Expert care, from the comfort of home: St. Joe’s and HHS unveil surgical program with virtual care
“It was all a bit surreal,” laughs Kamila Gemin, thinking back on the last month. “I went from stomach pains to having surgery.”
Abdominal pains on a Friday afternoon lead to a visit with her family physician, but within hours Kamila, a 44-year old wife and mother of two, was having an ultrasound in the Emergency Department at St. Joseph’s Healthcare. It was confirmed she needed her appendix removed.
“Everyone was very supportive and kind and positive, but it just sort of hit me, I was having surgery, and it was quite shocking.”
The surgery Saturday evening went largely as expected. It was the Monday afternoon discharge that broke from tradition.
“A staff member came and asked me if I’d like to be part of a new program, and that my doctor was in favour of it,” says Kamila. “I was just willing to be part of any added support that was being offered.”
The program is called Surgical Transitions and it’s a collaboration between St. Joseph’s Healthcare and Hamilton Health Sciences (HHS). Enrolled patients go home with the Cloud DX Connected Health kit that includes a tablet paired with equipment to capture the patient’s vital signs and weight. The technology is used by a virtual care team who remotely monitor the patient from the hospital command centre. The virtual care regimen includes daily patient vital signs review, nurse video visits and assessments, surgical wound photography and review, medication error detection and correction, and pain assessment.
“The first seven days I had a video call every day with a nurse and met the peri-operative physician on call who reviewed my history, my course in hospital and my medications. They asked me all the standard questions, making sure I was healing alright and feeling alright.” Patients can connect with the virtual command centre if there are concerns or questions.
“Sometimes patients don’t know if what their experiencing is routine,” says Raquel Picado, a nursing extern who has been working with the program.
The unit is comprised of an interprofessional team of Perioperative physicians - including cardiologists, surgeons, and anesthesiologists and nurses to support virtual rounds. Together, the nurses and physicians review the patients’ recovery daily, and nurses escalate care when the attention of a physician is needed.
“It is our goal that the innovative Surgical Transition program will provide support to post-operative patients as they transition home, simultaneously decreasing the need for returns to the Emergency Department and readmissions to hospital,” says Dr. Rahima Nenshi, the clinical lead for Perioperative Care and the director of Acute Care Surgery at St. Joe’s. “This will support the ramp up of surgeries that have been delayed during the last year and a half during the pandemic and are so desperately needed.”
“We’ve learned over the course of the pandemic that exceptional care can be delivered using digital technology,” says Ceara Holditch, Surgical Transition Project Lead for St. Joe’s. “Patients are safely monitored and are still able to communicate with their care team, all within the comfort of their home.”
“Patients appreciate having a healthcare team monitor them as it has been very difficult during these uncertain times,” says Raquel. “This program has made a huge impact on our patients as they have the opportunity able to see and keep track on how they are recovering and become more involved in their own health care!"
“I felt so supported and reassured,” says Kamila, “It’s such an excellent program.”