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Seeking solutions to hallway health care

Nov 14, 2018
Guylaine Spencer

Hallway health care

Dr. Michael McGillion, an associate professor in the McMaster School of Nursing, participated in a policy  discussion hosted by the Council of Ontario Universities (COU) at the Ontario Legislature at Queen’s Park on October 30. The audience included the Minister of Health and Long-Term Care and other members of parliament.

“This discussion was about how technology can be used to help address the problem with hallway health care in Ontario,” said McGillion.” Hallway health care refers to the practice of treating patients in hospital hallways because no rooms are available.

Michael McGillion

Photo above: Dr. Michael McGillion

The Queen’s Park legislature is an unusual venue for university researchers, but it’s part of the COU’s strategy of to “bring the university researchers in front of provincial members of parliament to talk about how universities are helping to tackle the problems of the day,” McGillion explained. This was the first of a series of university-government discussions planned by the COU over the next four years.     

Rheta Fanizza, Baycrest’s Executive Vice President, Residential and Community Programs, hosted the panel discussion which included Dr. McGillion and Deborah Simon, CEO of the Ontario Community Support Association.

McGillion spoke about “innovative tablet-based solutions and platforms that can help us manage complex patients after the discharge from hospital to help prevent them from coming back into the hospital.” Keeping patients healthy at home will reduce hospital overcrowding. One example under development is SMArTVIEW, a remote automated monitoring system that will allow nurses to keep tabs on vital signs through monitors worn by patients recovering from cardiac surgery.

Not all solutions, though, need to be complex, McGillion said. Sometimes it’s more about bringing the right people on board to help. He pointed to the Hope-4 Study as one example. Led by Dr. J-D Schwalm, associate professor, Division of Cardiology, Department of Medicine, this study involves community health workers who help patients manage their blood pressure safely. With the aid of tablet-based counselling systems, patients receive feedback about healthy lifestyle choices and choose goals for improvement, including medication adherence, smoking cessation, healthful diet choices, and physical activity. Participants also name a treatment supporter who is either a close friend or family member and who participates in goal setting and treatment discussions.

McGillion believes that one key to solving hallway health care is to carefully think through all of the steps, such as: What are the needs of the population? What problems are you trying to solve? And who needs to be involved in co-design of these solutions? “Often we don’t think of addressing infrastructure that can being other people in who are in the circle of care that can help ease transitions,” he remarked. The circle of care includes health care professionals, volunteers, and family and friend caregivers. Solving more complex hallway healthcare problems will require input and effort from the whole community.

“We also talked about the problems of the interoperability of systems, having solutions and devices that can communicate seamlessly with hospital medical records vs community-base management platforms. That remains a challenge,” says McGillion. “We need to progress toward flexible databases and structures that will allow systems to talk to one another. We also need structured, consistent, and ongoing engagement with primary care providers to increase awareness and facilitate referrals, partnering with hospitals to improve care transitions into the community, and sustained change management practices.”

See also, on Ontario’s Universities website: Bringing health care out of the hallway and into the future

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