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Collaboration in Action: Case Summaries

Public Hospitals


The caregiver of a patient requiring frequent out-patient hospital visits complained that the hospital’s patient relations process was unclear and difficult to use.

After discussing these concerns with Patient Ombudsman, the hospital agreed to revise its patient relations process and make information more accessible to the public to assist future patients.

At the time of an involuntary admission to hospital under the Mental Health Act, a patient reported having been assaulted. The patient later complained that the hospital had failed to adequately respond to the reported assault.

Patient Ombudsman determined that although the hospital had recorded the patient’s declaration, there was no evidence in the medical records that the hospital had followed its internal policy in responding to the patient’s alleged assault. As a result, the hospital apologized and updated its internal policies to prevent a similar incident from occurring in the future.

A man had a stroke which resulted in significant physical and medical challenge. Initially, he was taken to one hospital by ambulance for specialized treatment and then, once stable, transferred to his local hospital. Later, because he had long-term care needs that were too complex for a long-term care home, he was transferred again to a complex continuing care hospital – far from his caregiver’s home. His caregiver did not drive and had several chronic conditions herself. The caregiver did not understand why her husband needed to be moved to another hospital, especially one so far from her home.

Patient Ombudsman helped facilitate communication between the hospital and the caregiver to help her better understand the reason for the transfer and also helped facilitate the transfer of the patient to another complex continuing care hospital that was more accessible to the caregiver.

After a medical procedure, a patient with no additional health insurance requested a ward room in a hospital. Because none were available, the patient was put into a semi-private room and advised by hospital employees that the semi-private co-payment would not be charged. Upon discharge, the patient was billed at the semi-private room rate.

Patient Ombudsman reviewed the patient’s concerns with the hospital and it was agreed there was a perceived lack of communication. The hospital agreed to review its policy on billing for patient accommodation and more effectively communicate the policy to patients. The hospital also reimbursed the patient for the full amount of the semi-private room.

A patient with no informal support system was in a lot of pain and required out-patient surgery at a local hospital as soon as possible. The hospital policy required that day surgery patients needed to be accompanied home upon discharge. The patient tried to explain that no one was available to assist. The hospital, based on its policy, cancelled the surgery.

Patient Ombudsman worked as a facilitator between the hospital and the patient to achieve a resolution that resulted in the re-scheduling of the surgery and an agreement that the hospital would keep the patient overnight as an in-patient.

The complainant contacted Patient Ombudsman with concerns about the care provided to his sister, who has a major mental illness and is an in-patient at a hospital. The complainant’s sister had been hospitalized on an involuntary basis several times and has been issued Community Treatment Orders.
His sister was able to challenge the physicians’ assessments of her incapacity and the validity of Community Treatment Orders at the Consent and Capacity Board based on incomplete documentation and a failure to follow requirements under the Mental Health Act. The complainant was deeply concerned that his sister’s mental health was deteriorating, and the failure of physicians and other members of the care team to adhere to the requirements of the Mental Health Act was a contributing factor.

Patient Ombudsman reviewed the hospital’s support of physicians and other members of the care team in understanding their responsibilities and the importance of compliance with complex mental health legislation.

Because of this situation, the hospital created new policies, amended practices, conducted multiple training and education sessions, and is actively working to continue to implement improvements to prevent the complainant’s family and future patients from experiencing similar issues. Patient Ombudsman also provided the complainant with a detailed letter summarizing the issues with his sister’s care that he can use is his advocacy efforts for legislative reform.

A patient contacted Patient Ombudsman to complain about a bill close to $8,000 for a semi-private room during a recent hospital stay.

The patient was referred for in-patient rehabilitation following surgery. The first available rehabilitation bed was in a semi-private room and the patient was transferred there. Shortly afterwards, she was presented with a ‘responsibility for payment’ form even though she had not requested a semi-private room. The patient indicated that she was in no condition to understand what she was being asked to sign. She recalled that she did not sign the form but she may have initialed it.

Patient Ombudsman requested a copy of the form from the hospital and confirmed that the patient had not signed it, but there was an ‘X’ and her initials beside a box indicating that, if her insurance declined, she would be responsible for the charges.
In discussion with the hospital, PO raised concerns about:

  • the clarity of the form,

  • the patient’s condition at the time she was asked to sign it, and

  • the fact that she had never requested a semi-private room.    

The hospital agreed to waive the fee and to review their process for obtaining agreement to accept responsibility for payment and make appropriate improvements.

A patient contacted Patient Ombudsman to complain that not all hospitals are able to complete rape kits. She had attended a small rural hospital following a sexual assault and had requested a forensic examination or “rape kit” to be administered. The hospital responded that it was not able to carry out the examination and arranged for her to be transferred to a second hospital.

Because of the trauma of her experience, the complainant did not feel comfortable complaining to the hospital. Given the sensitive nature of this complaint, Patient Ombudsman contacted the hospital directly. Patient Ombudsman spoke with hospital senior leadership. Small hospitals may not have the specialized expertise necessary for forensic examinations. It takes a number of hours to complete the tests, and the evidence collected may be presented in court. To ensure that the evidence stands up in court, it is important that the tests are conducted by experts, not just any physician or nurse available. Small hospitals experience challenges to maintain this expertise given the low volume of sexual assault admissions. 

The hospital offered to contact the complainant directly to discuss her concerns and the patient agreed. 

A daughter contacted Patient Ombudsman to complain about her father’s care in a hospital emergency department. The daughter described bringing her father to the hospital. Because of respiratory distress and weakness, he was unable to walk safely from the car to the emergency department. When she requested a wheelchair, she was told to find one herself. Her father waited alone in the car while she found one.

After being admitted to the hospital he was placed on a chair in the hallway for several days because of overcrowding. While her father waited for a bed, the family was told that he was actively dying. During this time, both his intravenous bag and his oxygen tank ran dry. Another relative, who is a physician, found the father was in acute distress.

Following Patient Ombudsman’s review, the hospital issued a formal apology to the complainant and her family.

The hospital has since purchased 50 additional wheelchairs for the emergency department. Now, both volunteers and non-clinical staff retrieve wheelchairs to ensure that there are always wheelchairs available in the emergency department.

The hospital revised their procedure so that patients needing continuous oxygen support will not be placed in the hallway to wait for a bed.
The hospital will be opening a new and enlarged emergency department that it hopes will address privacy issues identified by the family.

Patient Ombudsman also helped the family refer a complaint to the College of Nurses of Ontario to address and review why the nursing team did not notice the patient’s state of physical distress.



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