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Staffing woes in Ontario’s health system drive growth in patient complaints

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Inadequate staffing in hospitals and long-term care homes around Ontario is at the root of a growing number of complaints from patients, says a new report from the province’s health-system watchdog. 

Ontario’s patient ombudsman received more than 3,000 complaints last year. The ombudsman’s annual report says common themes include a lack of staffing and a lack of access to care. 

“The complaints we received last year demonstrated the strain that everyone — both patients and care providers — is under,” says the report, to be released Tuesday morning. The patient ombudsman provided an advance copy to CBC News. 

The report cites a 43 per cent increase in the number of patients and caregivers who reported that they were treated with a lack of “sensitivity, caring, courtesy or respect” at hospitals. 

That increase signals that the strain faced by patients and health-care providers is affecting interactions at a personal level, said patient ombudsman Craig Thompson in an interview. 

“Looking at some of the health human resource challenges, you’re asking more from people who’ve already gone through a tremendous strain with the first two or three years of the pandemic,” Thompson said. 

Ontario’s patient ombudsman says hospitals need to a better job of communicating to people while they are waiting for emergency room care. (Alex Lupul/CBC)

“Everyone is drawn down in terms of their ability to cope,” he said.  “If you’re asking [staff] to do more with less, you’re going to have challenges.” 

Thompson says this is particularly apparent in emergency rooms, often when patients feel staff are not giving them enough information about what’s happening. He’s urging hospitals to do a better job of communicating clearly to people waiting for ER treatment. 

“Communication is fundamental,” he said. “We just can’t let that fall down, particularly at this time.”

Ontario’s hospitals have struggled with staffing shortages for the past year. Emergency room wait times spiked last spring, then some smaller ERs were closed at times last summer for lack of staff, then the spread of respiratory viruses swamped hospitals with patients last fall.

The ombudsman warns Ontarians not to expect the situation to improve quickly. 

The COVID-19 pandemic continues to be a factor “exposing and aggravating long-standing stresses on the health-care system,” says the report. 

Paramedics push a patient on a stretcher towards the door of an emergency department as four other ambulances are shown parked by the entrance.
The effects of the COVID-19 pandemic are still being felt in the health system and are reflected in complaints from patients and their families, says Ontario’s patient ombudsman. (Evan Mitsui/CBC)

“Rather than a rapid return to ‘normal,’ it’s likely that these stresses will continue for some time while efforts are made to address human resources shortages, wait times, access issues and backlogs in surgeries and other procedures.” 

Ontario’s patient ombudsman handles unresolved complaints about the quality of care provided by the province’s hospitals, long-term care homes and home-care system. 

While the report provides specific details about some complaints, it does not identify the hospital or long-term care home involved. 

“We’re not in the naming, blaming and shaming business,” said Thompson. “We really want to be providing information and insight based on complaints that will help health-care providers to do their jobs better.” 

Thompson says his office is concerned about how discharges from hospital to long-term care are handled. 

“The hospitals particularly need to make sure that the process starts not at the 11th hour,” he said.  “A lot of information needs to be communicated. People need time to make decisions. They need to feel like they’re being supported and not being coerced or forced into making decisions.” 

Ontario’s health system is still dealing with human resources shortages, long wait times, and surgical backlogs, so the patient ombudsman predicts that the stresses and strains described in his new report will continue for some time. (Chris Young/The Canadian Press)

The ombudsman devotes a section of his report to what he describes as aggressive behaviour by hospital security. 

“We’re seeing more complaints about the interventions between patients and families and security personnel, ” said Thompson. “This is a very, very concerning issue for us.”

Some hospitals don’t have proper policies about how to respond to negative interactions between security and patients, Thompson said. 

He said hospital management needs to do a better job of ensuring security staff are properly trained, because providing security in a hospital is significantly different from doing so in a retail setting such as a shopping mall. 

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