Developing a seamless continuum of care

Gary Furlong is Executive Director of the CLSC Métro

Partnership is important to Gary Furlong. As Executive Director of CLSC Métro (Downtown core and Westmount), his focus is on providing that territory with an extensive variety of health and social services.

At the same time, he sits on a number of committees alongside McGill University Health Centre (MUHC) professionals and other community partners, finding ways to make the larger health and social services network in Montreal as strong as it can be.

"At CLSC Métro we care for individuals across the life span," he comments. "Since our population is so varied—including residents of the downtown core as well as Westmount—we offer a wide spectrum of programs." Residents within the district can avail themselves of medical, nursing and social types of services, including post-hospitalization care at home or at the CLSC, the Info-Santé CLSC 24-hour health line, home care for the elderly and chronically ill, pre- and post-natal care, AIDS counselling with anonymous HIV testing, and lab tests.

"I’m convinced that the MUHC’s move to the Glen has to happen for the overall evolution of our city’s health care. I strongly support the construction of their new facility because in order for a network of health and social services to work, all the components must be given the tools they need. For the MUHC, that means a modern, up-to-date, specialized care facility. For the CLSCs and other community-based services, that means more adequate funding for resources and a coordination of medical assistance so that we can deliver frontline care in the manner that best serves our communities."

The collaboration between the MUHC and the CLSCs has produced some effective outreach initiatives. One involved setting up an anticoagulation protocol so that certain patients who are treated at the emergency department for blood clots can avoid a hospital stay by receiving the necessary treatments at home or at the CLSC.

Another joint pilot project involving five CLSCs and the MUHC offered a combination of day hospital and intensive home-based palliative care support to patients and their families.

The move to the Glen site will improve both these ventures by providing one location where services can be harmonized. As it stands now, for instance, nurses at the Royal Victoria Hospital site must pick up blood results from the Montreal General Hospital site because the data was sent to the hospital closest to the CLSC where blood was taken.

"Another example of MUHC-CLSC shared activities is the Community Health Information Network (CHIN) pilot project," continues Furlong. "It is a communications infrastructure that will allow professionals from the CLSC and private medical clinics in the community to exchange clinical information. The goal is to facilitate a network approach and bilateral access to internal information systems. The system permits the participating doctors confidential computer access to the hospital’s information system, for, say, the results of a pathology report or lab results. This provides the professional current, common information in order to give the best possible advice and care to the patient."

Confidentiality is ensured by a patient’s written permission and a rigorously enforced revocable consent process.

The move to the Glen’s ultra modern facility is itself a powerful motivator for the implementation and use of the latest technologies to support and enhance the work of virtually all health-care workers. For example, diagnosing illness is best done by an empathic, attentive human. However, when medications are input electronically into a patient’s chart, computer databases are particularly adept at flagging incorrect drug interactions and allergic sensitivities. Those doctors who may currently be resisting the switchover to this higher tech approach to medicine are expected to embrace the new automated culture more readily once they are immersed in it.

On the one site, as well, patients who are benefiting from home-based initiatives will have the added advantage of being able to visit one user-friendly, well-organized and professionally-staffed Patient Resource Centre where they can increase their sense of empowerment and understanding as they become involved with their own treatment, supported by health-care professionals. The Centre is also open to the public.

"Our joint projects," explains Furlong, "came about because CLSCs and the MUHC worked together to find a way to share health-care delivery to patients so that each part of the system would do what they do best and not duplicate services."

Carol Common, who, as Community Outreach Senior Advisor, MUHC adult sites, works closely with all network partners, describes the changing landscape of Montreal medical service. "The public has had to adjust to a new delivery of health offerings; instead of receiving most of their care within a hospital environment, they receive different forms of support from different institutions within the community. It is important for people to realize that they will not fall between the cracks once they leave the hospital, and that all of us in the network have been working very hard to make sure that their care is strong no matter what life stage they are at."

Furlong sums up by reflecting on the collaboration among his colleagues. "There is good will around the table to deliver a seamless continuum of care to our populations, and the openness and leadership of the MUHC have been invaluable," he says. "All of us who are health-care providers in this city are committed to being responsive to the public; it is always the patient’s best interest which is front and centre in all our efforts."

Published by the MUHC Foundation in The Gazette