The province’s new Patient Ombudsman, Christine Elliot, recently released the first Annual Report about the office’s initial year of operations, focusing on the complaints Ontarians have about the health care system, and on how she and her office will be working to resolve them.

The Patient Ombudsman

The Patient Ombudsman investigates complaints and facilitates resolutions about patient care and experiences in public hospitals, long-term care homes, and community care access corporations (CCACs). The Ombudsman is not a patient advocate. Rather, she impartial and unbiased, reporting to the Minister of Health but operating independently of the Ministry. The Ombudsman hears complaints from patients and caregivers about their experiences in these organizations. She does not hear complaints about physicians or other regulated health professionals- such remain the purview of the respective College that governs that individual. Where there is a complaint that the Patient Ombudsman has jurisdiction over, the office intervenes and speaks to the hospital or organization that is the subject of the complaint. They hear the organization’s perspective on the patient’s issue, and work to figure out what can be done to address and resolve it. At the end of the complaint and resolution process, the Ombudsman decides to whether there was unfairness in healthcare for the individual who made the complaint. If there is no evidence of unfairness, the Ombudsman will write and issue a report to that effect, and the file is closed. If there is evidence of unfairness, the Ombudsman will ascertain what needs to be done to resolve the patient’s issue, and whether there should be recommendations made to the government to make the system better.

Complaints

To date, the Ombudsman has investigated almost 2,000 complaints (1,431 by phone and 553 written). Of these complaints, 37% of the complaints were made by patients, 29% were by substitute decision makers, 23% by caregivers, and 6% by family members. 70% of the complaints related to hospitals, 19% to home and community care, and 11% to long-term care homes. Three-quarters of the complaints were resolved without a formal investigation.

Themes and Issues

The Report notes four areas for potential improvement province-wide that became apparent during the Ombudsman’s first year of operations:

• Improving communication;
• Strengthening patient relations processes across the province;
• Streamlining the experience for patients with complex complaints;
• Improving planning for discharge

Elliot told TVO that a common complaint was inadequate transfers or discharges involving alternate level of care patients (i.e. patients who do not need to be in the hospital, but cannot be at home due to their complex health care needs and are waiting for a bed in a long term care home). She noted that in many parts of Ontario there are insufficient beds in long-term care homes. Patients complain that they are given last minute information about long term care beds and that the information is often insufficient. This is something her office addressed numerous times.

Systemic Issues

The Ombudsman has noted that now that her first year of operations is done, her office will be keeping their eye on 10 to 12 issues that look like they may be systemic across the province. They are currently collecting evidence to figure out whether the issues truly are universal Ontario-wide, and expects that beginning next year the office will be involved in many more investigations of both specific and general complaints. We will continue to follow developments as the Patient Ombudsman’s office enters its second year of operations. At Wise Health Law, we provide exceptional guidance on health law matters to public hospitals, long-term care homes, and other health-care organizations across the province. We monitor trends and developments in health so that we can provide forward-thinking legal and risk management advice to all our clients. Contact us online, or at 416-915-4234 for a consultation.

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