Leila McClarty, manager of long-term care screening and placement in the Sun Country Health Region, made a presentation to the board of directors on Feb. 24 which outlined some major changes to the assessment and placement system.
McClarty said early indications point to a successful transition to a more efficient system of placing long-term care applicants into suitable accommodations.
At the outset of the presentation, she said there are 642 long-term care (LTC) beds available in Sun Country region, located in 18 facilities and records show admission numbers between 270 and 300 per year.
Before the change to a more effective system less than a month ago, there had been 108 people on waiting lists for a preferred LTC location or a first-bed offer. That list has already been reduced to 70, she said.
“In the past, we had five screening committees who met, on average, about once a week. We had a batching system in place and that led to system flow problems,” McClarty said.
Assessments, which can absorb up to four hours, often led down the line to such things as system manipulations and increasing screening costs that were registering around $460 per screening or over $136,000 per year, with 2.5 offers made for each bed that was eventually filled.
“There was a log jam and you can understand there were, no doubt, different messages being delivered by different people within a committee to the families and applicants,” said McClarty noting they couldn’t report proper metrics to the Ministry of Health due to the conflicting flows of information.
The new system, she explained provides a “single-point screening and placement system. We have one assessor, one-bed availability database so we have gone from a five committee system to a one-person system and that person is able to carry out six or seven assessments and recommendations per week,” she said, so there is no slowdown in the offer and acceptance flow, and a lot less confusion, since medical diagnosis and other information items flow right to the one source.
“If we have 14 beds available right now, I can tell you where they are, and I can tell you what the assessment results are and the scale of care requirements to help the placement process,” McClarty said.
With better medical and care outcomes, some clients have already been able to leave the LTC facility because their health has improved. “Many improved dramatically to the point where they were discharged because they no longer needed long-term care,” she said.
Those screened are now offered a bed within a 12-day window and some refuse the offer, but remain on the list and can be reassessed within the year with an offer coming to them at a later date. Clients and families often say yes to a transfer from one facility to another, and then might change their minds once the patient (client) settles into the LTC environment at the first location.
“With one person doing the screening, there is a better communication between the acute-care providers and the long-term care providers,” she said.
One thing that hasn’t changed is the ongoing pain and pain management situations that often accompany a LTC patient.
“If the care isn’t appropriate for the need, there is an appeal process available through a steering committee. We don’t force change,” said McClarty who noted, that since the new system had only been in effect for a matter of weeks, complete data collection and finessing was still a work in progress. But, she said, she and others in the LTC system were very pleased with the outcomes to date.
In the future, the intake of acute care and dementia patients from other health regions will be on the system’s agenda to chart and provide intake capabilities.
