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KW4 COMMUNITY WARD

In-Home Health and Outreach Team

Monday - Friday: 9:00am – 5:00pm ​

About

Who Are We?

The KW4 Community Ward provides primary care providers an opportunity to have their most complex patients assessed and supported in their homes. We offer collaborative support through a multi-disciplinary team approach to care. We bring services and care to patients in a customized and tailored way by understanding the patients’ needs first. 

In-home visits

Available Monday through Friday

Currently accepting referrals

Short waiting

times

Diverse team of professionals

Why The Name KW4 Community Ward?

Vulnerable community members in Kitchener-Waterloo-Wellesley-Wilmont-Woolwich (KW4) are falling through the health system gaps. These patients are often home-bound or unable to access healthcare/social systems.  As an opportunity to break the boundaries of traditional healthcare services, the interdisciplinary team brings services to patients in their homes. A "community" effort serving a "ward" of patients in the KW4 area. Hence the name KW4 Community Ward. 

The program was designed in 2013 through a collaborative effort of what was known as the Waterloo-Wellington  LHIN along with the Centre for Family Medicine Family Health Team. Both joined together to bring healthcare and outreach services to home-bound patients within KW4's catchment area. 

Our Goals

Support primary care providers by:

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Providing high quality comprehensive primary care consultation and assessment to patients with complex needs within their homes

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Intervening to improve the social determinants of health needs of patient population

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Understanding patients' complex needs from an in-home perspective​

What Our Clients Say

Client A

“This team is wonderful. I couldn’t have done it without them. They helped me wean off my opioid, especially when... I wasn’t able to tolerate the plan [my primary care provider] had in place. They also helped me quit smoking. It’s been almost 1.5 years since I quit smoking and I haven’t taken a puff since. I feel great now. I am thankful for the team’s efforts.” 

Client B

“I am so happy to you ‘guys’ in my life, because you care about me. Outreach worker reached out when I felt I was experiencing an anxiety attack. It was the perfect timing when they called me because he made me feel calm and was a friendly voice that made me feel so much better. It was a voice I knew and trusted”

Client C

"Since my last discharge from grand river hospital your efforts helped me to achieve goals I couldn't have done not for the tireless contribution.  Whether helping me to acquire essential documents or keeping track of appointments, I could count on your efficiency and promptness. Because of it now I am living an easier reality." ​
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