Introduction

Introduction

In Ontario, there are many signs of a health care system under pressure. Patients are: waiting longer than they should in overcrowded emergency departments, receiving health care in hospital hallways, not able to access specialized post-acute hospital care, and unable to transition out of hospital beds due to services not being available in the community.

Hospitals are an important point of intake into the health care system; however, too many patients are going to hospitals for conditions that could be treated in primary or community care settings or prevented altogether. Overcrowding of the emergency department means Ontarians whose care can only be provided in an emergency department are waiting longer to access the health care they need, and are sometimes waiting in unconventional locations – like hallways. On an average day in 2018, there were approximately 1000 patients waiting for a hospital bed in an unconventional space or emergency department stretcher.^{footnote 1[1]}

This should not happen.

The health care system is complex and hospitals receive patients from many different care settings: from primary care (like family doctors or nurse practitioners), long-term care homes, home and community care, mental health and addictions agencies, and from the emergency department.

In fact, the pathway through the health care system is often not a straight or simple line: patients will move between care settings depending on the severity of needs or the kind of care required at each stage of their journey. At the same time, there are other patients who, with just a little more help from a health care provider, could stay in their homes longer, avoid a visit to the emergency department, avoid hospital admission, and maintain their health and independence.

We are seeing the results of a system under pressure in our hospital hallways; however, hallway health care is a symptom of broader challenges facing Ontario’s health care system.

We’ve heard from many Ontarians that the health care system can do better, and that accessing the high-quality health care that’s available in Ontario should be a straight-forward process.

Oftentimes, that’s just not the case.

What is hallway health care?

Hallway health care is a term used when patients are waiting for a hospital bed in an unconventional or unexpected location. This could be a hallway, or another space within a health facility that was not designed for using the space in this particular way.

Hallway health care is measured by counting the number of people waiting for a hospital bed overnight in an unconventional space or emergency department stretcher. That captures the volume – or size – of the problem, but there are more things going on throughout the system that are connected to hallway health care, like wait times for long-term care homes, that also contribute to how well the system works.    

A high-performing health care system should have very few people waiting for a hospital bed if they need one.