A great innovation in delivering care

In case you missed the CBC report, this is a very interesting front-line innovation.


Paramedics in Deep River, Ontario realized that most of their 911 emergency calls were coming from seniors living alone. So they launched a preventive medicine program, where they set up a schedule to visit their frequent callers/users at their homes. This cut the number of 911 calls in half. More importantly, it improved the health of these people.

I like this idea because it’s practical, immediate, and has a measurable benefit to the people and isn’t just some cost-centre saving in the system.

Not only does it cut the number of emergency calls, it allows the health care and 9/11 system to better manage time, resources and health.

By going into the homes of their previous callers, not only do they improve that person’s health, they get to check on that person’s living conditions. This allows the paramedics to see if this person has a decent place to live, has heat, electricity, and food. There’s a TV series called Hoarding, Buried Alive, which shows the desperate, unimaginable conditions under which some people live. We don’t know how many elderly people are living lives of quiet desperation and semi-neglect. So seeing them in their own homes addresses the other failing with ‘corporate care’ where we treat an illness, but ignore or don’t know the person.

The end of this clip says a similar program operates on Long and Brier Islands. A day later CBC Cape Breton mentioned a program operated by the Cape Breton Health Authority had few people sign up for it.

Given Nova Scotia’s high numbers of elderly residents, we have to ask why Cape Breton hasn’t had much pick up? Is there an impediment in how the program operates there or is it merely the result of poor promotion? It’s worth finding out why.


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2 Responses to A great innovation in delivering care

  1. Bubbie says:

    Sounds similar to Capital Health’s Care By Design. This program is designed to improve the quality of life for residents in long term care facilities.

    One part of the of the program is designed to have physicians provide service 24/7 and to work in collaboration with the provincial ECPs (Emergency Care Paramedic) to determine when and if a resident should go to hospital for medical attention. ECPs are specially trained to assess nursing home residents. When the necessity arises to determine if a resident should go to hospital the provincial ECP team is contacted to assess the resident. The ECP is in constant contact with the nursing home Care by Design physician as well as the ER physician and a decision is made amongst them to decide if a transfer is necessary.

    Quite often transfer to hospital is not necessary and the resident can be medically treated right in the nursing home resulting in huge financial savings for our medical system.

    In the first year of this program over three million dollars in savings was realized as a result of fewer hospital transfers from long term care facilities. As a side note to this story, when the Care By Design Team requested funding from the provincial government, it was denied despite the three million dollars it had saved the government. Over the next couple of years the Dexter government made over a hundred million dollar in cuts to the provincial medical system. It seems that no matter how much money can be saved either through a program such as the Care By Design or through charitable fund raising like the QEll Health Science Foundation, the government will make drastic cuts that will negate any gains these programs produce.

    You would think the savings these valuable programs produce could be ploughed back into the system, but with government cutbacks its like being on a treadmill causing patient centred care to suffer.

  2. KM says:

    My mother recently experienced similar care in a Truro area nursing home. She was ill and in pain and 911 was called, but rather than take an ill, palliative woman with end stage COPD out into the cold night, paramedics came to her, examined her, communicated with their doctor, treated her accordingly in the care facility and stayed with her until she stabilized.

    The care was excellent, appropriate, and eliminated the need for a trip to the ER for recurring pneumonia where she would not gave gotten timely or as good care. She stayed in her own bed with the caring folks she knows there to help her, the paramedics provided the advanced medical care she required, and she recovered fully without ever having to go to hospital. A wonderful resource and one I am sure we will use again as she is palliative and does not want to go into hospital.

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