Patient Flow / Alternate Level of Care (ALC)

Patient flow refers to the movement and transition of patients between care settings, providers and organizations in order to accomplish the ultimate goal of the right care, in the right place, at the right time. Transitions might occur, for example:

  • within organizations (e.g. from the ED to an inpatient bed, from a medical inpatient bed to a rehabilitation inpatient bed or outpatient service); 
  • between organizations of the same type (e.g. from one hospital to another hospital, from one long-term care home to another long-term care home, from one community support service provider to another community support service provider); or
  • between sectors (e.g. from/to a hospital to/from primary care, Community Care Access Centre, long-term care home or assisted living program). 

When hospital-related patient flow is hindered, it can manifest as alternate level of care (ALC). ALC has been a significant challenge in Northeastern Ontario for a number of years. Hospitals, both large and small, struggle with moving patients to the most appropriate discharge destination due to a variety of reasons including capacity, absence of options and process issues. 

Continued ALC challenges in the region coupled with the new aggressive province-wide target of 9.46% ALC in acute care, and 12.7% ALC in combined acute and post-acute settings per the 2016/17 Ministry-LHIN Accountability Agreement (MLAA), point to the need for renewed focus on ALC in the NE LHIN.

Please read the new NE LHIN’s new Patient Flow Strategy: Improving Care Coordination and Alternate Level of Care (ALC) Performance 2016/17 – 2018/19.

Current patient flow-related and ALC performance indicators is located in the accountability section of the NE LHIN web site located here.

Engaging with Communities and Health Service Providers to Find ALC Solutions

Key component of the new patient flow strategy include: 
  • the engagement of providers both at the regional and sub-LHIN levels to address common projects and priorities across the region while also addressing unique local needs and taking advantage of local opportunities; 
  • formalized linkages with existing regional and local provider committees and tables in order to better coordinate efforts and avoid duplication; 
  • application of project management techniques to help guide, organize and track project activity (including the development of annual workplans at the regional and sub-LHIN levels); and
  • regular performance monitoring to ensure we are achieving the desired outcomes.