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Every Experience Matters

Patient Ombudsman Panel

CMHA Ontario Conference, April 1st 2019

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Ombuds for health

Patient Ombudsman

What is a Patient Ombudsman?

• Excellent Care for All Act • Authority to receive complaints about the actions or

inactions of a health sector organization• Require consent from Patient or Substitute Decision Maker• Office of last resort

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Ombuds for health

Patient Ombudsman

What is a Patient Ombudsman?

• Conduct investigations (escalated complaints)• Conduct investigations (own motion)• Make recommendations for system change• We ‘shine a light’ to improve quality• Not an advocate• Champion for fairness

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Patient OmbudsmanWhat is Fairness?

Fairness Triangle

Patient Ombudsman

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14 LHINs home and community

service

630long-term

care homes

141public

hospitals

Who we oversee

Patient Ombudsman

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14 LHINs home and community

service

630long-term

care homes

141public

hospitals

How we intersect: Patient Journey

Patient Ombudsman

Community Mental Health & Addictions

Community Health Organizations

Primary Care Providers

Private clinics

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Patient Ombudsman Data: What we’re hearing and seeing from Ontarians

Patient Ombudsman

• 8Patient Ombudsman

# of complaints to Patient Ombudsman continues to grow

1,431 in-take calls

553 Written Complaints

1,984 Total

Year 11,591 in-take calls

710 Written Complaints

2,301 Total

Year 2

Up 11%

Up 28%

Up 16%

Growth

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Top 10 Complaints – All Complaints

9Patient Ombudsman

Assessment/Diagnosis/Treatment 16%

Quality of Care 12%

Access or admission 11%

Complaints process 9%

Sensitivity/Caring/Courtesy/Respect 8%

Communication/Information/Engagement 8%

Discharge/Transfers/Transitions 7%

Finance/Cost 7%

Coordination/continuity 6%

Operational/Service/Procedural issues 6%

2,301 total complaints

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Navigation or referral assistance provided in 1,628 cases – Year 2 data

Patient Ombudsman

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Referral agency/organization Number of referrals

Patient Relations 622

College of Physicians & Surgeons Ontario 572

Ontario Ombudsman 206

MOHTLC 152

College of Nurses Ontario 140

Information & Privacy Commissioner 100

Law Society 75

The Health Services Appeal and Review Board (HSARB)

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Health Professions Appeal and Review Board

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MPP 34

Courtesy calls notedin 151 cases

Communication or meeting facilitated in 29 cases

Mandatory report made to MOHLTC in 28 cases

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Results achieved connecting to Patient Ombudsman – Year 2 data

Patient Ombudsman

88

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Result or resolution achieved

Number of resolutions

HSO met expectations 68

Suggestions made/accepted 47

Service provided 42

Confirmed action by HSO 20

Policy/Procedure/Forms revised 11

Fees adjusted 10

Apology 7

Official acknowledgement 5

90 complainants withdrew their complaint, often after ERS helped them connect with patient relations at HSO

PO was unable to establish further contact with 50 complainants

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Mental Health & Addictions – Year 2 Data

Top 10 Themes Number of Complaints

Diagnosis/Treatment 72

Access or Admission 51

Discharge or transfer arrangement 31

Examination/Assessment 29

Complaints process 27

Sensitivity/Courtesy/Respect 26

Communication Breakdown 23

Consent 20

Quality of Care 20

Patient Information 18

290 complaints of 2,301 total complaints

228 from Ontario public hospitals

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290 Complaints total

Overarching themes

• Waiting for services • Caregivers searching for options• Justice System/Mental Health Act (50 complaints)• Alleged abuse, restraints, isolation, (27 complaints)• Complaints about a regional CMHA (6)

Many of our mental health related complaints involved a significant amount of system navigation from our Early Resolution Specialists/Front-line team

Mental Health & Addictions

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Intake & Early Resolution

For many people, discussions with our office were the first opportunity to tell the whole story of their experiences with the healthcare system.

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Alleged abuse, restraints, isolation (27 complaints)

• Distressed parent complaint • Patient placed in isolation• Video-monitoring of room/no access to toilet• Allegation of assault from security • Application of restraints during clinical transport –

facilitated injury

Direct outreach (courtesy) call to HSO

Alleged abuse

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Justice System intersections

Patient Ombudsman

Health & Justice Systems intersect (51 complaints)

• We receive many complaints from patients & caregivers where their care journey to a hospital can begin in handcuffs

• Complainants also come to our office to dispute application of a form under the Mental Health Act (involuntary admissions)

• Lack of discharge planning to appropriate care settings & services

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First Responder Resilience

Patient Ombudsman

First responders have protective equipment and some wear protective clothing to keep themselves safe from physical harm, but these persons also face challenges to their mental health and well-being

• Personal safety & confidentiality compromised

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Mental Health Stigma

Patient Ombudsman

Sensitivity/Caring/Courtesy (26)

• “They told me I was crazy”

• Complainants & concerns being overlooked by health sector organizations by a complainant living with a mental illness

• Administrative barriers to services

• Barriers to internal complaints processes

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Patient Ombudsman – Enhancing our service

Patient Ombudsman

• Accessibility of our process (barriers & opportunities)

• HQO Patient Advisors providing feedback on complaint & consent forms (11 person committee – 4 self-identified living with a mental illness)

• CMHA-Toronto training to Patient Ombudsman staff on promising practices working with complainants with mental health & addictions challenges.

• Toronto Distress Centre upcoming training customized for our unique call centre environment.

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Patient Ombudsman: Better Serving Mental Health & Addictions sector

• Streamlining complaints process around community mental health & addictions services – please share with us your formal complaints process.

• Exploring opportunities for community outreach at CMHA branches. Helping clients formulate a complaint.

Collaboration in action

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Questions & Comments

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