Chronic diseases, such as cardiovascular disease, kidney disease, diabetes and respiratory disorders, are growing in prevalence. This is especially true in Scarborough where the population is highly diverse, with some ethnicities having a higher rate of these chronic illnesses. Patients with a chronic disease require a wide range of services and supports that evolve and vary over the course of their lives and conditions.
In order to help deliver outstanding care to our global community, The Scarborough Hospital has identified Chronic Disease Prevention and Management as one of its key areas of focus and has developed a Chronic Disease Management Program to ensure the delivery of comprehensive care to patients living with a chronic illness.
The goal of the Chronic Disease Management Program is to support patients in self-managing their chronic disease and help them to coordinate and access necessary care throughout their disease progression. The Chronic Disease Management Program is focused on providing timely, high-quality services in the most appropriate setting and with seamless access to diagnostics, assessments, interventions and education. Care is coordinated from community to hospital and back to the community with the focus on maximizing the ability of patients to remain at home.
Launched in 2013, the Chronic Disease Management Program has initially been based around diabetes, as it is a disease that spans across all chronic illnesses. However, the diabetes continuum of care model will ultimately be applied across all other chronic disease services available at TSH.