Photo: Members of the NICU team at Markham Stouffville Hospital participate in a test-run of the video virtual care using a simulation mannequin.
By: Julie Dowdie, Senior Communications Specialist, Markham Stouffville Hospital and Jessica Marangos, Lead - Strategy Implementation, Kids Health Alliance
When Katie and Jeff Lavelle's newborn son, Edward, needed to be treated for complications arising shortly after his birth, the world-class team of paediatric experts assessing him were simultaneously right by his bedside and more than 40 kilometres away.
Little Edward benefited from the launch of a new Kids Health Alliance (KHA) virtual care project that allows the care team at Markham Stouffville Hospital's (MSH) Neonatal Intensive Care Unit (NICU) to consult experts at The Hospital for Sick Children (SickKids) with the added use of video.
The project introduces video capabilities between consulting physicians and nurses in MSH's NICU and the SickKids Acute Care Transport Service (ACTS) team. With specialized training and equipment, the SickKids ACTS team brings the expertise of newborn and paediatric intensive care, as well as transport medicine, to community hospitals.
Currently in Ontario, 49 NICUs access the province's Neonatal Consult, Transfer and Transport program to seek input from paediatric and neonatal medical specialists. Up until now, this program has been available exclusively over the phone.
"Adding video capabilities to this process provides eyes on the baby, significantly improving the SickKids team's ability to determine if the baby needs to be transferred and what measures can be taken to keep the baby stable until the transport team arrives. The SickKids team is also able to collaborate better with MSH to identify and avoid unnecessary transfers," explains Larissa Smit, Interim Executive Director at KHA.
The project moves the consult process to the patient's bedside. The MSH team uses two tablets to provide the team at SickKids with different visual options. One tablet is clamped on the bassinet with the video facing the baby, and one tablet is on a floor stand with the video facing the monitors. The MSH NICU team can move the tablets to address requests and questions from the SickKids ACTS team.
Following the video consult with SickKids, Edward did not need to be transferred and was able to stay at MSH. For Katie and Jeff, having those "extra sets of eyes" to evaluate their son added an additional layer of reassurance during a very stressful time.
"We already were so confident in the health-care team at MSH and had chosen to have our baby here because of the hospital's great reputation. However, it was also such a relief to know that MSH was able to take Edward's care a step further and consult with other specialists," Katie says.
"Every second counts with these tiny patients," adds Jo-anne Marr, President and CEO of MSH.
"Participating in this KHA project to add the ability to see the baby in real time and monitor how they are doing will improve their health outcomes and allow us to deliver enhanced quality care close to home for the entire family."
"Access to virtual care is more important than ever. In a matter of weeks, virtual care has become a primary method of health care delivery," notes Dr. Ronald Cohn, Chair of the KHA Board and President and CEO of SickKids.
"We are excited to launch this initiative with Markham Stouffville Hospital that will provide timely advice between clinicians and a better experience for patients and their families."
Kids Health Alliance, founded in 2017 by SickKids, Holland Bloorview Kids Rehabilitation Hospital (Holland Bloorview) and CHEO, is a not-for-profit network of health-care organizations that collaborate to make tangible improvements in care for children and youth. The Network currently includes the three founding specialty paediatric hospitals and six community hospitals. In addition to MSH, this includes Humber River Hospital, Michael Garron Hospital, Orillia Soldiers' Memorial Hospital, Pembroke Regional Hospital and Southlake Regional Health Centre.
In the first month of the project, eight calls with the added use of video occurred for five different babies, including Edward.
Through KHA, the project teams at MSH and SickKids will participate in an evaluation of the project to measure outcomes, including clinician's perceptions about the benefits of adding video, avoidance of unnecessary transfers and overall experience.
KHA will also monitor if the added use of video translates to more 'advice only' calls that allow the baby to stay at MSH, financial benefits in avoiding unnecessary transfers. Based on the evaluation results, KHA plans to expand the project to the other community hospital partners.
For more information about KHA, visit www.kidshealthalliance.ca.