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Related Experiment Video

Updated: Jun 25, 2026

A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program

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Published on: April 19, 2019

Reducing Gaps, Improving Outcomes: Sunnybrook-to-Home Program.

Hend Al-Fayez¹, Courtney Bean², Kelly Bishop³

¹Hend Al-Fayez, is an interim program manager for Community Integration at the Sunnybrook Health Sciences Centre, Toronto, ON.

Healthcare Quarterly (Toronto, Ont.)

|June 24, 2026

Summary

This summary is machine-generated.

The Sunnybrook-to-Home (SB2H) program successfully reduced hospital discharge times for older adults by integrating care services. This initiative improved access to home care and social supports, demonstrating the value of community partnerships in transitional care.

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Area of Science:

Gerontology
Health Services Research
Public Health

Background:

Older adults face challenges transitioning from hospital to home.
Fragmented care services can lead to prolonged hospital stays and unmet social needs.

Purpose of the Study:

To evaluate the impact of the Sunnybrook-to-Home (SB2H) program on hospital transitions for older adults.
To assess the effectiveness of integrated hospital, home care, and community services.

Main Methods:

The SB2H program enrolled 593 patients between June 2024 and December 2025.
Tracked patient referrals, home care access, alternate level of care (ALC) days, and linkage to community services.

Main Results:

SB2H patients experienced faster home care access (1 day vs. 5 days regionally).
SB2H patients had shorter ALC stays (3.7 days vs. 7.5 days).
Approximately 20% of patients were linked to essential social supports.

Conclusions:

Integrated care models, like SB2H, significantly improve transitional care for older adults.
Embedded community partnerships and social navigation are crucial for successful transitions.
Co-creating transitional care with front-line teams enhances program effectiveness.