Better patient pathways, for better patient care

The referral that came across Rony Toma’s desk was for a patient at St. Michael’s Hospital who was receiving peritoneal dialysis, and was going to be needing rehab at Providence Healthcare.

Peritoneal dialysis is a treatment for kidney failure that uses the lining of a patient’s abdomen, called the peritoneum, to filter their blood. It is an effective form of dialysis, but it involves extremely specialised protocols and healthcare providers who have the training and expertise to apply them.

Rony Toma is a physiotherapist, and one of six Patient Flow Coordinators at Providence. When a patient is referred from another hospital, his job is to make sure that Providence is indeed the right place for that patient, and support the transition to rehab if it is. In the case of the dialysis patient, Rony reviewed the referral and consulted with the team from St. Michael’s about the specific needs of the patient. Then he collaborated with the nurses, physician and patient care manager at Providence to ensure everyone was on the same page, in order to ensure a safe transition to the rehabilitation program.

“I needed to know that everyone was aware of what the patient needed, that everyone was confident they could handle whatever might come up, and that everything was going to be in place for when he arrived.”

The Patient Flow Coordinator position was introduced in 2008 as a pilot project, at a time when Providence was looking for ways to use rehab and palliative care beds better and more efficiently. The position has grown in importance over the years, as Providence has taken in patients with increasingly complex needs.

Kelly Tough has managed the program for Providence since 2014. She says the program is a great example of how hospitals and healthcare institutions can collaborate to make things better for patients.

“We get more than 4,000 referrals per year. Some are straightforward, and we know we can accommodate them. But with others, it takes someone like Rony to talk to everyone involved, including the patient, to make absolutely sure that having the patient move from point A to point B, Providence, is really the best thing. Because that is the priority.”