In the fiscal year 2023-2024, Ontario’s Patient Ombudsman received its highest-ever volume of complaints at 4,429. These complaints were filed by patients, residents, and caregivers about a wide range of health care providers. This increase in complaints is mainly due to public hospitals and long-term care facilities. It’s directly tied to the home care sector and community-based surgical and diagnostic centers. More than 400 of these complaints specifically addressed the lack of access to mental health and addiction services. This is further indicative of a deepening crisis across these key areas. One patient-focused office that has been making waves since it was created in 2016 to resolve healthcare issues in Ontario is the province’s Patient Ombudsman’s office. Specifically, they closed 4,575 complaints this calendar year, closed cases from last year’s backlog, and opened six new investigations. With two of these investigations now completed, they serve to shine light on some of the still-present issues that plague Ontario’s healthcare system.
Quality of care and communication were consistently complained about in terms of being the biggest surprises. This response illustrates the issues that require swift rectification. The Patient Ombudsman made specific recommendations to a hospital, including revising its discharge policy and providing guidance on pediatric patient care. Moreover, staff were instructed to undergo education on the policies governing hospitals and the responsibilities of the Children’s Aid Society (CAS). The Ombudsman further recommended having a formal CAS escalation process developed to work alongside other community agencies and improve coordination.
Rising Concerns in Healthcare Services
The nearly 9,200 complaints served as a reminder that harassment and discrimination continue to plague Ontario’s healthcare system. The Patient Ombudsman is shining a light on an area of concern. The government has no way of knowing how many patients are transferred from hospitals to long-term care homes. This gap in knowledge limits the ability to provide high-quality, patient-centered care and efficient transitions of care across health systems. The Ombudsman’s report highlighted ongoing issues in emergency departments and with the issuance of no trespass orders.
A recently adopted young person with a developmental age of a five-year-old who weighed under 100 pounds was recently admitted to a pediatric emergency unit. This even happened at a large, regional teaching hospital after they tackled a mother in her home. The program’s clinical team subsequently discharged the youth into the care of the Children’s Aid Society. They made this decision knowing all along that no child safety problem existed.
“Two hospital nurses escorted the youth to the CAS office by taxi and left the youth in a waiting room without transition of care instructions for the receiving staff, no prescriptions for the youth’s medications, and no safety plan for supporting the parent to bring their child home,” – Report
This incident sheds light on an alarming lack of communication and coordination among our healthcare providers and social services. It highlights the need for greater procedures and protocols yesterday.
Addressing Communication and Quality of Care
Particularly, issues of communication and quality of care were noted as the top issues in the complaints received by the office of the Patient Ombudsman. In one such documented incident, a complainant went to an abortion care diagnostic center. Throughout the procedure, the sonographer displayed a tremendous amount of indifference.
“When the complainant arrived at the centre, she told the sonographer this would be a difficult appointment for her. The complainant shared that the sonographer showed no compassion and did not explain what the procedure would involve,” – Report
She wrote to the hospital explaining her reservations about how the sonographer conducted the scan. In doing so, she got the image of compassion by sharing their news scan.
“After the procedure, the complainant attempted to discuss her concerns about the sonographer’s lack of compassion and communication. The sonographer responded that they were not allowed to show compassion and focused on their inability to share the results of the scan, which was not the patient’s primary concern.” – Report
These examples are representative of broader patterns in the medicine-patient dynamic that need immediate redress to help foster humane, transformational health dialogue.
Recommendations for Improvement
In order to combat these concerns internally, the Patient Ombudsman has provided six main recommendations hospitals can use to do so. These include updating discharge policies, advising on pediatric patient care, training staff on hospital regulations and the role of CAS, and creating formal escalation processes with community agencies.
“People who are drawn to the health care world are caring people that want to do their best and to help patients, residents and long term care and their families. And so when you see that there’s a failure at that sort of fundamental level, it really makes us take notice and wonder what is causing that.” – Thompson
The Ombudsman is optimistic that a rise in complaints means better healthcare services. Now it has received constructive criticism and can improve.
“Complaints going up for me has never been a metric of whether something’s getting worse or better. I’ve always believed that a healthy system will have complaints because that’s one of our best feedback mechanisms. And so I’ve always wanted to see more complaints. I don’t see it as getting worse.” – Thompson
