Dialogue Volume 13 Issue 2 2017 - Page 41

health system One Year in, Patient Ombudsman Looks to Advocate for Fairness By Stuart Foxman I Christine Elliott n reflecting on her first year as Ontario’s Patient Ombudsman, Christine Elliott is clear about what the new office is about above all. “We advocate for fair- ness,” she says, “and hope we can make it an effective part of health care.” Ms. Elliott began her preliminary work in early 2016, and her appointment came into effect July 1, 2016. The Ontario Government created the role to complement the work of other bodies that handle patient complaints, including the Colleges, the Ministry of Health and Long- Term Care and the Health Services Appeal and Re- view Board. The Patient Ombudsman (patientombuds- man.ca) focuses on organizational or systemic issues, rather than complaints about individual practitioners. The office has authority to: • Respond to unresolved complaints from patients, residents and clients about their health-care experience at a health-sector organization. • Investigate a health-sector organization on the Ombudsman’s own initiative. • Make recommendations to a health-sector organization that is the subject of an investi- gation, following its conclusion. Ms. Elliott’s role isn’t just new to Ontario; it’s unique in Canada. In other provinces, ombudsman offices are responsible for overall government activities but not specifically for patients and health care. The office has 17 staff, including early resolution specialists, investigators, a policy and research specialist, and a lawyer. The team includes a doctor, dentist, nurse and social worker. “Clinical expertise is very important,” says Ms. Elliott. In its first year, the Patient Ombudsman has received about 1,500 complaints. Many of them are complex and identify multiple issues, but overall they revolve around several main themes. One common thread that weaves through more tha n 60% of the complaints is commu- nication or a lack thereof. For instance, patients feel that they haven’t been given everything they need to make fully informed decisions, or that they’ve received information in a way that’s hard to under- stand. To the office, communications seems to be the area of greatest opportunity for improvement in health care. Other significant themes emerging from the complaints are coordination of care and access to care. Ms. Elliott and her team often hear about the challenges in supporting people, especially frail seniors, as they transition between care settings. Some people have complained be- cause they’ve been told to move from hospital to a retirement home they can’t afford or to a long-term care home they didn’t choose. People also worry they won’t get sufficient Issue 2, 2017 Dialogue 41