We are pleased to share several case studies that demonstrate how SCOPE can help you manage your complex patients.
Patient AssessmentPatient had sustained multiple fractures and a head injury while on vacation and was transferred back to Toronto once stable for rehabilitation.
Need for SupportThe primary care physician contacted the SCOPE navigation hub for support with fragmented care as well as poor pain management. In addition, resources were needed to provide psychiatry, physical rehabilitation and support for caregiver burnout.
How SCOPE Helped
Nurse Navigator Intervention
The SCOPE hub team coordinated a case conference with the GP and CCAC pharmacist to develop recommendations:
The CCAC coordinator made several initial recommendations:
As ongoing case management services were provided, supports were added based on patient needs: