The right healthcare in the right place

As CEOs and Chiefs of Staff of some of Ontario’s largest hospitals, we are committed to caring for you and your loved ones. Recently, there have been worries and worries about Bill 7 – the More Beds, Better Care Act of 2022 – and what it will mean for patients, families and caregivers. We understand these concerns and hope to provide clarity and comfort in this letter.

We all want a healthcare system that’s there for us when we need it, with all partners working together to deliver seamless, high-quality care and an exceptional experience. Our healthcare system has been under tremendous pressure, especially during the pandemic, and now more than ever it is critical that we look for ways to alleviate some of that pressure and make the system work better. for all patients and their families. .

Hospitals across the province, especially those in high-growth communities in the Greater Toronto Area, are working hard to meet the demand. Part of the challenge is that every day large numbers of patients have been designated as Alternate Level of Care (ALC) and no longer require hospital care.

On average, these patients occupy 16% of beds in Ontario. These patients need care and services that acute care hospitals do not provide. This in turn creates a situation where patients who do need us are admitted and find themselves waiting hours and sometimes even days in the emergency room, or in unconventional spaces like a hallway, until a bed becomes available. It is not something we wish for our patients, ourselves, our friends or our family.

Hospitals are specialized care environments for acute care patients who need things like medical stabilization, diagnostics, and pre or post-operative care, to name a few. When a patient is well enough, we begin to plan their journey home, exploring all the resources and home support services they may need for their recovery and daily needs like walking, eating, dressing changes, be fed by tube or injections.

If home is not the best option, physicians, discharge planners, and home and community care partners work together with the patient and family to develop an individualized care plan that is right for them, which may include transfer to a retirement home, transition bed, or long-term care home. Many factors go into these discussions and decisions, such as specific needs, financial situation, and proximity to home or family.

When it comes to long-term care, we encourage patients and their loved ones to make informed choices about where they want to go. We also encourage patients to maximize the potential of transitioning to a place where they feel most comfortable by selecting multiple options.

Long-term care provides a much more appropriate and comfortable living environment when some patients no longer require hospital care, but cannot return home, as it is designed and operated specifically to meet their care needs. LTC homes also provide services that hospitals are not equipped for, such as social engagement, recreational activities, etc. Simply put, a hospital is not a place to live and is not a suitable or ideal environment for a patient once they no longer need the specialized services that only hospitals can provide.

We know that changes to a person’s routine or system of care are never easy, but we also know that patients awaiting LTC placement are not best cared for in an acute care bed, just as patients requiring hospitalization are not best cared for in a stretcher, the emergency room, or a hallway.

All of these issues are intertwined and lead to fissures in the broader base of health care. There is no overnight solution, and these are bigger issues that we all have a part to play in solving. Currently, across Ontario, new long-term care spaces are being built, acute care beds are being added, and we are building better community supports and connections through partnerships with our local Ontario Health Teams. We look to the future, but we also need immediate solutions to ease the pressure and improve health care now.

It is understandable that there are questions about Bill 7 and how it works. As these changes are implemented, all decisions we make regarding their implementation will be made with compassion, collaboration, ethical and fair considerations and in the best interests of the patient.

We are committed to working with our partners in healthcare to create a stronger, more connected system that works better for patients and their loved ones. We are committed to sharing more information as it becomes available and encourage anyone with concerns or questions to speak directly with your care teams.

Thank you for your continued patience, support and understanding.

Andy Smith is President and CEO of Sunnybrook Health Sciences Centre. Karli Farrow is President and CEO of Trillium Health Partners.

Also approve this letter:

Scott OvendenPresident and CEO, Baycrest Hospital and Long-Term Care Home.

Dr. Gary NaglieVice President of Medical Services and Chief of Staff, Baycrest Hospital and Long-Term Care Home.

Sarah DownyPresident and CEO, Center for Addiction and Mental Health.

Dr Sanjeev SockalingamChief Medical Officer, Center for Addiction and Mental Health.

Barb CollinsPresident and CEO, Humber River Hospital.

Dr S. Zaki AhmedChief of Staff, Humber River Hospital.

Cynthia DavisPresident and CEO, Lakeridge Health.

Dr. Tony Stonechief of staff, Lakeridge Health.

Altaf stationwalaPresident and CEO, Mackenzie Health.

Dr Steven JacksonVice President, Medical Planning and Chief of Staff, Mackenzie Health.

Wolf KlassenPresident and CEO (Interim), Michael Garron Hospital.

Dr Sheila LaredoChief Medical Officer, Michael Garron Hospital.

Karyn PopovitchPresident and CEO, North York General Hospital.

Dr. Donna McRitchieVice President of Medical and Academic Affairs, North York General Hospital.

Joanne MarrPresident and CEO, Oak Valley Health.

Dr Caroline Geenenchief of staff, Oak Valley Health.

David GrahamCEO (Acting), Scarborough Health Network.

Dr Elaine YeungChief Medical Officer, Scarborough Health Network.

Dr. Ronald D. CohnPresident and CEO, The Hospital for Sick Children.

Dr Lennox HuangChief Medical Officer, Vice President of Education, Medical and Academic Affairs, The Hospital for Sick Children.

Dr. Gary NewtonPresident and CEO, Sinai Health.

Dr. Maureen ShandlingExecutive Vice President, Academic and Medical Affairs, Sinai Health.

Arden CrystalPresident and CEO, Southlake Regional Health Centre.

Dr. Charmaine van Schaikchief of staff, Southlake Regional Health Centre.

Dan CassExecutive Vice President and Chief Medical Officer, Sunnybrook Health Sciences Center.

Dr. Dante Morrachief of staff, Trillium Health Partners.

Dr Kevin SmithPresident and CEO, University Health Network.

Dr Brian HodgesChief Medical Officer, University Health Network.

Dr. Tim RutledgePresident and CEO, Unity Health Toronto.

Dr. Thomas ParkerExecutive Vice President of Clinical Programs and Chief Medical Officer, Unity Health Toronto.

Dr Frank MartinoPresident and CEO, William Osler Health System.

Dr Brian KlarActing Chief of Staff, William Osler Health System.

Heather McPhersonPresident and CEO, Women’s College Hospital.

Dr Cynthia MaxwellVice President of Medical Affairs and System Transformation and Senior Medical Director, Women’s College Hospital.

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