Integrated Comprehensive Care – Bundled Care
Better, Faster, Cheaper
February 27, 2013 | Dr. K. Smith
Integrated Comprehensive Care Bundled Care Better, Faster, Cheaper - - PowerPoint PPT Presentation
Integrated Comprehensive Care Bundled Care Better, Faster, Cheaper February 27, 2013 | Dr. K. Smith S T . J OSEPH S H EALTH S YSTEM (SJHS) SJHS IS ONE OF THE LARGEST CORPORATIONS IN C ANADA DEVOTED TO HEALTH CARE . O UR MEMBER
February 27, 2013 | Dr. K. Smith
HAMILTON
CHARLTON CAMPUS is a tertiary care teaching centre, which includes the regional kidney transplant centre, oncologic surgery and a large acute care hospital. KING STREET CAMPUS provides
State-of-the-art, stand-
alone facility including a Surgery and Satellite Dialysis Centre. WEST 5TH CAMPUS provides specialized tertiary mental health services for residents of Central South Region in Ontario.
Annual budget: $500 M Established: 1890 www.stjoes.ca
SJHC provides a multitude
community needs. Mandate is to help people including the frail, elderly, and disabled, lead more independent lives. This is done through nursing, personal and home support, and volunteer services, as well as our Constant Care, Palliative Care, Healing Touch, With Seniors in Mind, and Corporate Health Programs.
Annual budget: $10 M Established: 1921 www.stjosephshomecare. ca
CENTRE GUELPH
Guelph has been serving the Guelph and Wellington community since it first opened as a refuge for the sick, injured, frail and the indigent in 1861. Today it is Guelph's leading, fully accredited, non-for-profit provider of resident long term care, complex continuing care, and rehabilitation services.
Annual budget: $30 M Established: 1861 www.sjhh.guelph.on.ca
CENTRE, BRANTFORD
SJLC is a multigenerational place of care, hope and
concept of health care combines long term care with Brant County’s first hospice as well as a centre for research and
commitment to the Mission and philosophy of providing compassionate care will never change.
Annual budget: $11 M Established: 1955 www.sjlc.ca
DUNDAS
SJV has built a new vision
understands that “there’s no place like home”. SJV staff embrace the mission; providing compassionate care with dignity and
in new buildings transformed the Villa and Estates into a modern home able to meet the needs of seniors and their families.
Annual budget: $22 M Established: 1879 www.sjv.on.ca
HOSPITAL, KITCHENER
SMGH provides adult, acute care to people in Waterloo Region and
Regional Cardiac Care Centre SMGH provides a full range of cardiac care including surgery, angioplasty, and pacemaker insertions. SMGH continues to meet the needs of the community, recently
Annual budget: $120 M Established: 1924 www.smgh.ca
SJHS TOTALS BEDS = 1,800 BUDGET = $683M
INTERNATIONAL OUTREACH PROGRAM
International Outreach has been bringing good intentions to life around the world since 1986. From Haiti to Uganda to Sudan, IOP partners with developing countries to provide training in current medical and nursing techniques, transport basic medical supplies, and make donated equipment operational. International Outreach is funded by the Sisters of St. Joseph of Hamilton, Canada and supported by member
Patient centered model Follows the patient across the continuum of care
Three client groups with broad applicability in Ontario (1,200 clients)
Evaluation
Integrated Care Coordinator Home Care Team
"Please help me fully understand my health challenges so that I can make informed choices about my care.” “I would like timely care when it is necessary, in the most suitable location.” “I want to be clear about what will happen next so I can prepare properly and try to worry less.” “Help support my recovery at home."
community
68 years old, Lives at home with his wife, in Brantford ON Diagnosed with Lung Cancer through the Lung Diagnostic Program at St. Joseph’s Healthcare Hamilton In August 2012 underwent Lung Cancer surgery at St. Joseph’s Healthcare Hamilton
After 7 days in hospital, he is discharged home on Thursday
Saturday: His chest tube site is bleeding quite a bit, and he and his wife decide to go the Brantford General Emergency Room; they are sent home after a change in dressing. The CCAC Thursday evening: He is suffering from shortness of breath and right shoulder pain; His wife bring s him to the Brantford General Hospital ER for assessment He waits a few hours for an assessment and tests and is sent home ; The CCAC and home care providers are not aware of the visit After 5 days in hospital, he is discharged home on Thursday Saturday: His chest tube site is bleeding quite a bit, and he and his wife call the ICC central contact number; They speak with the Integrated Care Coordinator…
After 7 days in hospital, he is discharged home on Thursday
Saturday: His chest tube site is bleeding quite a bit, and he and his wife decide to go the Brantford General Emergency Room; they are sent home after a change in dressing. The CCAC and home care providers are not aware
Thursday evening: He is suffering from shortness of breath and right shoulder pain; His wife bring s him to the Brantford General Hospital ER for assessment He waits a few hours for an assessment and tests and is sent home ; The CCAC and home care providers are not aware of the visit After 5 days in hospital, he is discharged home on Thursday Saturday: His chest tube site is bleeding quite a bit, and he and his wife call the ICC central contact number; They speak with the Integrated Care Coordinator… The ICC sends the nurse in to assess the bleeding. A picture is sent to surgeon for review. The patient stays at home, with a follow up in the clinic in 2 days. All events are documented in the electronic record Thursday evening: He is suffering from shortness of breath and right shoulder pain; The Integrated Care Coordinator sends a respiratory therapist in the home for assessment, using an oximeter. A direct visit with the thoracic surgeon is scheduled immediately, with all his information provided to the physician.
Hip and Knee Replacements
Lung Cancer Surgery
Chronic Disease
Patient/client satisfaction is very high
$0 $2,000 $4,000 $6,000 $8,000 $10,000 $12,000 $14,000 $16,000
CMG 112 Open Lung Resection CMG 114 Endoscopic Lung Resection CMG 320 Total Hip Replacement CMG 321 Total Knee Replacement
Average estimated direct costs
F2011/2012 Q1 F2012/2013
21
Client in Hospital Client at Home Integrated Care Coordinator Home Care Team CCAC Contract