More than beds needed to end hallway healthcare: report

Doug Ford campaigned on a promise to end hallway health care and in October his government announced that it was moving forward with a five-year plan that would introduce thousands of new long-term care beds across the province.

“One patient treated in a hallway is one patient too many,” Ford said at the time.

But according to a new report from the Premier’s Council on Improving Healthcare and Ending Hallway Medicine, it will take more than a new influx of beds to fix an overwhelmed health care system.

The report, titled Hallway Health Care: A System Under Strain paints a grim picture of an overburdened system in dire need of an overhaul. While a lack of beds is undeniably a problem, there’s myriad factors contributing to the strain on the system, including an increase in mental health and addiction problems, a rapidly growing and aging population, and a system that’s complicated to navigate.

“Simply adding more beds to the system will not solve the problem of hallway health care,” the report states. “For example, community mental health and addictions services, as well as community rehabilitation services are two areas where additional access to services could help relieve some of the pressures causing hallway health care.”

The Council heard from over 340 patients. Many said they felt they had nowhere to turn except an emergency room.

“Ontarians cannot always see their primary care provider when they need to, wait times for some procedures and access to specialists and community care are too long, and emergency department use is increasing,” the report states. “A lack of early intervention and prevention is contributing to more patients becoming ill. All of these challenges are connected to the problem of hallway health care.”

“Most mental health and addictions issues are more appropriately treated in the community; however, long wait times for community treatment means sometimes patients’ conditions worsen as they sit in the queue, giving them no other option but to seek care through the emergency department.”

According to the report, the strain on the health care system could be alleviated not only through more supports for patients, but also by better embracing technology, including virtual care and apps.

“The health care system can make better use of available technology, and should aim to deliver integrated and efficient services in all parts of the province. People have more access to digital tools and information than ever before, and expectations for high-quality, efficient, and integrated health care have changed.”

“Solving hallway health care will not just be a matter of adding more beds to the system. Increasing capacity in the community, staffing levels, training, and support will play an important role in building a high-functioning system that works for all Ontarians — including the ones who work in health care.”

Here are some key findings from the report.

• On an average day in 2018, there were approximately 1,000 patients waiting for a hospital bed in an unconventional space or emergency department stretcher.
• According to the 2018 Health Care Experience Survey, 41 per cent of Ontarians who went to the emergency department and 93 per cent who went to a walk-in clinic received care for a condition that could have been treated by their primary-care provider.
• Visits to emergency departments across the province increased by about 11 per cent over the last six years, to 5.9 million in 2017-2018.
• In November 2018, only 34 per cent of patients admitted to hospital were admitted to an inpatient bed from the emergency department within the eight-hour target.
• Ontarians who require admission to an inpatient bed are spending an average of 16 hours in the emergency department before a bed becomes available, which is the longest that wait has been in six years.
• The median wait time for long-term care home placement in Ontario in fiscal year 2017-2018 was 146 days, and the median wait time for home care was around six days for patients waiting at home.
• Approximately one in three adults who went to the emergency department for mental health and addictions care had not previously accessed physician-based care for their mental illness
• There was a 72-per-cent increase in emergency department visits and a 79-per-cent increase in in-patient admissions for children and youth with mental health issues over the last 11 years.
• In October 2018, almost 16 per cent of days in hospital were spent by patients that were waiting for care in another setting.
• Demographic projections suggest that the province will see an increase in its population by roughly 30 per cent by 2041.
• By the year 2041, the GTA’s population is expected to grow by 41 per cent or by approximately 2.8 million people compared to the year 2017.

 

Read the complete report below.

Files from The Canadian Press were used in this report.