Nursing Week 2018: Just a phone call away, St. Joseph’s Health System improves access to care
When the phone rings, Anna Tran and Josie Knox are always eager to answer. They know that it’s a patient needing help with a burning question or concern about their recent surgery or health condition. Anna and Josie are Registered Nurses and Care Coordinators in St. Joseph’s Health System’s Integrated Comprehensive Care (ICC) Program.
ICC brings hospital and community services together to improve both access to care and outcomes for individuals recovering from knee, hip or lung surgery, or managing complex illnesses like chronic obstructive pulmonary disease. ICC was developed and piloted at St. Joseph’s with nurses and other health care professionals to fundamentally redesign care delivery and address gaps between acute hospital and community care.
Receiving national recognition and heralded as a tremendous advancement in patient care, one of the defining characteristics of ICC is improved access to care. Across our region providing 24/7 access, Care Coordinators and a team of nurses and other healthcare providers from St. Joseph’s Home Care are truly transforming care and making a positive difference in people’s lives.
“We encourage patients to call us with any and every question or concern”, says Anna. Josie adds, “From surgical side-effects and whether their incision is healing properly, to whether a new issue could be related to their surgery, we’re here to answer questions, triage concerns and make sure patients have the assurances they need every step of the way.”
But St. Joe’s isn’t stopping there. Patients in our lung program now have access and support online through an innovative electronic application (app), currently being piloted. Patients log-in daily and respond to a series of health questions. The app tracks responses and provides an individualized report that confirms the patient’s progress, encourages them to call their Care Coordinator if there are areas of concern, and provides targeted exercises they can begin at home.
Gordon Kinney, who recently underwent lung surgery at St. Joe’s, says: “The follow-up through St. Joe’s ICC Program was something I really didn’t expect. Nurses have come to my home in Niagara Falls, I can call anytime, and I check-in each day on the app. It’s been great to have up-to-date information about my health and recovery.”
As Care Coordinators, Anna and Josie are part of an innovative program that is improving the care we provide, and one more example of St. Joe’s nurses supporting the community we serve.