Blog Archive

June is National Indigenous History Month, a time to recognize the history, heritage and rich contributions of First Nations, Inuit, Métis and Urban Indigenous peoples across Canada.

As Patient Ombudsman, our role is to champion fairness in health care. And yet, we are keenly aware of anti-Indigenous racism in the health care sector. Between 2019-21, our office received 27 complaints from 25 individuals reporting discrimination or lack of culturally sensitive care for Indigenous patients in hospitals, long-term care homes, and home and community care. The complaints covered a wide range of issues, including use of racial slurs and general lack of sensitivity or compassionate care. Several noted that incorrect assumptions were made about alcohol or drug use in evaluating their physical/medical concerns. Other complainants noted that the health care organization did not provide or refused to permit culturally appropriate care, such as not allowing smudging or healing circles, or that the health care organization was not open to engaging family members or Elders in care planning.

These complaints are disturbing, and we recognize that they are just a small fraction of what Indigenous patients are experiencing. We know we’re not hearing from many patients and caregivers across Ontario. Last year, the Wabano Centre released a report that highlights personal stories from more than 200 individuals across Ontario’s Champlain region who experienced Indigenous-specific racism while accessing health care. These individuals not only shared their own experiences, but 40% also reported having witnessed racism and discrimination against others.

Patient Ombudsman recognizes the need for us as an organization to better support Indigenous patients and caregivers as they navigate the health care system, and we share the concerns about negative experiences. We are working to build our own capacity and continue to support our staff in building cultural competence. We have a dedicated Early Resolution Specialist - Indigenous Experiences staff member to support complaint resolutions for Indigenous patients and caregivers and assist with community outreach to help us ensure we are a welcoming space to receive concerns.

These are just the first steps. There is always more for us to learn and ways for us to improve our practices. We welcome opportunities to hear from Indigenous patients, caregivers and communities about how we can better support people’s needs.

Our Early Resolution Specialist – Indigenous Experiences can be reached at indigenous.experiences@patientombudsman.ca

As shown in our annual report, we receive thousands of calls or emails from residents, patients and caregivers every year who want to know how to make a complaint and resolve their concerns about health care experiences. We know it can sometimes be confusing to know who to complaint to or even how to complain.

If you’ve had a negative health care experience, we’ll work with you to help you understand Patient Ombudsman’s complaint process and how we might be able to help.

Here's what happens when we get a call or email:


We make sure you’ve come to the right place.

If your complaint is about an experience in a hospital, long-term care home, or home and community care services, we’ll double check that the organization is within our jurisdiction. Patient Ombudsman is not able to review complaints about walk-in clinics, doctor’s offices, or retirement homes. In addition, if your complaint is about a clinical decision made by a regulated health professional, such as a doctor or nurse, we’ll direct you to the organization that can help. For example, health care providers are overseen by their professional regulatory colleges.

Next, we’ll confirm that you’ve first tried to resolve the issue with the health care organization directly. For a complaint about a hospital, this means contacting the patient relations department. Patient Ombudsman can only review complaints after the organization involved has had a chance to resolve your concern. If their response or resolution was not satisfying, that’s where we can step in.


We gather information.

Once we’ve determined we’re the right place for your complaint, we’ll start to gather information. We may ask you to submit your complaint in writing so that it can be assigned to an Early Resolution Specialist, and we may ask for you to provide consent so that we can contact the health organization for more information. We want to understand the situation from all perspectives to determine what is fair.


We listen.

You can help by telling us what happened, who was involved, and what would put things right. Next, we’ll reach out to the health care organization to hear its perspective and to gather additional information. We work with all parties when trying to resolve complaints.


We try to facilitate a fair resolution.

Once we’ve reviewed the complaint and all the relevant information, we’ll work with both sides to see if a resolution is possible. We apply fairness principles to determine whether the health care organization acted fairly. Sometimes, we may need to escalate the complaint to our investigations team.

Every complaint is different, and every resolution can be too. Maybe you're looking for an apology, or you want to make sure that what happened to you doesn’t happen to anyone else. It takes courage to bring forward concerns about a negative health care experience, and these complaints give us the opportunity to improve Ontario’s heath care system for everyone. Once we feel the issue has been addressed to our satisfaction, we’ll let everyone involved know and close the file.

If you have a concern about your or a loved one’s experience in a hospital, long-term care home or with home and community care, contact us! We provide service in English and French, as well as other languages upon request. Accommodations are available as needed.

Fairness by Design and Long-term Care Placement

This past fall, the More Beds, Better Care Act, 2022 came into effect.

For hospital patients who have been deemed “alternate level of care” and are waiting for long-term care placement, the act allows placement coordinators to carry out certain steps of the long-term placement process without patients’ consent. For example, it allows placement coordinators to select long-term care homes and share the patient’s application and health information with the homes.

While the act helps move patients who no longer need hospital care into long-term care homes, freeing up much-needed hospital beds, it also makes some significant changes to the long-term care placement process.

It’s important to recognize that moving from home or hospital into a long-term care home is a significant transition for many seniors and their families.

Patient Ombudsman sees many complaints related to hospital discharge and care transitions, with patients and caregivers frequently reporting concerns about poor communication, inconsistent information, and pressure to rush important decisions.

Several of our past annual reports have highlighted these kinds of complaints to try to shine a light on the hospital discharge process and the importance of clear communication during the long-term care placement process. Both stories show how important it is to ensure the long-term care placement process is fair and includes patients and caregivers.

One way health care organizations can better ensure decisions around long-term care placement are made in a fair manner is to incorporate fairness into their processes and review their decision-making through a fairness lens. The concept of using fairness standards when creating policies and reviewing your decisions at the outset is “fairness by design.”

Patient Ombudsman has developed a resource to help hospitals and Home and Community Care Support Service organizations evaluate the fairness of how they implement their long-term care placement processes. In addition to the main resource, we have also developed a one-page checklist that highlights the main questions to keep top of mind.

By keeping the patient’s needs in mind, health care organizations can help make the long-term care placement process as smooth as possible.

What is the Patient Ombudsman?

What happens when you or someone you love has a bad experience in a hospital, long-term care home, or with home care?

We’re often at our most vulnerable when we’re seeking health care, and a negative experience can leave you feeling frustrated or hopeless, especially if you’ve complained and feel like nothing improved.

If you’ve tried resolving your concern with the health organization directly and feel you aren’t getting anywhere, we can help.

 

We’re here to help

Patient Ombudsman is an independent, impartial office established by the provincial government to receive, respond to and help resolve complaints from patients or caregivers about their care experiences with public hospitals, long-term care homes, and home and community care.

Patient Ombudsman is not a patient advocacy organization. We work with both sides – patients/caregivers and health care organizations – to find a fair resolution.

 

What do we mean by fair?

Before coming to Patient Ombudsman, you need to try to have your complaint addressed by the organization that you were dealing with. If you aren’t satisfied with the outcome, that’s where we come in. When we’re working to resolve a complaint, we use a set of principles that look at what was decided, how was it decided, and how people were treated. We often ask questions about how the health organisation came to its decision, and whether policies and procedures were properly followed.

 

How can we help?

Every complaint is different, and so are the possible resolutions.

A resolution could be an apology from the health organization, it could be a commitment to change a policy or process, or it could be fixing an issue to make sure it doesn’t happen to anyone else.

If your complaint is about treatment decisions made by a health care provider (such as a nurse or doctor), or about an organization that is outside of our jurisdiction (such as a retirement home or walk-in clinic) we can help direct you to the right organization that deals with those concerns.

In certain situations, Patient Ombudsman can also carry out investigations and make recommendations to health sector organizations based on the findings of the investigation.

Together, we can help make change in our health care system to ensure others have more positive health care experiences.

Learn more about:

• Our work

• How to make a complaint