Executive summary

Hallway health care is a significant problem in Ontario. The entire health care system is too complicated to navigate, people are waiting too long to receive care and too often are receiving care in the wrong place; as a result, our hospitals are crowded.

The Premier’s Council on Improving Healthcare and Ending Hallway Medicine has been tasked with providing advice to government on how to solve this problem and improve health outcomes across the province.

This first report provides an overview of some of the key challenges contributing to hallway health care, and identifies opportunities and emerging themes from the Council’s initial work – including the potential to integrate health care and introduce technology solutions to build strong and efficient community and hospital services, support better outcomes for patients, and to fix the problem of hallway health care. 

Key findings

  1. Patients and families are having difficulty navigating the health care system and are waiting too long for care. This has a negative impact on their own health and on provider and caregiver well-being.  
  2. The system is facing capacity pressures today, and it does not have the appropriate mix of services, beds, or digital tools to be ready for the projected increase in complex care needs and capacity pressures in the short and long-term.
  3. There needs to be more effective coordination at both the system level, and at the point-of-care. This could achieve better value (i.e. improved health outcomes) for taxpayer money spent throughout the system. As currently designed, the health care system does not always work efficiently.

Chapter 1: The patient experience

Patients and families are having a difficult time navigating the health care system. Ontarians cannot always see their primary care provider when they need to, wait times for some procedures and access to specialists and community care are too long, and emergency department use is increasing. A lack of early intervention and prevention is contributing to more patients becoming ill. All of these challenges are connected to the problem of hallway health care.

Chapter 2: Stress on caregivers and providers

Health care providers, family members, and friends are feeling the strain of a system that isn’t making caregiving easy. This leads to high levels of stress and places a heavy burden on caregivers to act as advocates for timely and high-quality health care services.

Chapter 3: Different health care needs

There are more patients with complex needs and an increase in chronic issues that require careful and coordinated management, like an aging population living longer with high rates of dementia. Fair access to health care across the province continues to be a concern.

Chapter 4: Immediate and long-term capacity pressures

Ontario does not have an adequate or appropriate mix of services and beds throughout its health care system. This leads to capacity pressures on hospitals and long-term care homes. Demographic projections indicate there will be additional strain on existing capacity in the near future.

Chapter 5: Responsibility and accountability in the system

Ontario’s health care system is large. Responsibility for coordinating high-quality health care is spread across many government agencies, organizations, and the Ministry with no clear point of accountability to keep the focus on improving health outcomes for Ontarians.  There is a fundamental lack of clarity about which service provider should be providing what services to patients and how to work together effectively. Ontario could be getting better value for the money it currently spends on the health care system.

Opportunities for improvement

The health care system can make better use of available technology, and should aim to deliver integrated and efficient services in all parts of the province. People have more access to digital tools and information than ever before, and expectations for high-quality, efficient, and integrated health care have changed.

Next steps

The Council is working on a second report, which will include recommendations and advice for government on how to remedy the problem of hallway health care in Ontario. Four key themes have emerged through the Council’s initial work that will help guide the development of detailed recommendations in its next report:

  1. A pressing need to integrate care around the patient and across providers in a way that makes sense in each of our communities in the province, and improves health outcomes for Ontarians.
  2. Growing demand and opportunity to innovate in care delivery, particularly in the use of virtual care, apps, and ensuring patients can access their own health data.
  3. The potential for greater efficiency in how we streamline and align system goals to support high quality care.
  4. The critical role for a long-term plan so that we have right mix of health care professionals, services, and beds to meet our changing health care needs.