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Not enough home care top concern for Ontario patients, study finds – CBC.ca
The three biggest problems for patients surveyed about their discharge from Ontario hospitals all concern publicly funded home care, according to new research published in an international medical journal.
The researchers hope the findings will encourage improvements in the hospital-to-home transition navigated by some one million patients every year in this province.
The study involved more than 700 patients who had been admitted to Ontario hospitals over the previous three years. The researchers aimed to find out what affected the patients’ experience during their discharge and transition to home.
Among 52 factors considered in the study, the single greatest concern was “not enough publicly funded home care services to meet the need.” That issue was ranked number one issue consistently across geographic, age, gender and ethnic groups, the researchers determined.
Participants ranked home care support not being in place when returning from hospital as their number two concern, and the third-ranked priority was “having to advocate to get enough home care.”
“We know that when patients are discharged home from hospital it can be a really tricky time for them,” said Dr. Tara Kiran, lead researcher of the study, in an interview with CBC News.
“Our goal was really to understand from patients and caregivers themselves where we need to prioritize our improvement efforts,” Kiran said. “We asked them to rate the top gaps in the system that we needed to improve, and the top three gaps all related to home care.”
Kiran is a family physician in Toronto and an associate scientist with St. Michael’s MAP Centre for Urban Health Solutions. She says she didn’t expect the strength of concern about home care nor its consistency.
- Have you had trouble accessing home care after hospital discharge? Email CBC Toronto to tell us your story.
“The number of comments that we got about home care was overwhelming,” said Kiran. When patients were asked to rate their biggest concerns for action, “these three priorities around home care rose to the top very clearly,” she said.
The study is published in BMJ Quality & Safety, an offshoot of the prestigious British Medical Journal. The research was conducted in conjunction with Health Quality Ontario, a provincial agency that is now folded into the government’s centralized system known as Ontario Health.
Kiran hopes it will help prompt the provincial government to consider expanding and enhancing home care.
“Ultimately, I think we need more investment in publicly funded home care,” she said.
“Right now, medicare covers doctors and hospitals 100 per cent. We’ve had some good public conversations about whether as a society we want to move toward including pharmacare. I think we need to have some of those same conversations regarding home care.”
Ontario Health Minister Christine Elliott calls the research important and says it confirms things the health ministry already knows about how difficult transitions home can be for patients and how they sometimes don’t receive adequate and effective home care.
“This is something that we take very seriously,” Elliott said Monday in an interview with CBC News.
“Very often people feel that once they leave the hospital that they’re disconnected from the entire health care system. It shouldn’t be that way.”
The Ford government increased annual home care funding by $155 million last year. It has also launched a reform of how the health system is organized, creating local Ontario Health Teams that bring hospitals and home care agencies together under a single umbrella.
Those teams “will know where the gaps in services are and will be able to fill them,” said Elliott. “I feel very confident that we will see people’s satisfaction in our home care services increase in the next year.”
The creation of the Ontario Health Teams marks a big change from how home care was coordinated previously in this province, and provides an opportunity for addressing the issues raised by the study, said Kiran.
“I think they can use our findings to really prioritize what it is that they’re working on,” she said.
The research suggests hospitals can take actions to improve patients’ experiences in recovering at home, including giving them a specific number to call when they have post-discharge issues.
Air Canada reported a technical issue with its flight communications system on Thursday, causing delays across the country for the second time in a week.
In a statement to CTVNews.ca, the Montreal-based company said it was experiencing a “temporary technical issue” with the system it uses to communicate with aircraft and monitor the performance of its operations.
By Thursday afternoon, the airline said the system had “begun to stabilize,” though flights were expected to be impacted for the remainder of the day.
“The communicator system has begun to stabilize, and aircraft continue to move although still at a lower than normal rate. As a result, customers may experience delays and in some instances cancellations as we move through recovery,” Air Canada said.
“Customers are advised to check the status of their flight before going to the airport as we anticipate the impact will persist through the balance of the day.”
As a result of the system failure, the airline said it implemented a “flexible policy,” allowing customers who wished to change their travel plans to do so at no cost.
Speaking to reporters before question period, Transport Minister Omar Alghabra said the federal government has been in touch with Air Canada and is encouraging the airline to get its communications system back up and running “as quickly as possible.”
“They understand the consequences of these delays and we’ll keep following up on the situation,” said Alghabra.
The system failure caused delays for the majority of flights scheduled to depart from the Winnipeg James Armstrong Richardson International Airport on Thursday morning, said Michel Rosset, communications manager for the Winnipeg Airports Authority.
Some Air Canada flights in the afternoon and evening were scheduled to run on time at the Winnipeg airport, but Rosset advised passengers to look online for updated flight information as that could change.
“With flights, even on a good day, things could change pretty quickly. So I’d recommend, if you’re looking for updated (flight information) throughout the day, the best bet is just to head to our website,” he told CTVNews.ca in a phone interview.
Leah Batstone, communications and marketing advisor for the Halifax Stanfield International Airport, said the Halifax airport was aware of the “IT issue” that Air Canada was experiencing and recommended passengers to keep tabs on their flight status.
“As always, travellers are advised to check their flight status directly with their airline before coming to the airport,” Batstone said in an emailed statement to CTVNews.ca.
Air Canada was forced to ground its planes last week due to a similar problem with its communications system, which delayed nearly half its flights.
The airline said the issue it experienced this Thursday was in the “same systems as that of May 25, but it was unrelated.”
“We have been in the process of upgrading this system using a third-party supplier’s technology. Air Canada will continue to work with the manufacturer to ensure stability in the system in the future,” it said.
“We apologize for the impact on our customers and appreciate their patience. We are working hard to get people on their way as soon as possible.”
Several Air Canada flights are delayed at Toronto Pearson International Airport due to a temporary technical issue.
The Canadian airline said its system used to communicate with aircraft and monitor operational performance is impacted. Flights were delayed all across the airline’s system as a result, a spokesperson for Air Canada confirmed to CTV News Toronto.
At around 1:30 p.m., the airline said the communicator system has “begun to stabilize,” with flights continuing to move “although still at a lower than normal rate.”
“As a result, customers may experience delays and in some instances cancellations as we move through recovery,” the statement reads.
Greater Toronto Airports Authority media manager Rachel Bertone told CTV News Toronto that Toronto Pearson passengers are encouraged to check their flight status before making their way to the airport.
“We have also put in place a flexible policy for those who wish to change their travel plans at no cost,” Air Canada said.
As of Thursday afternoon, numerous Air Canada flights initially scheduled to leave Toronto Pearson this morning have been delayed to the afternoon.
Plus, many of Air Canada’s flights headed to the Toronto airport from places like Orlando, Fla., Vancouver, B.C., and New York’s LaGuardia Airport, have been delayed.
In terms of cancellations, however, just over two per cent of departures and roughly 3.5 per cent of arrivals have been cancelled – though it should be noted these percentages include all airlines.
“We apologize to those affected, and appreciate their patience,” the statement reads.
This is the second time in a week that Air Canada has suffered a technical issue with its computer system, which delayed nearly half of all its flights.
The airline confirmed in its statement, “The issue today was in the same systems as that of May 25, but it was unrelated.”
Air Canada has not said how long the technical issue is expected to last, but said they are “working hard” to get fliers on their way as quickly as they can.
Air Canada is experiencing an issue with one of its internal systems, leading to flight delays across its network.
The airline said Thursday it is “experiencing a temporary technical issue with its communicator system, one of the systems that we use to communicate with aircraft and monitor operational performance.”
The issue is causing delays across the system, with 234 flights delayed so far on Thursday and 34 cancellations, according to FlightAware.com. That’s about 44 per cent of the airline’s daily load.
Air Canada’s flanker brand Rouge is also impacted, with 78 delays, or 52 per cent of its flights, as well as 11 cancellations.
It’s the second time in less than a week that the airline has been hit by a problem with its communicator system that caused delays or cancellations. On May 25, U.S. aviation regulator the FAA ordered a ground stop of all Air Canada flights due to unspecified internal computer issues. The outage lasted a little over an hour.
Air Canada says the impacted system is the same as the one from last week, but says the two outages are “unrelated.”
“We have been in the process of upgrading this system using a third-party supplier’s technology. Air Canada will continue to work with the manufacturer to ensure stability in the system in the future.”
Duncan Dee, a former executive at the airline, described the affected system as an “electronic tracking system to allow them to identify the location of their aircraft at any given time within their network.”
“It’s the system which allows them to track their aircraft and to communicate with flights in a more automated way,” he told CBC News.
He was scheduled to fly on an Air Canada flight himself on Thursday and said it was disheartening to see the system fail twice “in such a short period of time. This isn’t something that happens very regularly … because obviously systems aren’t supposed to go down and certainly not to go down so soon, one after the other.”
Government monitoring situation
Early in the afternoon, the airline said the system has begun to “stabilize” but is not yet back to normal and delays continue.
The airline is advising anyone who is supposed to fly today to check the status of their flight before heading to the airport.
“We are working hard to rectify this situation,” the airline told CBC News in an emailed statement. “We apologize to those affected, and appreciate their patience.”
Transport Minister Omar Alghabra said he has been in constant contact with the airline and has been assured that the company is doing everything it can.
“I encourage them to get it up as quickly as possible,” Alghabra said. “They understand the consequences of these delays … they are working on restoring it as quickly as possible.”
Last month, the government tabled new rules designed to make it harder for airlines to wriggle out of compensating passengers for costly delays and cancellations. Those rules have yet to be tabled, but Alghabra said what’s happening on Thursday would be covered by existing rules since it’s being caused by something the airline can control.
“Based on current rules, passengers are protected,” he said. “Air Canada has obligations to passengers.”
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