NGH’s new Nurse-Led Outreach Team brings care to Long-Term Care residents in Haldimand-Norfolk
(Photo left to right: Nurse Practitioner (NP) Ashley Prues and Registered Nurse (RN) Maya Pineo)
(Simcoe) – Trips to the emergency department can be stressful for elderly residents in long-term care (LTC) homes. Many have complex health needs and face a greater risk of complications during these visits. Recognizing the need for better care options, Norfolk General Hospital (NGH) has launched the Nurse-Led Outreach Team (NLOT), a partnership with LTC homes, to bring healthcare directly to residents.
The NLOT program, which began in January 2025, is designed to provide care to residents where they are most comfortable—in their LTC homes. This reduces the need for many emergency department visits and ensures timely, personalized care.
The team is made up of Nurse Practitioner (NP) Ashley Prues and Registered Nurse (RN) Maya Pineo. Together, they work with nine local LTC homes, including Cedarwood Village, Anson Place, and Dover Cliffs, offering assessments, treatments, and consultations.
“Our goal is to keep residents in their homes where they are comfortable, surrounded by familiar caregivers, and have access to 24-hour nursing care,” said Ashley. “Anything we can do to provide care there instead of in the hospital is better for them.”
Paula Thomson, Director of Care at Cedarwood Village, shared her positive experience with the program:
“We are beyond pleased with the NLOT Team and find it most helpful, especially with respect to teaching staff and helping us to manage more extensive care in the home. We look forward to growing this partnership and enabling our staff to manage the residents’ care in the home and reduce transfers to ER.”
A Team Effort
The NLOT team works closely with LTC staff, family doctors, and emergency departments at NGH and West Haldimand General Hospital (WHGH) to deliver the best care possible. This includes coordinating rapid diagnostic services when needed.
“Care teams in the homes know their residents best,” explained Ashley. “Our role is to enhance their efforts by providing expert assessments and acute-care services in a familiar, comfortable setting.”
Meeting a Growing Need
The launch of NLOT comes at a crucial time. Between 2016 and 2024, the population of residents aged 65 and older in Haldimand-Norfolk grew by over 25%. By 2046, that projected number is expected to grow another 41%. Programs like NLOT are essential to meet the unique healthcare needs of this aging population.
“The response from families and staff has been overwhelmingly positive,” said Ashley. “They’re so relieved to have options for care before heading to the emergency department.”
How the Program Works
The NLOT program supports nine long-term care homes, with plans to expand to others in the future. Services provided by the team include:
- In-person and virtual consultations
- Rapid diagnostic coordination with emergency departments
- Enhanced wound care and management of chronic health conditions
The success of the NLOT program is due to the dedication of its team and the collaboration with LTC staff and families.
“We love meeting the residents and hearing their stories,” Ashley shared. “The staff in the homes have been so welcoming and eager to work with us. It’s rewarding to see the difference we’re making together.”
NLOT is transforming the way care is delivered to long-term care residents. By reducing the need for hospital visits and providing high-quality care in a familiar setting, NGH is improving the quality of life for residents while easing pressure on emergency departments.
“This program allows us to work with a skilled and caring team who truly understand the needs of our local long-term care residents,” said Kim Mullins, Vice-President Clinical and Chief Nursing Executive, Norfolk General Hospital and West Haldimand General Hospital. “By delivering care directly in their homes, we are helping residents stay comfortable, improving their quality of life, and reducing hospital visits. This program shows the incredible teamwork and dedication of everyone involved, and we’re proud to work with our local LTC homes to make a difference in our community.”
Media Contact:
Aaron Gautreau
Director of Communications & Public Relations
W: 519-426-0130 ext. 2454
