The Chronic Disease Prevention and Management Program includes Northwest Regional Renal Program, the Centre for Complex Diabetes Care, the Bariatric Care Centre and the Internal Medicine Clinics. The Medicine Service includes Inpatient Units 2A Renal and Medicine Care; 2B Chronic Disease, Clinical Teaching Unit and Medicine Care; and 3TM Medical Short Stay Unit, as well as the Hospitalist Service. The new combined Program and Service focuses on four diseases/ conditions: chronic kidney disease, diabetes, obstructive lung diseases (COPD & asthma) and obesity. Our Strategic Direction will be based on Ontario’s chronic care model, spanning the full patient continuum and integrating primary to tertiary care assessment and management. The Program/Service also provides leadership for the Admitting department, administrative coordinators, local ground patient transportation, and the Nurse-Led Outreach teams.
- Approximately 4,500 patients without a family doctor, or orphan patients, per year (~25% of all patients at TBRHSC) receive care from the Hospitalist Service;
- Funds from the Ontario Renal Network allowed the Renal Service to hire Body Access and Independent Dialysis Coordinators who have worked hard to promote and increase home dialysis rates and increase vascular access rates;
- Our home rates have been some of the best in the province, meaning patients receive excellent care at home;
- Patients have also been able to receive care at home thanks to new Telehomecare Equipment with funding from the Local Health Integration Networks.