Chidwick Paula, Oliver Jill, Ball Daniel, Parkes Christopher, Hansen Terri Lynn, Fiumara Francesca, Ferrari Kiki, Hawkswell Cindy, Lumsden Karyn
director Research & Corporate Ethics at William Osler Health System.
Community ethicist at William Osler Health System.
Healthc Q. 2017;20(2):37-43. doi: 10.12927/hcq.2017.25226.
A significant issue affecting the healthcare system across Ontario is the number of patients admitted to hospitals that are then subsequently being designated alternate level of care (ALC). In 2016, 14.5% of Ontario in-patient beds were occupied by ALC-designated patients. Contributing to this phenomenon are ethical errors that can affect decision-making around discharge. Since 2012, William Osler Health System has redesigned their discharge process to eliminate ethical errors and align more fully with the Health Care Consent Act (HCCA) and the Public Hospitals Act (PHA). Through quality improvement processes including the use of scripting, education, checklists, mentoring and role clarity, Osler's ALC days are currently the lowest in the province of Ontario. The elimination of such errors also decreased patient confusion and improved the discharge experience.
影响安大略省整个医疗系统的一个重要问题是，被收治入院的患者随后被指定为替代护理级别（ALC）的数量。2016年，安大略省住院床位的14.5%被指定为ALC的患者占用。导致这一现象的是可能影响出院决策的伦理错误。自2012年以来，威廉·奥斯勒卫生系统重新设计了其出院流程，以消除伦理错误，并更全面地符合《医疗保健同意法》（HCCA）和《公立医院法》（PHA）。通过包括使用脚本、教育、清单、指导和明确角色在内的质量改进流程，奥斯勒目前的ALC天数在安大略省是最低的。消除此类错误还减少了患者的困惑，并改善了出院体验。
