Local hospital launches new Hospital to Home program

The launch of the new Hospital to Home Program at AHI and TDMH was announced by Oxford MPP Ernie Hardeman last week at the Tillsonburg hospital. Taking part in the announcement were, left to right: Donald Williams, H2H navigator; Jennifer Row, vice-president; Susan Goble Hall, board member; Nadia Facca, president; Ernie Hardeman, Oxford MPP; Dr. Clay Inculet, chief of staff; April Mullen, vice-president RRHS; and Heather Dubeck, director of clinical services. All hospital leaders in the photo are from AHI/TDMH. (Jeff Helsdon Photo)

Jeff Helsdon, Local Journalism Initiative Reporter

Tillsonburg District Memorial Hospital and Alexandra Hospital Ingersoll are two of five health care facilities in the province being added to an innovate program to assist patients to transition from hospital to home.

Called the Hospital to Home (H2H) Program, it is designed to promote safe and timely transitions from hospital to home for eligible patients, providing up to 16 weeks of wrap-around services to be delivered in their home or community setting following discharge. The care may include a combination of nursing, personal support workers, and rehabilitation therapy, dependent on the needs of each patient.

The new program has already been implemented in eight hospitals across the province. The announcement of the addition of Tillsonburg and Ingersoll hospitals, now jointly called Rural Roads Health Services (RRHS), will bring the total to 13.

Oxford MPP Ernie Hardeman was in Tillsonburg on Friday for an announcement of the program, which is now up and running.

"Our government is committed to ensuring that Ontarians receive the right care, in the right place, at the right time,” he said. “This initiative will not only improve patient outcomes but also strengthen the health care system here in Oxford County by reducing pressures on our hospitals and supporting families close to home."

Hardeman appreciates that many people don’t want stay for a long time at the hospital, saying he saw it with his own mother.

“For a long time, we’ve known and appreciate people want to age in their own home,” he said.

The local MPP was also pleased to see two hospitals participating in the program in the riding.

“The number of hospitals getting this opportunity is a lot smaller than the number not,” Hardeman said.

By enabling hospitals to become approved Home Care Providers, H2H allows them to deliver essential home care services in partnership with service provider organizations. This approach has program standards that prioritize high-quality, patient-centered care. In the case of AHI and TDMH, the services will be delivered by Bayshore Health Care.

“Together, we are committed to providing seamless, compassionate care to support patients every step of the way—from hospital to home,” said Nadia Facca, president of AHI/TDMH.

She gave credit to Donald Williams, local H2H navigator, and Heather Dubeck, director of clinical services, for bringing the program to fruition so quickly.

There is specific medical criteria that must be met for a patient to be part of the program. If approved, Bayshore can respond and provide services in the home within 24 hours.

The goal is to enroll 80 patients in the program by the end of this fiscal year on March 31, 2026.