Groundhog Day – Escaping the Loop in Healthcare
Groundhog Day is right around the corner and the early arrival of spring isn’t the only thing I’m rooting for.
Let’s rewind for a minute to the early 1990s and the classic movie of the same name. Cited as one of the best comedy films of all time, Groundhog Day stars Bill Murray as a TV weatherman who gets trapped in a time loop, waking up to relive the same day over and over and over again.
Based on this story, the term ‘Groundhog Day’ is now commonly used to describe situations that continually repeat. After working in the home care system for nearly 30 years, it’s a feeling I can relate to.
When I first joined SE Health in 1992 – less than one year before the film’s release date, go figure – I saw a massive opportunity to impact the way people live and age at home.
On so many fronts, there seemed to be this burning platform for change: the population was aging, more and more Canadians were living with chronic conditions like hypertension, diabetes and heart disease, and governments were concerned about the rising cost of healthcare. Together, these factors created a powerful case for shifting care out of institutions into more cost-effective community settings.
At the same time, healthcare needs and expectations were changing – people wanted to remain in their own homes and take a more active role in their wellbeing and care. Technology was paving the way for this to happen, fuelling innovation in every corner of society.
From the National Conference on Home Care in 1998 to the Romanow Commission in 2002, experts agreed: it was time to modernize our health system and home care needed to play a central role.
As Andie MacDowell, Bill Murray’s love interest in the film, muses, “There is something so familiar about this. Do you ever have déjà vu?”
Fast forward several years through an impressive roster of pilot projects, expert panels, studies and reports – all grappling with and reinforcing similar themes.
There’s been structure changes, too – from the introduction of Community Care Access Centres to Local Health Integration Networks and now Ontario Health Teams.
Funding announcements have been plentiful; yet in Ontario, home care still only accounts for about five per cent of total healthcare spending and 40 per cent of this goes toward administration and care coordination.
There is growing consensus the current model of home care is broken.
A new study involving more than 700 Ontario patients overwhelmingly identifies home care as the single greatest concern for people and families who’ve experienced a recent hospitalization. According to lead researcher Dr. Tara Kiran, the top three priorities for change (of 52 identified) all relate to gaps in publicly-funded home care services.
Scan the headlines and you find the story of a woman in Thunder Bay who spends at least six hours a day at the local hospital, 365 days a year, to get the treatment she needs to manage a rare kidney disorder. She would like to receive at least some of these treatments at home but has been denied five times.
I often hear from patients and families who are struggling to get the home care they need. And like many Ontarians, I’ve also experienced this with my own family members.
It’s Groundhog Day in healthcare and we keep stepping off the sidewalk into the same icy puddle over and over and over again. Will we finally catch ourselves mid-step – like Bill Murray’s character in the movie – and take a different path? What would this look like?
Democratizing the system
Home care should be the first line of support, not a hot commodity in short supply. It's less expensive than other care settings and a key solution for healthy aging, solving hallway healthcare and ensuring the sustainability of our publicly-funded system.
Additionally, as healthcare becomes more omnichannel, people want and expect a seamless and connected experience. Whether they are getting care at a hospital, clinic, at home or through a mobile app, services should be accessible, comprehensive and universal.
Care process redesign
We need to shift to a new way of working that honours and empowers the people at the heart of care – patients, family caregivers and front-line health professionals. This is nearly impossible to achieve under the current transactional fee for service model.
There is substantial evidence that self-directed healthcare teams are more productive, more proactive in patient care, and less expensive overall. At SE Health, we are collaborating with AMS Healthcare on an ambitious four-year project to implement and scale a holistic nurse-led approach to home and community care called the H.O.P.E. Model®. You can follow our progress at hopeinitiative.ca.
A new day
At the end of Groundhog Day, a new day finally dawns for Bill Murray’s character when he uses his knowledge of the day’s events to better himself and the lives of others.
To escape the loop in healthcare, we need bold action that is informed by the knowledge and lived experience of people, families and providers. This is starting to happen. For example, many hospitals are partnering directly with home and community care organizations to design programs that are contributing to better clinical outcomes, improved patient and staff satisfaction, and significantly lower costs.
We must move quickly to ensure this way of working becomes the new normal in healthcare, marking the end of a very long day.
It’s time to wake up to tomorrow.
Of course, an early spring would be nice as well.
About the Author
Shirlee Sharkey is President and CEO at SE Health
Reprinted with permission from https://www.linkedin.com/pulse/groundhog-day-escaping-loop-health-care-shirlee-sharkey/
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