The eShift program connects up to four specially trained personal support workers on overnight shifts in a patient’s home with a registered nurse through a smartphone application. The bedside worker reports on the patient’s condition, and the nurse uses the real-time observations to direct care.
It started as a pilot project the South West Community Care Access Centre based in London in 2009, then launched here on April 1 by the Waterloo and Wellington agency in charge of home care.
Research on the pilot project showed good results, including decreased emergency visits and hospital stays for poorly managed symptoms and caregiver burnout, and most people achieved their wish of dying at home — earning it the title of a leading practice by Accreditation Canada.
“We did move forward on this model given that it’s a best practice and we think it’s in the best interests of the patient,” said Gloria Cardoso, a senior director at the Waterloo Wellington Community Care Access Centre.
But that worries the chief executive officer of the Registered Nurses’ Association of Ontario.
“If you want to expand this program, there is work to be done,” Doris Grinspun said.
The nurses’ association got in touch with the South West centre when it heard concerns about the model from the public and nurses. After discussions, the association offered written recommendations last November calling for safeguards to ensure safe and quality care. Those included making sure workers in patients’ homes were only providing care they were competent to perform safely.
They also urged a working group that included the nurses’ association and the Ontario Association of Community Care Access Centres to establish a standardized model before it expands to other regions in the province. But that has not happened, nor did the nurses’ association give their stamp of approval.
“We never actually endorsed the program,” Grinspun said.
And they never had talks with the Waterloo Wellington centre, despite a comment that they were consulted during a presentation on eShift at a May 14 board meeting.
Chief executive officer Gordon Milak, who came here a year ago from the South West agency, said he did mention the nursing association during a discussion after his presentation.
“My intent was not to say there has been a formal endorsement,” Milak said.
Rather, he simply said that the association was aware of the program and had weighed in. He explained the Canadian Nurses Association had been consulted with to ensure the program aligned with their regulations, and it did.
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