“Care Everywhere.” Those two simple words represent the current strategy of the Jewish General Hospital (JGH) and its associated healthcare network, the CIUSSS West-Central Montreal.

For Dr. Lawrence Rudski, the JGH’s Director of the Azrieli Heart Centre and Medical Director of Virtual Care, the words guide a large part of his team’s innovative work at the hospital, much of which has been made possible through donations to the JGH Foundation.

Perhaps the most obvious “Care Everywhere” initiative is the JGH’s pioneering “[email protected]” program, which allows qualified patients to complete their treatment at home while still under remote hospital care.

The program, co-led by Erin Cook, Associate Director of Quality, Transformation, Evaluation, Value, Clinical & Organizational Ethics, and Virtual Care, has been active for a year, has involved more than 200 patients and has saved more than 1,400 hospital bed days.

“The program is value-based and patient-centric,” said Dr. Rudski. “Everyone who participates completes a survey so we can learn and improve. I’m very proud that 100% have said they prefer the at-home program to staying in the hospital. The overall satisfaction is almost 100%.”

“We’re not resting on our laurels because we know it can be stressful for caregivers, so we’ve made some adjustments,” he added. “After all, the average age of the patients in this program is approximately 80.”

Dr. Rudski said the program now screens for caregiver distress and provides better technology, including a tablet for caregivers that can be taken over remotely by a nurse at the hospital to fix a problem or demonstrate how something is done.

Pioneering innovation with HoloLens technology

Another element of pioneering virtual care is the hospital’s work with Microsoft HoloLens headsets, working in conjunction with supplier Medtronic Canada and the engineering consulting firm Auger Groupe Conseil, based in Trois-Rivières. A HoloLens is a computer headset equipped with augmented reality capabilities that is worn by a health professional. It sends real-time, high-resolution video of what is being viewed to a computer screen and also displays data in the vision of the wearer.

Dr. Rudski’s team (Drs. Ali Abualsaud and Emmanuel Moss) pioneered the use of technology in surgical settings to allow, for example, a world-leading expert in a certain procedure to “participate in” and remotely guide a new or specialized surgery technique from anywhere. Previously, this type of “proctor” training was only possible when the expert made a costly and time-consuming trip in person. Now, training and supervision of complex or unusual cases can be held anywhere by watching the HoloLens feed.

There are other more basic uses for the technology within the CIUSSS. Dr. Rudski cited the example of a nurse in a long-term care facility being able to wear a HoloLens to show a nurse specialist at the JGH a patient’s wound, with plans to expand to many other conditions. Decisions can then be made about care without the patient going to the hospital – which saves time and resources.

Improving outcomes at the Azrieli Heart Centre

The JGH, as part of the CIUSSS West-Central Montreal, is in a unique position to straddle ALL aspects of care, from first-line all the way to tertiary and quaternary care. That means that the patient is always kept at the centre of innovation. At the JGH, it is imperative to execute the basics in a patient-centred manner and add cutting-edge facilities, technologies and programs to ensure the needs of patients are being met.

In his position as Chief of Cardiology, Dr. Rudski is very proud of the JGH’s pioneering work to integrate the usually separate teams of cardiology and cardiovascular surgery, leading to greater efficiency and continuity of care for patients along their journey. The work has been made possible by donations to the JGH Foundation.

The hospital’s ultra-modern cardiology facility, the Azrieli Heart Centre, was inaugurated in 2017 following a major gift from the Azrieli Foundation. Other donations to the JGH Foundation have allowed the creation of a pivot nurse service for cardiovascular surgery. Pivot nurses, originally developed in oncology, follow patients throughout their care and coordinate the different services needed to maximize patient comfort and hospital efficiency.

Technology is also put to work in cardiovascular surgery to lead to greater efficiency and better outcomes. The hospital has two da Vinci robots used by Dr. Emmanuel Moss, Chief of Cardiac Surgery. Because of their precision, they make surgery less invasive, so patients recover faster. This is ideal for patients and also saves hospital resources. Similar efficiency has been gained by installing fluoroscopic equipment directly in the operating theatre in the form of a hybrid suite, used extensively as well by the Vascular Surgery program.

The department’s tertiary and quaternary missions are also part of delivering better and more efficient patient care. This is true of the Cardiovascular Rehabilitation program (Dr. Ann Walling), Pericardial Diseases (Dr. Vartan Mardigyan), Cardiac Imaging (Dr. Igal Sebag), Cardio-oncology (Dr. Caroline Michel), its innovative research in geriatric cardiology (Dr. Jonathan Afilalo) and its internationally-renowned treatment centre for pulmonary hypertension (Dr. David Langleben).

Hospital innovations attract attention

“Our innovations have been noticed,” Dr. Rudski said. “The federal minister of health visited and wants to keep in touch. The Quebec government is using the JGH as a model for other hospitals and health regions. The Quebec health minister is very enthusiastic about what we are doing.”

It hasn’t all been easy. “There have been many challenges because people fear change, or rather they fear the transition,” said Dr. Rudski. “It’s hard to be first, but we have a great team of motivated people who are willing to do the hard work to serve our patients and community.”

Dr. Rudski and his teams know their missions and they never stop striving.

To make a donation to the Jewish General Hospital Foundation, please go to jghfoundation.org

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