Toronto Grace Health Centre is a 119-bed facility providing complex continuing care, post-acute care rehabilitation and palliative care. They are focused on providing person-centred care for a more vulnerable and fragile patient population with determinants of health that are not typically in their favour. We spoke with Patricia Skol, Director of Quality and Patient Experience at Toronto Grace Health Centre, to find out more.
Can you tell us a bit about your organization and how you are working to provide equitable care?
Our mission is to serve the underserved – the people who are most vulnerable, including elderly people, young people with mental health and addiction issues, and people experiencing homelessness. We typically serve patients who need a lot of support. This may range from providing clothing and a toothbrush, to covering the costs of medication, to mental health/emotional/spiritual aspects of care. As we find out what our patients’ needs are, we try to intervene and meet these needs however we can.
We have undergone tremendous change over the last five years. We recently moved to a new, updated facility, and the need to upgrade our site was connected to the patient population we serve. Our new facility includes a much more accessible space for people with physical needs that we were not meeting before. This is really important for our patient population– we can see from our sociodemographic data that 73% of our current patients report having a physical disability.
You mentioned your changing patient population. What are you working on to address the shifting needs based on your patients’ characteristics?
We are partnering with University Health Network to care for patients with multi-organ transplants. These patients may be from out of province and have nowhere to stay, but often have many comorbidities. We collaborate with University Health Network to help cover the cost of medications for these patients, which are very expensive. We want to reduce some of the burden on the patient by taking care of this aspect.
We are also seeing more patients with mental health needs. These needs may have always been there, but we are now more aware and are focusing on these problems. We have partnered with St Michael’s Hospital for our mental health program– we identify patients who may benefit from psychiatric assessments and a visiting psychiatrist from St Michael’s assesses them personally.
Can you tell us a bit about your organization’s journey to collecting sociodemographic data? How are you using sociodemographic data?
We are collecting sociodemographic data using the eight-question standardized questionnaire as part of the Measuring Health Equity project led by Mount Sinai Hospital and the Toronto Central LHIN. We began collecting this data in 2016. Although we have met the targets for data collection set by the LHIN, we still see room for improvement and are working to increase our data collection rates. We have described our approaches to this in the Narrative section of our QIP.
As part of the Measuring Health Equity project, we submit a report each year where we select two indicators and stratify them according to three demographic variables. The first year we did this, we chose to look at outcomes for a cohort of patients in our Assess and Restore initiative, where we partner with St Michael’s Hospital, WoodGreen Community Services, and the Toronto Central LHIN to help frail elderly patients integrate back into the community after they have visited the emergency department and then came to us for rehabilitation and/ or reconditioning.
We looked at data showing how many patients were discharged home and how many returned to acute care in relation to sociodemographic characteristics in order to identify barriers that these patients may encounter when returning home. This year, we looked at similar outcomes for patients in our multi-organ transplant program.
We also look at how our patients’ preferred language changes over time. We are in the process of revising our welcoming package for patients and families, and translating this into other languages. We use our sociodemographic data to determine which languages we should prioritize. We often default to French as a second language, but our data shows that we have relatively few French-speaking patients, and we should actually be prioritizing Italian or Portuguese.
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Quorum’s Indicators & Change Ideas page. Find more information on QIP indicators and related change ideas.