NHH announces ALC partnership with The Landmark

By Cecilia Nasmith

Northumberland Hills Hospital announces a temporary local partnership that promises to alleviate a long-standing problem shared by so many Ontario hospitals.

As an acute-care hospital, NHH is designed to care for people with urgent (or acute) health-care needs. In recent years, however, hospitals have acquired the role of a fallback, a less-than-ideal place to stay for those who cannot be discharged because of the lack of community resources that would be necessary in each individual case – usually a long-term-care bed, as many of these patients (though not facing a specific health crisis) require more care than just being discharged to their own homes.

The need for these spaces has exceeded the need for them, the hospital's press release noted. Without this discharge option, the patients continue to occupy a hospital bed and receive what is known as an alternative level of care. Often called ALC patients, they use hospital resources that might better be directed to acute-care patients.

At present, 25% to 30% of acute-care beds available at NHH are occupied by ALC patients, which leaves only 75% beds intended for acute care technically accessible to acute-care patients. The result is longer waiting times in the emergency department, as admissions take longer. This increases the frustration for patients and their loved ones, as well as for the health professionals who care for them.

NHH was pleased to hear of new long-term-care beds announced for Northumberland County. But the reality is that new construction takes time, and these beds will not be available for several years.

In the meantime, a new transitional-care option has been introduced, thanks to a temporary partnership the hospital has struck with the retirement-home of Extendicare Coboug, The Landmark seniors' residence. While longer-term solutions are being developed, the press release said, “this is a release valve with immediate, tangible benefits for the patients, their families and the local health-care system.”

The partnership allows up to four ALC patients to be transferred to a temporary home at The Landmark, improving their quality of life with a more home-like environment while they wait for a more permanent long-term-care placement. The Landmark also has supports beneficial to their over-all health and independence, including daily programming to support social and emotional well-being.

At the same time, four acute-care beds at NHH are freed up for those requiring urgent care.

Patients eligible for The Landmark beds will have placement for long-term-care papers completed and assessed as appropriate. A repatriation agreement is also in place for the patients' return to NHH in the event his or her health needs change or in case program funding is not sustained.

At present, funding has been granted through the Central East Local Health Integration Network through March 31, with the potential of continuing (and possibly expanding to include other local partners) until additional long-term-care capacity is available.

The new option does not increase the cost to patients. They will be expected to pay a daily fee to The Landmark equal to the current co-payment due to the hospital as an ALC patient awaiting transfer to long-term care.

Eligibility for transfer to The Landmark is based on a range of clinical factors, and a process is in place to identify those ALC patients most appropriate for this move. Ultimately, the decision of whether to go for a temporary transfer to The Landmark is made by eligible patients and their loved ones.

NHH president and chief executive officer Linda Davis said this stop-gap measure is one that hospitals are exploring in order to meet their accountability to acute-care patients.

“Our aim is to free up bed space for those with acute-care requirements – the care we exist to provide – while at the same time providing alternate-care space for ALC patients that is better suited to their current needs.”

Extendicare vice-president of long-term-care operations Michael Harris said they are pleased to partner with the hospital and help alleviate its over-capacity challenges.

“It's a win-win-win in our view, to use excess capacity at The Landmark and create a temporary solution while new long-term-care capacity is being built,” Harris said.

“We look forward to welcoming patients and their families to The Landmark community.”

Northumberland-Peterborough South MPP David Piccini congratulated both institutions on the partnership, which he termed an innovative strategy.

“Our government was elected to put the patient at the centre of a sustainable health-care system,” Piccini said in the press release.

“We have moved forward to address some of the immediate challenges faced by Ontario's health-care system through the creation of more beds to address hallway health care. We appreciate the support of all our health-care partners in creating new transitional-care options.”