In Dr. David Walker’s summer ALC (alternate level of care) report he gives the example of the Toronto Central LHIN’s efforts to reduce their ALC roster.
Alternate level of care patients are said to be indivdiuals who have completed their acute care but are unable to go home or secure a long term care bed. There used to be an ugly word for them — bed blockers — which appeared to put the blame on the patient for a failure of the system to provide a continuum of care.
The Toronto Central LHIN identified 148 long-stay ALC patients for review. While the LHIN was able to transition 28 of these ALC patients to alternate destinations, 22 were deemed medically unstable and not ALC at all. That’s nearly 15 per cent.
This would indicate that measuring the ALC problem is not as simple as it appears. Nor does it give us confidence that this is the significant problem government has made it out to be.
Walker also indicates how easy it is to get rid of the problem – by deeming wards with ALC patients to be appropriate. Apparently by simply doing this it no longer makes these patients ALC and clears up the embarrassing statistical problem. Walker recommends small rural hospitals retain their ALC patients, most of whom would not have access to the kind of community resources available in southern urban areas.
This is not the first time we have seen this. Northumberland Hills Hospital had similarly gotten rid of its ALC problem by creating an ALC unit. A stroke of a pen and the problem goes away.
It seems government has hit upon an inexpensive method of solving the ALC problem – stop labelling patients “ALC.”
Maybe we need a new term — “patients formerly known as ALC.”