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Creatively addressing ALC needs in the GTA

A shuttered Toronto hospital has reopened to provide specialist care for 150 alternative-level-of-care (ALC) patients transitioning out of area hospitals.

In an unusual move to address bed shortages in acute-care wards, the Humber River Hospital’s Finch Avenue site has been renovated to serve as an intermediate-care facility for patients waiting to return home or for other forms of care in nursing or palliative care homes or rehabilitation centres.

Five hospitals — Humber River Hospital, North York General Hospital, Southlake Regional Health Centre, Mackenzie Health and Markham Stouffville Hospital — will each staff and operate their own 30-bed units at the Reactivation Care Centre as an extension of their own hospitals. The centre started accepting patients in early December 2017.

The newly refurbished centre aims to provide highly specialized care, including activation therapies designed to support patients’ transition to home or health care facilities more suitable for their needs. Optimizing patients’ strengths and abilities outside the acute care setting is expected to lead to better health outcomes for them, as well as to reduce hospital backlogs and free up beds for people with acute care needs.

Some 3,000 beds in Ontario hospitals (about 16% of the total) are occupied by ALC patients, who don’t need acute care services and have been discharged but remain in hospital, waiting for a bed to become available at a facility that offers the appropriate level of care. The shortage of long-term care and home care spots means that frail, elderly patients are occupying hospital beds for an average of 68 days as they wait for alternatives.

That creates overcrowding, capacity issues and significantly longer wait times up the line as far as the emergency department. This situation becomes especially challenging during peak flu season, and the challenges are expected to continue to grow as the population ages.

The CMA applauds this innovative solution to reduce wait times in acute care facilities while providing better care for ALC patients in more appropriate settings. In recognition of the growing demand for complex care as our population ages, the that governments invest in residential care infrastructure, including retrofit and renovation. The new Reactivation Care Centre, operating on a site that was closed in 2015 when Humber River Hospital opened its new state-of-the-art facility, is a step toward meeting that goal.

More broadly, the for a pan-Canadian seniors strategy funded by the federal government to deal with Canada’s aging population. With provinces and territories facing individual economic challenges, a federal approach will ensure system renewal and better health care delivery across the country.

Further, the CMA calls on the federal government to convene an all-party parliamentary international study to explore how elderly persons could avoid inappropriate acute care and how their caregivers could be

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