Photo credit: Nanomed Dreams/Wikimedia Commons

Photo credit: Nanomed Dreams/Wikimedia Commons

Ontario’s hospitals are facing an under-publicized crisis:  an inability to discharge patients. In a recent Hospital News article, hospital discharge is described as “a systemic issue that gets little attention in the media but is rapidly growing into one of the most significant problems in our Province.” It can also lead to instances of medical malpractice.

Through no fault of their own, “alternate level of care” (ALC) patients are central to Ontario’s hospital discharge problem. These patients no longer require immediate acute care and are waiting to be discharged and transferred to more appropriate settings. In many cases, the ALC designation is applied to seniors waiting to move into retirement homes, but it can also apply to patients with disabilities.

In May 2016, ALC patients occupied 15 per cent of Ontario’s acute care hospital beds; in June, more than a third of these patients were waiting to be placed in long-term care, while a further 18 per cent were anticipating a discharge to home care settings. In certain Local Health Integration Networks (LHIN), the picture is even bleaker: 24 per cent of inpatient beds in Ontario’s North West LHIN were occupied by ALC patients this May, and in the South East LHIN 64 per cent of ALC patients were waiting for placement in long-term care facilities in June.

A variety of factors are contributing to Ontario hospitals’ inability to discharge ALC patients, and in some cases to instances of medical malpractice. To begin with, the province’s rapidly aging population has made beds in long-term care facilities increasingly scarce. This issue is compounded by both a lack of affordable retirement and assisted living facilities, and the preference of patients’ families for specific facilities.

Even when a patient is to be discharged to assisted home living, obstacles often emerge. In some cases, families may not feel safe or have the time or resources to provide an acceptable level of care. For patients, these scenarios mean being stuck in perpetual acute-care limbo.

“I have a client with ALS who has been living in a downtown hospital for close to 3 years,” wrote Audrey Miller, Managing Director of Elder Caring, in response to the Hospital News article. “There is simply no place for him to go.”

For ALC patients, Ontario’s hospital discharge issue makes life harder. But for incoming hospital patients, the problem can lead to adverse medical results and possibly medical malpractice. The discharge issue has contributed to backlogs in emergency departments, Hospital News reports, and leads to a lower quality of care for patients who cannot access needed hospital beds.

There is an economic cost to the discharge crisis, as well, which Hospital News succinctly breaks down: “As of June 30, 2016, there were a total of 2765 ALC patients occupying acute care beds in Ontario at an average cost to the system of $800/day ($2.2 million … per day).”

There are no clear answers to Ontario’s hospital discharge crisis. As Audrey Miller put it, “we need more residences, we need more supports in the community. We need to understand that ‘bed blockers’ do not want to be part of the problem; we need to acknowledge the magnitude of our current situation and acknowledge that this problem will only get worse until we start working together and thinking outside the box.”

If you or a member of your family has suffered an injury as a result of a medical or hospital error, contact the Medical Malpractice Group at Neinstein Personal Injury Lawyers today. They can help you access the care and compensation you need on your road to recovery.

Greg Neinstein

Greg Neinstein, B.A. LLB., is the Managing Partner at Neinstein Personal Injury Lawyers LLP. His practice focuses on serious injury and complex insurance claims, including motor vehicle accidents, slip and fall injuries, long-term disability claims and insurance claims. Greg has extensive mediation and trial experience and has a reputation among his colleagues as a skillful negotiator.
Greg Neinstein