November 25, 2024
London Health Sciences Centre (LHSC) has launched a permanent Early Discharge Program that will see high quality, individualized postpartum and newborn care provided to patients in the comfort of their own homes.
The Early Discharge Program allows eligible birthing persons and newborns to be discharged prior to 24 hours in hospital and have a midwife follow-up with them at home to complete required assessments and screening tests. It was initially offered in 2021 and 2022 using temporary funding from the Ontario Ministry of Health, but relaunched earlier this fall after permanent funding was received through the province’s Expanded Midwifery Care Model.
“Many patients who give birth express a desire to return home as soon as possible and this program allows them to do just that,” says Jacqueline Ferreira, midwife at LHSC.
Newborn screening tests are completed within 24-48 hours of life, which means the birthing person and newborn typically need to remain in hospital until then, even if they are otherwise ready to be discharged.
“Through the Early Discharge Program, we can help them transition from hospital to home quicker while still meeting these screening timeframes,” explains Ferreira.
The program is primarily available to patients living in London if the birthing person and newborn meet all eligibility criteria. The birthing person may be deemed eligible if they had a vaginal delivery, are voiding independently, have adequate pain control and no history of conditions that could cause postpartum complications. Their newborn may be eligible if they were carried to term, have been examined by a physician and have been observed feeding successfully at least once.
Patients are not required to have a community midwife to participate, as the program is staffed by LHSC midwives.
“By streamlining care that can be done at home versus in hospital, we can ensure patients are being cared for in the most appropriate place at the most appropriate time,” says Claire Martin, Director of Women’s and Children’s at LHSC. “That said, participation is entirely voluntary, and a patient may decide they still prefer to remain in hospital. We're happy to support whichever route the patient is most comfortable with.”
Patients who opt into the program will receive a call from a midwife the morning after they’re discharged from the Postpartum Care Unit (PPCU) to schedule their home visit for later the same day. They will also have access to a pager in case any urgent concerns arise overnight.
When the midwife arrives the next day, they will complete all required newborn screening tests; check the baby and birthing person’s vitals; assess the birthing person’s uterus, vagina and mood; and address any potential feeding concerns.
After their one-time visit, the patient will contact their regular primary care provider (e.g. family physician or nurse practitioner) for ongoing care.
Funding for the Early Discharge Program allows three staff midwives to care for four patient dyads (birthing person and baby) a day, 365 days a year. The small but mighty team has already supported more than 50 families since the program launched permanently on September 30.