A new report by the Ontario Patient Ombudsman says thousands of complaints from Ontario patients last year were about communication, sensitivity, and sensitivity among patients, their families, and caregivers when navigating the healthcare system. , and details a lack of respect.
The report, released Tuesday morning, reveals: patient ombudsman The Office received a total of 3,306 complaints in fiscal year 2021/2022.
Over 60% of these complaints were related to experiences in public hospitals. Another 10% of him involved experiences in long-term care facilities in Ontario.
Other complaints related to home and community care and other health care facilities.
According to the report, more than 1 in 10 patients or caregivers “expressed concerns about premature, unsafe, or poorly planned hospital discharges or transitions between care settings.” Visitation restrictions and waiting times were also often the subject of complaints.
Although no complaints related to COVID-19 were filed last year, ombudsman Craig Thompson said the pandemic “exposed the vulnerabilities that exist in our healthcare system.”
“The complaints we received last year show that both patients and providers are suffering,” Thompson wrote in the report.
“More and more complaints touch on issues of sensitivity, care, courtesy and respect.”
The report says the pressure on Ontario’s healthcare system is unlikely to ease in the near future.
Over 300 emergency room complaints
Last year, there was a 43% increase in the number of patients and caregivers who reported being treated with a lack of compassion and respect in hospitals, especially emergency rooms, according to the report.
In addition to complaints about waiting times, the Patient Ombudsman found that patients and caregivers also detailed poor communication in their complaints.
One of the most harrowing complaints detailed in the report is the death of an elderly patient in a hospital emergency department without his family present.
The complaint alleges that hospital staff discouraged patients from seeking treatment based on the risks associated with COVID-19. According to complaints, the family was not allowed inside her ER, even though the patient did not speak English and needed translation services.
“Evaluation in the emergency department revealed that the patient was debilitated rapidly and was unlikely to survive. Family members were informed that they would be available to visit the patient once he was admitted to the ward,” the report said. said.
“Two days later, the patient died in the emergency department and the family never got a chance to say goodbye.”
The family was not informed of the patient’s death until hours afterward, according to the complaint.
In an interview with CTV News Toronto, Thompson said the complaint “speaks to the challenges of the ER department.”
“It’s the nature of a system that has been called upon a lot without the capacity, the resources, and allowing people to do it the way they want. And families sometimes find themselves on the outside. I realize.”
Thompson added that the incident was an “unintended consequence” of restrictions imposed to keep patients and staff safe during the pandemic.
In another complaint, an elderly patient who arrived by ambulance with blood in his urine waited nine hours to be discharged on antibiotics. I refused to go back.
The report also highlighted a case involving a COVID-19 patient who was left overnight in an ER and denied medication to treat a fever. received intensive care.
On Tuesday, January 25, 2022, during the COVID-19 pandemic in Toronto, paramedics transferred patients to emergency room triage but were forced to leave them in the hallway at Humber River Hospital because the emergency room was full. There was no. THE CANADIAN PRESS / Nathan Dennett
Thompson added that many of the complaints reflect the importance of communication. This includes providing details about waiting times, making information available about alternatives to ER care, enabling family members and caregivers to remain in the ER with vulnerable patients, or to make sure they know who to contact if they are not allowed to stay.
“Even just telling people how long they have to wait goes a long way,” he said.
hospital security intervention
Approximately 5% of complaints about negative interactions between providers, patients, and their caregivers involved hospital security.
Many of the complaints were about being held in an unsafe manner. Twenty-two of the 98 complaints alleged assault or physical harm.
One patient who sought treatment at a psychiatric hospital reported being tied to the ground and restrained by hospital staff and security. “The patient said he was being held down with his arms bent back and his knees on his back,” the report said, adding that the patient told security that he was having trouble breathing.
In another incident detailed in the report, an indigenous patient who was discharged in the middle of the night during a winter storm and escorted by security guards was allowed to re-enter to retrieve his gloves and hat. did not.
“Hospital security did not allow the patient to retrieve his hat and gloves, and the patient suffered frostbite on his fingers,” the report said.
“As a result of this negative experience, the patient was reluctant to return to the hospital for evaluation by a plastic surgeon. Eventually, several of the patient’s fingers were amputated.”
The report found that patient relations officers often ignored hospital security and did not take an active role when reviewing complaints. It also highlighted the need for a standardized investigation process for incidents involving security and patients. All cases should be fully documented, and a comprehensive policy on investigation of detention cases should be implemented, the report recommends.
Discharge of patients requiring long-term care
Since the office opened in 2016, complaints about patient discharge from hospitals and other care settings, including long-term care, have consistently ranked among the top three complaints to the Patient Ombudsman, the report said. says.
Approximately 11% of hospital-related complaints relate to hospital discharges and transitions of care, with many patients reporting poor communication, inconsistent information and pressure to make hasty decisions.
In one complaint, a patient in his late 90s who had been hospitalized with an infectious disease was discharged and given a letter stating that he would be charged a per diem if he did not leave the hospital.
When the patient’s family, who had previously been in contact with Patient Relations regarding home support, questioned the decision, they were told to arrange a hotel room.
Another complaint was filed after the patient’s family was told that a loved one would be transferred to another hospital days after the long-term care application was submitted. Families were unable to attend because the transition took place so soon after notice, according to reports.
“After the transfer, the patient became confused and began exhibiting defiant behavior, including refusing to take medication to prevent another stroke,” the report said.
The family was also informed that if they did not accept the first long-term care bed available, they would have to pay the full hospital day rate. ’” the report found.
This scenario occurred before newly enacted legislation allowed inpatients waiting for space in long-term care facilities to be moved to another location up to 150km away. $400 per day can be charged if the patient or decision maker refuses.
Prior to these regulations, the maximum charge for Alternate Level of Care (ALC) patients who chose to stay in hospital rather than move to one of their five preferred homes was $62.18 per day. was.
Among other things, the difficult discharge transition detailed in the report highlights the need for early discharge planning that engages patients, families and surrogate decision makers, the Patients Ombudsman said.
Clear and consistent information should be communicated in writing, he suggests. The office also encourages flexibility so that individual needs and circumstances are taken into account.
34 Sexual Assault and Frigidity Treatment Complaints
Last year, the Patient Ombudsman received 15 complaints about sexual assault. 13 of his cases occurred in hospitals and 2 in other care settings.
The Patients Ombudsman also highlighted a series of sexual assault complaints in its previous annual report, saying his office “continues to be concerned about how these complaints are being addressed by organizations in the health sector. There are,’ he said.
In one of the complaints filed last year, an indigenous person reported being sexually assaulted by hospital staff while in a mental health facility. According to the complaint, staff refused to conduct a sexual assault investigation and no video footage was retained.
The patient ombudsman said the complaint was eventually dropped so the patient could pursue other avenues.
Nineteen other complaints outlined “insensitive care” for sexually assaulted patients.
The Patient Ombudsman reiterated that all reports of sexual assault should be taken seriously and that medical facilities should have clear, trauma-based guidelines to ensure patients are treated with dignity and respect. rice field.
“While not all hospitals may have access to trained assault nurse inspectors, all hospitals have a number of procedures in place to ensure safe and supportive care for victims of sexual assault. We need to have a protocol in place.” This includes designated reporting, a safe place to wait for care, and supported transport to the care setting.
Expanding Jurisdiction to Private Clinics
In 2021-2022, we received 879 complaints involving concerns about organizations outside the jurisdiction of the Patient Ombudsman. This includes cases related to private clinics, family medicine, and municipal public health.
However, this will change in the future.
A new bill introduced earlier this month would allow independent medical facilities to perform OHIP-related surgeries and diagnostic procedures. The Ministry of Health said at the time that clinics had processes in place to deal with complaints and that unresolved issues could be referred to the Patients Ombudsman.
Thompson said it makes sense for complaints to be streamlined to a single location, but there are still questions about how his office will approach expansion.
“We are still working with our stakeholders on how this will operate. Because it means,” he told CTV News Toronto.
