How can Ontario’s new ombudsman address patient concerns?

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THE QUESTION

I have a complaint with the care my father received at an Ontario hospital. I've heard in the news media that the province has a new patient ombudsman – Christine Elliott. Can she help me?

THE ANSWER

Ontario is the first province to establish an ombudsman to deal specifically with the concerns of patients and their caregivers.

The office has already received several hundred calls from the public since it opened July 1, says Christine Elliott, who had been a Progressive Conservative member of the provincial legislature for almost a decade before resigning her seat last year and being appointed ombudsman in December.

"I think there is a big desire out there on the part of the public to have someone deal with their health-care concerns," says Elliott, a former Whitby-Oshawa MPP, who had been her party's health critic.

In other provinces, health-care matters fall under the watchful eye of an ombudsman who is responsible for overall government activities.

Ontario decided to set up a separate patient ombudsman office to deal exclusively with patient concerns following the release of a report by a provincial committee, which called for a mechanism to investigate critical health-care incidents. Health-care organizations have been largely responsible for running their own complaint processes.

Elliott considers her appointment to be part of a trend toward "patient-centred care." Her office, she adds, "can bring forward the voice of patients and families in areas where their voices might not have been heard and where change is needed."

In particular, the patient ombudsman will deal with unresolved complaints involving hospitals, long-term-care homes as well as home and community care.

However, if the complaint is about a specific doctor, nurse or other health-care provider, then the body that regulates that specific profession will continue to handle it.

Elliott notes that complaints tend to be "multifaceted," involving a variety of elements. "The task of my office will be to sort out what part of their complaint we can deal with and what parts need to be dealt with by other organizations."

Before her office becomes involved, though, patients or caregivers must have exhausted the normal complaints process of the health-care facility.

They then need to fill out a form that outlines the complaint, as they see it, and what they are looking for in terms of a "satisfactory resolution." The forms are available on the website: patientombudsman.ca. "We, of course, will help people who have trouble putting the complaint into writing."

Once the complaint is filed, a member of Elliott's staff will follow up with a phone call to get more details and try to resolve the dispute. If a resolution isn't reached, the case may be assigned to a patient-ombudsman investigator who might need to conduct more extensive interviews with the health-care facility involved.

The patient ombudsman's office plays the role of an impartial third party that tries to mediate a solution. "We advocate for fairness," Elliott says. "We want to make sure that we treat everybody with respect – patients and health-sector organizations alike," she adds.

"When people have a chance to see the perspective of the other side in a different light, that can sometimes lead to resolutions that at first glance might not seem possible."

She readily acknowledges that some patients or their caregivers may not always be happy with the outcomes. Even so, she believes most people have realistic goals and expectations.

"The vast majority of people really want what we call the common-good resolution," explains Elliott. "They want to make sure that the same negative experience they have had isn't experienced by anyone else."

In addition to probing individual complaints, her office also has the authority to carry out investigations into trends and system-wide problems. Her recommendations will be in a publicly accessible annual report to the Minister of Health and Long-Term Care.

Elliott's office is not set up in the usual manner of an ombudsman. Unlike the provincial ombudsman and auditor, she is not an independent officer of the legislature. She is technically an employee of Health Quality Ontario, a provincial body under the Health Ministry.

Some critics have suggested that Elliott may be limited in her ability to speak openly about the problems she encounters.

But Elliott says her office's connection to the Ministry of Health is well-suited to her responsibilities. Her reports to the minister will enable her to speak on behalf of patients "at a level where it can truly make a difference in terms of policy," she says. "So I see it as a great advantage, actually."

Paul Taylor is a patient navigation adviser at Sunnybrook Health Sciences Centre. He is a former health editor of The Globe and Mail. You can find him on Twitter and online at Sunnybrook's Your Health Matters.