Year 2 Highlights 2017/18

Enusring ‘no trespass orders and visitation restrictions’ are fair

A hospital staff member is shaking her head 'no' to a woman with her hands on her hips

Situation

A caregiver contacted Patient Ombudsman to complain that he was issued with a no trespass order and restrictions had been placed on his ability to visit a family member in hospital.

He complained to Patient Ombudsman that he was unclear why the restrictions were imposed and he had been unable to get a satisfactory explanation from the hospital. He also felt the patient relations representative at the hospital had closed his complaint prematurely.

What we did

Patient Ombudsman reviewed the letter sent to the caregiver about the restrictions and all other relevant documentation of the incident, the complaint and how it was addressed. The documentation outlined the incident that led to the restrictions and confirmed that a full explanation was provided to the caregiver. A process to review the restrictions at intervals was in place. In addition, reasonable efforts were made to enable the caregiver to visit his family member in a way that ensured the safety of staff and other patients. Further, Patient Ombudsman determined that the caregiver’s complaint had not been closed and efforts had been made to give the caregiver a full opportunity to voice his concerns, including a meeting with the hospital’s senior management. Patient Ombudsman’s findings were that the complainant was treated fairly. A full report was provided to the caregiver and the file was closed.

Patient Ombudsman received over 50 complaints from patients and caregivers who had restrictions placed on their access to health care settings or their ability to visit family members in hospitals or long-term care homes. The restrictions were often in response to verbal threats or threatening or disruptive behaviour by patients or visiting caregivers.

Hospitals and long-term care homes must take reasonable steps to ensure the safety and comfort of all of their patients or residents, as well as safe workplaces for their staff. At the same time, challenging patients still need access to vital health care services. Visits from loved ones can also be important to health and well-being of patients/residents. In long-term care homes, this right is included in the Residents Bill of Rights in the Long-Term Care Homes Act, 2007.

These complaints were often complex, and the perceptions of the parties on the seriousness of the incident frequently varied. Rather than focusing on the incident or behaviour that led to the restrictions, in attempting to resolve these complaints Patient Ombudsman generally examined and considered the fairness of the process.

Suggestions for Hospitals and Long-term Care Homes

  • Ensure there is detailed documentation of the incident and the assessed risks
  • Ensure there is a documented process for reviewing the restrictions at reasonable intervals
  • The patient or caregiver should be given a clear explanation for why the restrictions have been imposed
  • The specific conditions of the restrictions should be clearly explained and should be no more restrictive than necessary to ensure the safety of patients/residents and staff
  • Consider and communicate what would be required to ease the restrictions, if appropriate