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Highly Integrated Rehabilitation Outreach Service

Posted Oct 11th, 2019 in News

Last week the Provincial Government announced a significant investment in a program designed to improve patient flow, provide safe discharges and better connect patients with rehabilitation services in the community.

In partnership with Niagara Health, Hotel Dieu Shaver will be part of an OT/PT team that will provide assessment and rehabilitation treatment to patients at Niagara Health acute-care sites.

We hope to be able to collaborate on three teams. The purpose of the initiative is to improve access and timeliness to different levels of rehabilitation care across the Region.

Pre-identified patients located at a Niagara Health acute care site, who are determined to be potential candidates for rehabilitation, will be assessed by the Team, with possible bedside treatment at the Niagara Health site, or a referral to Hotel Dieu Shaver for a more intensive rehabilitation experience, if appropriate.

The team(s) will be referred to as a HIROS Transition Team – standing for Highly Integrated Rehabilitation Outreach Service Transition Team.

Responsibilities of the Team members will be to help ensure a successful patient transition across the healthcare continuum by:

• Assessing pre-identified patients’ potential for rehabilitation to aid in the appropriate determination of the correct rehabilitation path.
• Team members will make recommendations for movement of rehabilitation patients into the appropriate program and location.
• Provide rehabilitation care to patients who are awaiting transfer to a rehabilitation bed, or who have barriers to transferring to a rehabilitation bed at Hotel Dieu Shaver.

This new program is an excellent example of how we are strengthening partnerships with other care providers to improve access to health care services and build a better-connected health system.

It is also gratifying to see this government’s continued recognition of the value of rehabilitation as a clear and effective intervention in reducing acute care Hospital congestion and emergency re-admissions by ensuring that patients receive the rehabilitative care that they need to improve their quality of life and return them to the highest possible level of independent living.

The collaborative approach will bring Hotel Dieu Shaver’s specialized rehabilitation service delivery model to the bedside at Niagara Health.

We are sure that this innovative front-line initiative will prove to be a vanguard measure in our collective efforts to end hallway healthcare, improve health care capacity in our region, and ensure that patients are receiving the right services, at the right time and in the right place.

By way of logistics, half of the team members will be employees of the Hotel Dieu Shaver and half will be employed by Niagara Health.

Temporary Full Time Postings will be issued in the near future.