Quinte healthcare team learns from Brockville's Restorative Care and Enhanced Activation Program

Posted Feb 9, 2012 By Doreen Barnes

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EMC News - For three days in January, the Brockville General Hospital (BGH) hosted a healthcare team from Quinte Healthcare on BGH's National Leading Practice.

This group was in Brockville to learn about the accredited BGH Restorative Care and Enhanced Activation Program group.

"The Brockville General Hospital has two separate programs," said Sherry Anderson, director of complex continuing care, rehabilitation and palliative care.

"We have a restorative care program at the Garden Street site and an enhanced activation program at Charles Street in the acute care. Basically both programs are to work with frail, elderly patients, so they do not become de-conditioned while they are hospitalized. This has led to a great decrease in our Alternate Level Care patients. We are not sending near as many patients to long-term care."

According to Anderson most of the patients are able to return home with a support system in place.

"Over the last two years we have developed these two separate programs which work pretty much in conjunction with one another," said Anderson. "It seems to be a way the Local Health Integration Network, (LHIN) is pushing hospitals to develop programs like this."

As stated in a previous BGH media release, the success of this innovative program, Restorative Care and Enhanced Program (RCEA) has shown a reduction in the number of Alternative Level of Care patients from 21.2 per cent in 2009 to 5.5 per cent in 2010.

The Quinte Healthcare team learned about the Brockville General Hospital's recorded statistics and results, deciding that they too, wanted to start their own program.

For three days, six staff members came from Quinte to shadow members of the Brockville team, at both sites including nursing, personal support workers, physiotherapists, occupational therapist, recreational therapists and discharge planning personnel.

"As a discharge planner, I just want to mention that the Home First Program has seen such success in this area (Brockville) and I believe that it is purely related to the use of our Enhanced Activation, as well as our Restorative Care Program," offered Cari Bailey.

Bailey continued to say that they work in collaboration with Home First to enable its senior residents to return to their home more safely and to potentially wait for long-term care placement.

Home First is a program wherein local health care partners in a coordinated effort with the BGH provide the needed home support for mature adult patients upon treatment being completed and await entry into a long-term care facility.

The Quinte Health Care Team felt very appreciative that their peers saw the value in the team coming to Brockville.

"It was a recommendation that was made by our management," said Quinte Healthcare clinician Grace Zwart, "and it has proven to be a really good way to see first hand how the front line staff actually do implement their plan of action and their plan of care. Speaking personally, I spent most of my time with Michelle McCabe, (restorative/enhance activation nurse), yesterday and she was incredibly informative going through the charts, giving background information on the patient so that a care plan could be best set up for that patient We also went to the bedside of the patient to interview and pass on that information. I can see where that process will really benefit us."

The Quinte Healthcare team all agreed that the Brockville group was very generous with their time.

"Day one was spent on giving the education background, the theories behind the process and how the program works," stated Zwart. "There was ample time for questions, absorbing the information and there are some budding actors in the group which was helpful for us. It helped us put the patient/nurse roles into perspective."

For day two Quinte Healthcare team shadowed their counterparts in restorative care and occupational therapy, along with attending restorative care rounds with multidisciplinary team, as well as observed fitness class with therapeutic recreation.

"While we were on Charles Street, Heather O'Brien spent time with Vaughnette Chatzikiriakos at the bedside actually working with the patient," said Zwart. "Margaret Anderson and I stayed with Michelle McCabe to review a tool for triage risk assessment on people over 65 and we went through the Blaylock tool, a numeric tool for assessing the patient's level of risk."

On day three, there was more shadowing of nurses, personal support workers, physiotherapists and occupational therapists.

"They were very receptive," said Brockville's McCabe of the Quinte Healthcare team.

As the three days came to a close, final questions and concerns were addressed before the six Quinte Healthcare individuals departed.

Some comments echoed by the Quinte Healthcare team were that the Brockville group has a great team, that they work well together, amazed to see how they support each other, how they interact with the staff on the floor, how they relate to each other, good morale and that they do not realize the success and benefit they have made to the patient as well as the staff.

"I think one of the things is that nurses are not numbers people, we are relational," ended Zwart. "I think when you look at what has happened in Brockville, the numbers speak for themselves.

We talk about evidence based practice, they (Brockville) have evidence based practice firsthand and it has been successful. They should be very proud of that."

Anderson has sat on Provincial Services Roadmap for the South East LHIN, specially the restorative care group.

"A lot of what we are doing in Brockville, I think will be implemented across the LHIN," said Anderson. "Other hospitals in our region sit on it, Quinte is there, Kingston General Hospital, Perth and Smith Falls, we would be more than happy to do this again, even outside of our region. We definitely see the benefits to the patient and we would be glad to share it."

When asked what makes the BGH's Restorative Care and Enhanced Activation Program team work?

In unison, the Quinte Healthcare staff said, "Communication and passion for what they are doing, because they know it works".




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