Hospital hotline lends support to long-term care homes during COVID-19

A 24-hour hotline for long-term care homes launched before the pandemic is proving to be extra valuable now that many are dealing with COVID-19.

Known as LTC+, the hotline run by Women’s College Hospital provides the facilities with telephone access to immediate medical assistance. It’s a partnership involving many hospitals, community agencies and long-term care homes across Toronto.

Dr. Danielle Martin, chief medical executive at Women’s College Hospital in Toronto, says the hotline connects staff at long-term care homes to doctors and nurses and has been designed to keep seniors from being transferred to hospital emergency rooms unnecessarily.

Seniors need to be careful during the pandemic and decreasing the number of transfers helps to protect their health and prevent the spread of the virus, the hospital said on its website.

The hotline is working, Martin said.

Since it was launched earlier this year, the hospital estimates that 50 per cent of calls to the LTC+ have prevented a transfer of a senior to an emergency department, thereby cutting down on unnecessary hospital visits.

“This is a program that actually started out before COVID-19 hit the city of Toronto but now has been really accelerated,” Martin told CBC Toronto.

“What we are trying to do is to support the staff and doctors working in long-term care homes to take care of mostly the seniors who are living in those homes without having to transfer them to the emergency department,” she said.

“That’s the goal — to keep people in place as much as possible where it’s safest and where they are known best.”

Martin said large numbers of seniors are transferred by ambulance to hospital for such medical issues as bladder infections, fevers, falls, increases in confusion, and worsening of symptoms of chronic conditions, such as lung or kidney disease.

But she said care homes are often more suitable places for seniors to receive care because the staff there know them and their medical issues best.

“Hospitals are often not the best places to be supporting a frail senior, sometimes leading to increased confusion and complications.”

Staff at long-term care facilities simply have to call the hotline. If they press one, they get a general internal medicine specialist, a doctor. If they press two, they get an advanced practice nurse navigator who will trouble shoot and link to other services.

33 long-term care homes have signed up for service

Martin said long-term care homes in Ontario have already been assigned what the province calls a “hospital resource partner,” or hospital in their region that can send in teams of staff for infection, prevention and control support. She called the teams “boots on the ground.”

The majority have not required a huge influx of hospital staff, she said, but many need basic advice on how to manage one or a few cases of COVID-19, such as how to isolate residents and staff appropriately and to prevent further infection.

“We can get a specialist to speak to the nurse at the bedside by phone or by video visit. We can send out oxygen. We can send out lab services. We can connect them with their hospital resource partner, their local hospital, if they are short-staffed because of the COVID-19 crisis,” she said.

“It’s really a one-stop shop or one number to call for long-term care facilities that are trying to take care of their seniors in place,” she added.

“Part of what this program is about is preventing homes from getting into a situation where they would need a hospital resource partner to activate their full SWAT team to come in and also to help those homes that are recovering from crises to continue to have more virtual support at a distance,” she said.

She said 33 long-term care homes out of a total of 86 in Toronto have signed up for the virtual service, which is run out of a small hub at Women’s College Hospital downtown. It links to people’s cell phones and it is staffed 24 hours seven days a week.

“The reality is, long-term care facilities have been needing this kind of support for a long time.”

A total of 147 homes have reported outbreaks of COVID-19 as of Sunday.

Overall, a total of 654 people in long-term care homes have died of COVID-19 in Ontario, according to data provided by the provincial health ministry. Some 2,520 residents and 1,161 staff members have tested positive.

CBC