focuses on a specific group of patients: seniors who no longer need the acute care that hospitals are designed to provide, but who are not yet well enough to go home.

These men and women are typically admitted to hospital due to surgery, accident or severe illness. Once their conditions stabilize, though, they remain in hospital – the most expensive place to deliver care – because our health care system has no appropriate alternative. Approximately 60 to 70 of these patients are in the Ottawa Hospital at any given time. And studies demonstrate that the longer the hospital stay, the more likely a patient’s health will decline.

Studies demonstrate that the longer the hospital stay, the more likely a patient’s health will decline.

The pilot project, known as SAFE (Sub-Acute care for Frail Elderly), established a 20-bed unit at the Perley Rideau in 2018. Eligible patients transfer from the Ottawa Hospital to the SAFE unit, where they access the medical and restorative care needed to recover and return home. In addition, SAFE patients undergo cognitive screening and an overall frailty assessment to identify any other issues, such as undiagnosed dementia.

The findings of an independent evaluation demonstrate the benefits of SAFE. The recently completed evaluation compared the health outcomes of 153 SAFE patients with a control group of approximately 1,700 similar patients who had recovered in hospital. One significant difference is that the SAFE patients had more complex disease profiles: more of them suffered from ailments such as coronary heart disease or cancer. Despite this difference, though, SAFE patients had shorter lengths of stay, were more likely to return home and not require additional supports, and were no more likely to visit a hospital emergency room.

Dr. Alan Forster, vice-president Innovation & Quality, the Ottawa Hospital, says: “It’s clearly good for patients and for the health care system. The Ottawa Hospital is proud to partner on such an innovative and effective project.”

Earlier this year, the SAFE Unit also began to accept patients from the Montfort and Queensway Carleton hospitals. Along with supporting better health outcomes, SAFE saves the system money because it delivers health care less expensively than hospitals. By some estimates, SAFE could reduce health care costs by approximately $700,000 per year. To quantify these savings, a separate study is planned.

The Perley Rideau is home to 450 seniors – including approximately 250 veterans – in long-term care, as well as another 200 seniors in independent-living apartments. Residents and tenants access a wide variety of the therapies, services, amenities and activities needed to live life to the fullest.

Known for innovation since its inception, the Perley Rideau recently established the first Centre of Excellence in Frailty-Informed Care. The Centre of Excellence conducts and shares the applied research needed to properly care for Canada’s burgeoning population of frail seniors. To remain effective and sustainable, the health care system requires evidence-based innovations such as SAFE.

Akos Hoffer is Chief Executive Officer, Perley and Rideau Veterans’ Health Centre. Dr. Virginia Roth is Chief of Staff, The Ottawa Hospital.

 

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