Relationships are at the heart of the hospital

Daniel Prévost is manager of the National Program for Home Ventilatory Assistance, McGill University Health Centre.

"Some people are worried about the impersonality of a superhospital," says Daniel Prévost, "but I tell them: ‘A medical facility is not so much about structure and equipment, it is more about people and the development of trust in relationships; that’s what will make you feel comfortable or not.'"

As Respiratory Therapist and Manager of the National Program for Home Ventilatory Assistance, McGill University Health Centre (NPHVA-MUHC), Prévost leads a team that forges those very relationships by working intensively with patients one-on-one in their homes. "Even though our services will essentially not change once the Glen facility is built, I am confident that the move to the Glen will be a positive one," he says, adding that the framework within which the NPHVA functions will continue to evolve.

"The new building will provide many benefits for our patients. Often the clientele we serve has multiple medical problems that require them to be seen by a variety of specialists. By having patients arrive at one wheelchair-accessible campus, with ample parking and public transportation connections, the organization of several appointments and diagnostic tests will be facilitated."

NPHVA team members typically work with patients who have neuromuscular diseases, spinal cord injuries causing respiratory muscle paralysis, kyphoscoliosis (severe curvature of the spine), amyotrophic lateral sclerosis (Lou Gerhigs disease) or post-polio syndrome requiring ventilatory assistance from a few hours a day to 24 hours a day.

What began as a pilot program in 1993 with a budget of $300,000 and a staff of four to follow a clientele of 21 adult patients has evolved into the NPHVA service that follows 179 patients plus 46 others on a waiting list, with the recent addition of the pediatric population of Quebec. The staff is up to ten professionals and the budget has doubled. Last year, the staff travelled close to 78,000 kilometres, delivering home care throughout western Quebec. The program offers its clientele a 24 hour a day, seven day a week on-call service.

This notion of bringing care directly to the patient is one of the main pillars upon which planning for the new health centre is predicated. As much as possible, treatments, consultations, teaching and research opportunities will be delivered at a patient’s bedside to ensure maximum comfort and a greater measure of respect.

For the NPHVA and other programs similar to it, the patient-focused approach is very important and the MUHC’s commitment to it is one indication that the programs will benefit from their place within the MUHC infrastructure.

The kind of service provided by the NPHVA does not exist in a vacuum; it requires a well-coordinated and highly-specialized body of respiratory-care professionals and nurses, and Prévost, along with his team, coordinates constantly with connections inside and outside the MUHC network on behalf of clients.

"On the new site, it will be easier for the various health professionals involved to collaborate so that the case is reviewed thoroughly and effectively with everyone available for consultation and discussion at one time," says Prévost. "As a team which constantly consults with other health-care professionals, we will also find it less complicated to locate the right specialist or pertinent test results when everyone is under one roof."

The facility at the Glen will help reinforce the NPHVA’s mission of not only helping to extend the life expectancy of its clientele, but providing a better quality of life. Prévost explains: "Our purpose goes beyond manipulating equipment in order to treat symptoms. We want to support, educate and empower the patient and family, respecting their wishes and values. This often means training them to manage the illness in a safe and effective manner within their own community." Enhanced education facilities and private rooms for consultations and demonstrations are all planned Glen features that will make it easier. As well, the patients and their families will have access to a wheelchair-accessible Patient Resource Centre, where there will be computer stations, reference books and staff to help them with their questions.

Finally, the NPHVA personnel will also be able to be more effective at the Glen and it won’t be just because they will have better storage room for their equipment—which they will. It is anticipated that after the move, the NPHVA offices will be located next to the Respiratory and Pulmonary departments. "I look forward to my staff having their own offices for private patient consultation in the new building," comments Prévost. "They deal with highly taxing and emotional issues on a daily basis, meeting with patients and family members to discuss confidential concerns and the current spaces are really inadequate to provide for everyone’s privacy. I believe that the new site will offer everyone—patient and staff alike—a more satisfactory and efficient working environment."

Published by the MUHC Foundation in The Gazette