Long waits, too few beds — Ontario healthcare indicators going in 'wrong direction:' report

Ontario Premier Doug Ford spent the election campaign pledging to end, in Ontario, what he called "hallway healthcare."

That was five months ago. How he plans to do that was unknown then and is unknown now.

A new report by Ontario's health quality watchdog paints a dim picture of hospitals in the province. They're overcrowded. The waits are too long. There are not enough beds. Anna Greenberg is the interim president of Health Quality Ontario, the organization that authored the report.

She spoke with the CBC's Conrad Collaco about what her report revealed about what's working and not working in health care in Ontario. You can read an abridged and edited version of the interview or listen to the full audio interview by hitting the play button above.

Anna Greenberg, interim president of Health Quality Ontario

What did your look at health care in the province discover? What are the main findings?

We look at the major trends over the last few years in Ontario. What we see is a health care system that is under increasing pressure to care for the needs of the population. We are seeing more and more patients who are showing up in the emergency departments, particularly sicker patients. And we see that patients who need to be admitted to hospital are waiting longer for a bed. One of the key findings is that patients who are already hospitalized and waiting to be discharged elsewhere are still in hospital. Patients are in beds in hospital but need to be seen in a long term care home or to be cared for in their homes. They are waiting for that right spot for them to leave the hospital safely.

We've heard about many of these problems before. So what's new?

The pressure is building. A key set of indicators are continuing to go in the wrong direction. Although it's highly visible in an emergency department that may be crowded this is not going to be easy to fix. No single solution that just targets one care setting is actually going to be enough. It's about how different parts of the health system work together whether it's a hospital with home care supports with long-term care. This is about recognizing that patient care needs are changing and, although they may not need to be in hospital, they made need support to be cared for in other settings.

We note that the government has committed to trying to solve this issue and has brought a spotlight on 'hallway healthcare.' There is an understanding that this isn't just a hospital problem. The commitment by the government to look at root causes and how can look at how health and long-term care works with the hospital and other supports — I think that commitment gives us a lot of hope. Our data shows that is the right focus.

How does Hamilton compare to the rest of the province?

The provincial government says it plans to make health care in Ontario "more efficient." What do they mean by that and how realistic is it?

If we look at one of our key findings, the percentage of in-patient beds, that are taken up by patients waiting to be taken care of elsewhere, so patients who don't need to be in hospital. That's the equivalent of more than ten large, 400 bed hospitals every single day. I think we would all agree that's not the right use of hospital resources. If we can make some gains in making sure those patients have spots in the community which is more appropriate and a less expensive option. There is an opportunity to marry this need for higher quality and efficiency.

Is there any good news in this report?

One of the big findings in any health system that we should be proud of is that people are living longer. This is really good news. The flip side of that is that we have an increasingly elderly population. It means we may have more and more patients who are frail and have complex needs. We've also seen really good news in terms of wait times for patients who have cancer and are waiting for surgery. Those have come down and they've stayed down. We've also seen that a hospital acquired infection like C. difficile has come down over time with a sustained focus.

What would be the first step you would take to solve some of these problems?

I think the first step is something that has already happened which is to say that this is something we are focusing on. The key will be try and unpack the real root causes of some of these issues and make sure we are looking across different settings based on how patient's care needs change. We know that many patients want to age in their homes and be cared for in their homes. Having a system that is responsive to that and making sure the hospital is there when they need it but that other types of supports are also available in a timely way when they need to be in their homes. That is the kind of solution we are looking for and this may include things like digital health and virtual care as well as in-person supports in the home.