2013 Auditor General of Ontario’s Report – Rehabilitation Services at Hospitals

December 10, 2013 – In her first annual report as Auditor General of Ontario, Bonnie Lysyk has called for a better coordinated system for hospital rehabilitation services to ensure patients aren’t treated differently depending on where they live.

Among findings identified in the 2013 Auditor General’s Report:

         ·  There is a wide variation in the supply of short-term rehabilitation inpatient beds across the 
province, which means patients could have to travel outside their areas to get the services they 
need;

         ·  Lack of information on the use or outcomes of long-term inpatient rehabilitation or on 
outpatient rehabilitation means the Ministry does not know if those services are sufficient or 
effective;

         ·  Patients who no longer require hospital care may be occupying beds needed by other patients. 
The Ontario Hospital Association reports that as of March 2013, about 2,300 alternative-level- of-care patients who were ready to be discharged were waiting in acute care hospital beds for arrangements to be made. Of these, 25% were waiting for short-term rehabilitation or complex continuing care, which includes longer-term rehabilitation;

         ·  With the exception of stroke, for most conditions requiring rehabilitation, there are few best practice standards in Ontario for such matters as when therapy should start and frequency of treatment. As a result, practices varied at the hospitals visited during the audit. 
The Ministry of Health and Long-Term Care welcomed the advice and recommendations highlighted in the value-for-money audit of hospital-based rehabilitation services. It noted the work of the 14 Local Health Integration Networks (LHINs) in establishing the Rehabilitative Care Alliance in April 2013. The Alliance is a province-wide collaborative providing a support system for improving access, efficiency, effectiveness, quality, integration, value and equity in the delivery of rehabilitative services across the care continuum, including developing best practice guidelines to enhance outcomes and increase community capacity. Secretariat support for the Alliance is provided by the GTA Rehab Network. 
“The findings in the Auditor General’s Report further reinforce that the work of the Alliance is on the right track in addressing the need for provincial standards and best practice guidelines in rehabilitative care,” says Dr. Peter Nord, Alliance Steering Committee co-chair. “We embrace these recommendations which will further inform our work in the coming weeks and months ahead and look forward to working together with the LHINs and Ministry of Health and Long-Term Care to ensure province-wide consistency in the approach to delivery of rehabilitation services.”

The report also acknowledged the work of the GTA Rehab Network in promoting best practices and knowledge exchange on developing measures for service planning and performance improvement.

To read a copy of the Auditor General’s findings on Rehabilitation Services at Hospitals, please click here.