New teams on the horizon are trying to steer patients away from unnecessary hospital admissions CBC News

Horizon Health Network says it may have found a way to prevent 600 hospitalizations a year and save $8.6 million.

The health agency has introduced “diversion teams” in many local hospital emergency departments, Horizon CEO David Arbiio said.

These teams help organize care at home or in the community, when appropriate, rather than admitting people to the hospital, Arbiio said in an interview. Information Morning Fredericton.

If a patient comes to the emergency department and the medical team there feels that the person needs to be admitted, but may stay at home, the diversion team will review their chart, talk to the patient and their family and organize some interventions.

“I think generally people, if they’re in the hospital, they don’t want to be there,” said Arbiio, the health agency’s clinical executive director, patient flow and ambulatory care.

Asked later why diversion efforts hadn’t happened earlier, given the long availability of the supplemental program, Arbiio responded via email that it took time to develop and activate the right structure, resources and partnerships in a complex, interconnected system of care.

The Horizon expressed dismay at the number of hospital beds taken up by people who no longer need medical care but are waiting for places in nursing homes.

The crisis has affected emergency departments, where people can be found waiting for beds to open up in the halls and elsewhere.

Arbio said Information morning He said many people don’t know what services are available that might allow them to receive care at home or in the community, or they don’t have a family doctor to refer them to.

An example of a person who may be delayed is a patient who has an infection and requires intravenous antibiotic therapy.

“Instead of staying in the hospital for that kind of treatment, they’re actually being sent home. We’re referring to a team of outpatients,” Arbio said. “They go in and work with the pharmacy to deliver the medication and then administer the medication at home.”

In most cases, caregivers just need some support, he said, while also acknowledging that sometimes caregivers burn out.

If the patient or caregiver isn’t interested in home care, no one is kicked out of the hospital, Arbiio said.

So far, diversion teams have been set up at regional hospitals in Miramichi, Fredericton, St. John’s and Moncton, he said.

Each team has a nurse navigator, occupational therapist, physical therapist and social worker, Arbio said.

Moncton is running an additional pilot program, through which transition patients can get faster access to geriatric specialists.

The first teams started in December and as of March 8, they have collectively “helped more than 230 patients avoid hospital admissions,” Horizon Health said in a news release, estimating savings of 3,600 hospital days and $3.3 million.

Arbiio said patient outcomes are being evaluated and future plans for the program will be made in April.

He said: “The general response has been very positive.

He noted that during follow-up calls to patients and families, a problem was identified that in-home services sometimes did not start when they should have started.

After being asked for details, Arbio did not provide specifics but said most of the delays were resolved quickly, and Horizon was “working with partner agencies to address any gaps.”

CBC News contacted the extra program to find out about current wait times. This information is not provided.

However, its most recent annual report for 2024-2025, and its website, show that 50 percent of referred patients waited four days or less to start treatment and 10 percent of patients waited more than 40 days. The goal is a day or less.

In addition to idiosyncratic, people can also be referred to Ability NB, to help with mobility issues, and the Alzheimer’s Association for dementia-related support, Arbio said.

Another could be a nursing home without walls, he confirmed.

The latter program provides services such as check-in calls, social visits, transportation to visits and use of nursing home baths and other equipment.

Suzanne Dupuis-Blanchard created a nursing home without walls and is director of research on population aging at Université de Moncton.

Asked about her impressions of Horizon’s new flexibility teams, she said she supported the idea of ​​having someone perform this type of exercise in the ER, adding that sometimes a person’s needs are non-medical.

But she wondered if community and home services would be accessible and available in a timely manner.

“We refer to services and sometimes the person is not in a position to wait two or three months.” Dupes Blanchard said. “They need it right away.

“I imagine it’s a lot more when they present in the ER.”

Jean-Claude Basque of the New Brunswick Health Coalition was also skeptical that adequate support services would be available.

“If they do that, that would be great,” he said. “If they are successful in finding services that is a good thing.”

Basque added that diversion will not work for many people because they are too sick or because there is no support in their family or in their community.

Many people need nursing home care, he said, and nursing homes cannot operate at capacity because they are understaffed.

According to Horizon, at least 20 percent of patients who have been discharged from the hospital so far would otherwise have been “medically discharged” but are waiting to be placed in an alternative care setting in the hospital, such as a nursing home.

Those hospital stays averaged more than 50 days each, Arbio said.

Asked if anyone is looking at possible care at home for patients whose admission date is before the new diversion teams, he said clinical teams are working closely with patients, families and system partners to ensure these patients can be safely transferred to the most appropriate care setting as soon as possible.