​​​​​​​​​​​​Recommendations Supporting Integrated Support for Relocated Patients​

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To support system efficiency and cost effectiveness in addressing the needs of patients that are required to leave their communities to access health services, we recommend the following:​​​​​

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1. That comprehensive funding for transportation, accommodation relocation and per diem costs be covered for all organ transplant patients who are required to relocated to Vancouver or a regional centre for care;

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2. That provision of funding for out-of-pocket costs to be managed by an established Non-Governmental Organization with an established track record and existing infrastructure;

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3. That the city of Vancouver, supported by the Ministries of Health and Housing, recognize increased efficiencies in making available targeted, affordable, subsidized patient accommodation for organ transplant patients as part of an integrated provincial strategy addressing the access needs of all patients, regardless of disease category;

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4. Although temporary existing solutions will be necessary to address immediate need, dedicated patient housing (e.g. Ronald McDonald House, Canuck Place, Jeneece Place, Canadian Cancer Lodges) must be developed. These accommodation solutions should be multi-purposed across all health care needs to ensure efficiency and cost-effectiveness;

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5. To achieve (4) above, we recommend that an interdisciplinary working group be struck to develop housing options for relocated transplant patients adjacent to health services; 

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6. A critical response program should be implemented to support the immediate needs of relocated patients. This program would bridge all costs associated with the transplant journey and include funding for:

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a. Relocation expenses for patient and caregiver throughout the transplant journey; 

b. Accommodation expenses for caregiver in during the active transplant phase (e.g. while patient is in the hospital);

c. Accommodation for care provider and patient during mandatory residence in Vancouver and

d. Per Diem for food and expenses. 

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7. Funding be established for third-party system navigators for solid organ transplant patients (and other high acuity patients) to provide centralized oversight and create feedback loops for system improvement. Tasks would involve centralized booking and system flow to streamline process, improving the experience for the patient and reducing system costs through efficient patient movements; 

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8. That all programs be embedded in a Quality Improvement Framework for monitoring outcomes with particular attention to meeting patient needs and costs to ensure optimal health outcomes and patient experience and increased health system efficiency. 

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9. Recognize the psycho-social impact of organ transplants on patients and their families by:

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a. Ensuring full access to mental health resources for patients and their families/caregivers throughout the transplant journey;

b. Facilitating natural communities of peer-support among transplant patients by providing an infrastructure and resourcing, and 

c. Ensuring consistency of non-clinical resourcing information for transplant patients (e.g. available inter-ministerial subsidies and housing, applicant requirements, etc.);

 

10. Support and enhance regional centres of care for more proximal pre- and post- transplant care, where clinically appropriate; this may include the use of virtual technology to support sub-specialist visits, supported by local care providers. 

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* A provincial task force be struck and supported by the Ministry of Health to provide leadership in creating patient-centred solutions for rural patients who need to travel to access health care. The task force will include representation from patients, communities, rural and urban health care providers, health care administrators, policy, non-profits with vested interest, decision-makers and researchers. Tasks will include the high-level work of:

 

Closing the gaps between existing programs and process supporting patients to provide a stream-lined, efficient approach to the patient journey, including efficient and effective information-sharing between:

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​- currently funding program and emerging programs;

- Regional Health Authorities and 

- Provincial ministries; 

 

Providing provincial leadership on a global housing solution for rural patients relocating to access health care;

 

Bringing together interest groups across all clinical disciplines (e.g. cancer care, organ transplant, experimental medicine) to ensure comprehensive planning, and 

 

Overseeing the expedient implementation of a critical response program.  

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