Holland Bloorview Kids Rehabilitation Hospital recently had a unique opportunity to facilitate the transfer of a client by demonstrating care through “bedside videoconferencing.” Both clinicians and parents acted in a teaching role via the remote communication model. The virtual knowledge exchange took place with health care providers in the client’s hometown of Thunder Bay where they had never before received a pediatric ventilator-dependent patient.

Zoey Faith Lamarche came to Holland Bloorview as a client at eight months of age. She had a complex diagnosis and was considered a client who was medically fragile technology dependent (MFTD) requiring round the clock care. Zoey Faith’s parents, Amanda Mintenko and Mathew Lamarche, were committed to learning how to care for their daughter so they could take her home to live in Thunder Bay where son Liam was anxiously awaiting their return.

“I was really scared at first because we thought Holland Bloorview was a long-term stay facility but the hospital had a high level of communication with us and included us in all decision-making,” Amanda said. “They made me feel more like a mom.”

Joy Vergara, a nurse at Holland Bloorview, cared for Zoey Faith and provided education to Zoey Faith’s parents regarding her care. “Zoey’s parents were very motivated to take her home and it was very exciting to help them meet their goals,” Joy commented.

The Holland Bloorview team created a transition plan based on the family’s needs and then worked with health care providers in Thunder Bay to facilitate the transfer. Through the innovative use of Ontario Telemedicine Network’s (OTN) videoconferencing, members in the circle of care in Toronto and Thunder Bay were able to attend family team meetings during Zoey Faith’s entire stay. The videoconferencing was also used to train respiratory therapists and nurses in Thunder Bay on Zoey Faith’s care to reduce the possibility of surprises upon transfer.

Robert Gangnon, a respiratory therapist at Holland Bloorview helped coordinate multiple videoconferencing sessions for the team in Thunder Bay. “The technology was amazing,” said Robert. “I could easily zoom in with the camera and move it around to show detailed equipment examples by myself as I was explaining specifics.”

Amanda and Mathew were trained on all aspects of Zoey Faith’s care by the Holland Bloorview team and then participated in a month of “care-by-parent” at the hospital. During the care-by-parent period that is intended to simulate the future experience at home, Amanda and Mathew provided all care for Zoey Faith with the ability to call a nurse if needed. Equipped with this experience, Amanda and Mathew were then able to help train the remote team in Thunder Bay via videoconferencing on things like tracheostomy care and daily physiotherapy activities.

Maryanne Fellin, a clinical resource leader at Holland Bloorview, was pleased that Zoey Faith’s parents could demonstrate their comfort level with care and also act as teachers for the Thunder Bay team. “Having the family show Zoey Faith’s care right at the bedside helped the Thunder Bay team visualize what they would need to do,” Maryanne commented. “It also allowed the Thunder Bay team to get to know the family, see how Zoey Faith would react in a real setting and then have a discussion during the videoconference.”

In early 2014, Amanda and Mathew made the journey to Thunder Bay ahead of Zoey Faith to get everything set up at home. Joy and a respiratory therapist from Holland Bloorview then accompanied Zoey Faith on the flight home by medical transport. “We provided the Thunder Bay team with comprehensive transfer of care information and were able to meet Zoey’s older brother plus a few of their family members. Seeing the family reunited was such a heartwarming experience. It was then wonderful to get an update in person 3 months later when Zoey Faith returned to Holland Bloorview!”

Zoey Faith’s family greeted her upon arrival and was thrilled to be reunited. Amanda reports that Zoey Faith’s older brother Liam is now enjoying having his little sister home. “It was a long hard process but we got through it,” Amanda said. “If it wasn’t for Holland Bloorview we wouldn’t have been able to bring Zoey Faith home.”

The team at Holland Bloorview was pleased to have the opportunity to work with the team in Thunder Bay in such a unique remote communication model. “It was a bittersweet transition,” Maryanne said. “We were sad to see Zoey Faith leave, but we felt like we found a really innovative solution and implemented it well to get this little girl home.”

Adapted from Hospital News feature Bedside video-conferencing facilitates patient transfer.