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Ontario

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Ministry of Health and Long-Term Care

Local Health Integration Networks

Psychiatric Patient Advocacy Office

(N.B. These websites can be very helpful when it comes to understanding health care in Ontario and patient rights. However, the large amount of information they provide can make navigating the sites tricky and sometimes overwhelming. If you have a specific question it might be useful to contact the main office of the organization. Contact information can be accessed from the home pages for these sites.)

Background

In Ontario all hospitals have a patient advocate, a requirement under the province's Excellent Health for All Act. Each hospital determines its own complaints procedure, however, few provide details on feedback processes on their websites. This is unfortunate since Ontario has one of the more confusing set of regulations when it comes to formally lodging complaints. In order to understand your options, it can be helpful to know a bit about the governance of health care in Ontario. The province is divided into 14 Local Health Int Networks (LHIN's) which are comparable to the Regional Health Authorities of provinces like Nova Scotia and British Columbia.

Each LHIN has an office which serves as the local contact for area health service providers, including hospitals. If you are in a Ontario public hospital, you will have access to an in-hospital Patient Advocate through the Patient Relations Department. However, if you are in a public hospital designated as a psychiatric facility and you are admitted to a psychiatric patient, you also have access an external provincial Psychiatric Patient Advocate Office (PPAO) through which they can lodge a complaint. Unlike the Hospital Patient Advocate, the PPAO is not affiliated with any particular institution. It is the only province wise, full-time advocacy service for hospitalized psychiatric patients.

Finally, Long-Term Care Homes in Ontario are pursuant to the Long-Term Care Homes Act, which requires that they provide a written complaints procedure, posted where it can be easily seen. Long-term care concerns can also be phoned in through an ACTION line or filed with the Director of Performance Improvement and Compliance Branch at your Local Service Area Office (run by the MOHLTC). There are five of Service areas in Ontario; Toronto, Hamilton, London, Ottawa and Sudbury. We have not broken down the steps to complaining about a Long-Term Care Homes since their complaints procedures warrant an entirely separate guide. Those admitted to these facilities are not only considered to be patients but also tenants. This dual status attributes to an individual a very specific set of  rights.

Steps in complaints process and how to navigate the websites

Complaints regarding non-psychiatric hospital or health-service treatment
  1. It is recommended that the issue first be brought to the attention of those most immediately involved in care i.e. the nurses, physicians or other staff members. Communicating your complaint to individuals with first hand knowledge of the situation is the most likely route to a quick and efficient resolution.
  2. If the service you received was not administered in a hospital setting, and you are not able to resolve the concern at the point of care, then your next option is to contact the manager of the area where incident occurred should be contacted. In most cases, the manager will contact you and set up at a time to meet in order to discuss the concern.
  3. If  your complaint is regarding hospital care, you should contact the hospital directly and ask for the Patient Advocate. You can also often find the direct contact information for the Patient Advocate under the link for the Patient Relations Office on an individual hospital's web page.
  4. If there is no Patient Advocate then call the hospital and ask to speak with the President or Chief Executive. This contact information may also be available on a hospital's website.
  5. If you are still not unsatisfied after taking the above steps, then you can contact your Local Health Integration Networks (LHIN). All the contact information is available through the LHIN website. To determine your network, click on Find your LHIN. You can also find contact information through the Contact Us link.

Please note: At this time the Ontario Office of the Ombudsman cannot deal with general hospital complaints. Hospital complaints (non-psychiatric) received by the ombudsman will not be investigated but will be redirected to the appropriate body.

Complaints regarding psychiatric treatment in hospital

Steps one through three are the same as listed above.

The Mental Health Act gives psychiatric hospital patients the external resource of the PPAO (see Background section). We recommend contacting this agency if you are not able to resolve your complaint through the hospital's Patient Advocate. The PPAO website is well designed and provides a lot of useful information not just for mental health patients but Ontario patients in general.

How long will this take?

Complaints generally should be acknowledged within 48 working hours. Most hospitals indicate that they aim to work with you to resolve your complaint as quickly as possible. However, the length of time it takes to investigate or resolve an issue will be influenced by its complexity and the number of individuals involved in the investigation.

Appeals process

Once the complaint has been resolved or closed, the individual leading the investigation will contact the complainant. No details for appeal processes could be found on hospital websites. If the problem persists after all avenues at the hospital have been exhausted then complaints about doctors can be taken to the appropriate College of Physicians or other professional organization. One such organization is The Health Professions Appeal and Review Board. This independent adjudicative agency's main function is to review decisions made by the Complaints Committees of the self-regulating health professions Colleges in Ontario.

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