When a patient does not require the intensity of services provided within a hospital but continues to occupy a bed, the patient is designated as requiring an Alternate Level of Care (ALC). The resultant prolonged length of stay places the patient at greater risk for adverse outcomes, while increasing the strain on the hospital by negatively impacting patient bed flow and wait times.
The ALC Avoidance Framework is the fruit of a collaborative effort between the Toronto Central (TC) Community Care Access Centre (CCAC) and the 17 hospitals of the Toronto Central Local Health Integration Network (TC-LHIN). The Framework outlines pockets of ALC best practices from throughout Ontario and brings them together in a self-assessment tool. It also provides a structured approach to developing and implementing ALC improvement plans.
Michael Garron Hospital (MGH) was an early adopter of the ALC Avoidance Framework. Upon completion of its self-assessment, MGH had approximately 50% of 54 ALC avoidance strategies in place. Following prioritization of improvements and a focus on three key tactics, MGH met 84% of the strategies – the highest of the 17 hospitals in the LHIN. Through its focused effort, MGH exceeded its annual ALC target by 15% and, in April 2016, achieved its best performance in over two years with an ALC rate of 8.4%, despite rising ALC rates LHIN-wide. In addition, MGH has decreased the number of ALC patients waiting in hospital for a long-term care bed by 50% and has ensured that 100% of long-term care bed offers are accepted.
The Framework has been adapted for:
– Acute Care
– Post-Acute Care
– Regional Cancer Centres
– Mental Health and Addictions Facilities
– Community Care Access Centres (CCACs)