Bayshore’s innovative @home programs improve ALC patient outcomes, increase system capacity

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By Krystyna Oakman, Communications Coordinator

Bayshore is helping to add capacity to the healthcare system, reduce emergency room visits, and divert patients from long-term care through innovative @home programs that transition frail, elderly or long COVID patients from hospital to home in a 16-week pathway.

Since the launch of its @home programs four years ago, Bayshore has partnered with 13 hospitals across Ontario to save more than 240,000 Alternate Level of Care (ALC) hospital bed days. Of the 2,900 patients admitted, 94% said they would recommend the program. The @home transitional care model has also reduced risk of fall by 77%.

“When I came home from the hospital Bayshore took over,” said Vimal Kochhar, a patient in Bayshore’s @home program in partnership with North York General Hospital. “They had a walker waiting for me when I arrived at home. Nursing care and physiotherapy were provided on a constant basis. All the staff I have dealt with have been courteous, professional, kind, and always on schedule.”

Bayshore’s @home programs are a form of transitional care program, which supports the patient by offering physiotherapy, nursing, and rehab services from home. The 16-week program leverages an interdisciplinary care team and digital solutions for workflows with the hospital. It also provides patients with an individualized care plan and works with community support agencies in their area.

After the duration of their care, the @home program safely transitions patients requiring more care back to services in the healthcare system, such as Home and Community Care Support Services. Thanks to @home programs more than 80% of patients have been diverted from long-term care, with 40% of those patients continuing to live independently in their home.

“We are delighted by the success of our @home programs which are helping to relieve our overburdened hospital sector and allow for more patients to receive the high-quality, personalized care they deserve in the comfort of their homes,” said Maureen Charlebois, Chief Nursing & Clinical Officer, Bayshore HealthCare.