Telehomecare Post-Acute Care Program: Meet Trudy Epp

Jeff Yahn, Nurse Practitioner, Thunder Bay Regional Health Sciences Centre, Post-Acute Care Telohomecare Program and Trudy Epp, Congestive Heart Failure Patient. Photo NWLHIN

“Telehomecare is a life-line for me. It is a very important resource for people like me, coming out of the hospital with a new, serious diagnosis. I am privileged to be a part of this beneficial program,” says Trudy Epp, a congestive heart failure (CHF) patient of the Telehomecare Post-Acute Care Program at Thunder Bay Regional Health Sciences Centre (TBRHSC). 

In August 2015, Trudy was admitted to cardiac care at TBRHSC and diagnosed with CHF. After discharge, Trudy was referred to the Telehomecare Post-Acute Care Program to help her transition from the hospital to self-managing her new illness.

“I feel like I have been given a life-line. I have access to my Nurse Practitioner, Jeff, for professional advice and resources five days a week. My vitals are being monitored- the vulnerability I felt when I first got home from the hospital is gone. It is very reassuring to know that a qualified person is following your health, every day,” says Trudy. 

Trudy is grateful for the support she received during her time on the program. In October 2015, she completed a cardiac procedure which had amazing results in returning her heart to a consistent rhythm. The rhythm stayed consistent until January 2016. Trudy spoke with Jeff and he arranged for Trudy to see her cardiologist within 24 hours. Two weeks later, Trudy underwent the second cardiac procedure.

“Jeff was wonderful for his support and knowledge of the system and referral processes. The mental health piece of this program is irreplaceable,” says Trudy. “When you have questions or need help, he is there for you. What could have been a complicated process was seamless and supportive.” 

The Telehomecare Post-Acute Care Program is led by two Nurse Practitioners that support severe to very severe CHF and chronic obstructive pulmonary disease (COPD) patients. After an acute stay at TBRHSC, patients are referred to the program through physician referral. Once enrolled in the program, patients are asked to come in to see the Nurse Practitioners for an initial visit and to be trained on how to use the equipment provided. Additional visits may be needed. 

The technology is simple, straight forward and easy to use. Each patient is provided with a tablet, a weigh scale, oxygen saturation monitor and a blood pressure cuff. Monday through Friday, the patient completes the simple questions on the tablet, including weight measurement, O2 levels and blood pressure readings. Once completed, all of the vitals are transmitted to the Nurse Practitioners computer to monitor each patient individually.

“The equipment is easy to use even for people not confident with technology,” says Trudy. 

The most important part of the program for Trudy has been the ongoing availability of resources.

“Most patients, when they have left the hospital think…..I should have asked! With Telehomecare you have the supportive, professional, knowledgeable people to support you and the resources you need to take the worries you have away,” says Trudy. 

The Post-Acute Care Telehomecare program is funded by the North West LHIN at Thunder Bay Regional Health Sciences Centre (TBRHSC).

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