The effects of altering discharge policies to alternate level of care patient flow


Alternate Level of Care (ALC) patients are patients that stay in the acute care setting while waiting to be transferred to an ALC facility. They are not receiving the appropriate type of care and are occupying acute care resources. ALC patients occupy 5,200 patient beds everyday in Canada, and 12 percent of these ALC patients die during their waiting period. This study evaluates Toronto General Hospital’s (TGH) discharge policy in the General Surgery and General Internal Medicine (GIM) departments using a discrete-event simulation. For long-term care ALC patients, it was found that applying to one extra application or maximizing the number of short waiting list facilities in their total number of applications significantly reduces the number of ALC days and the number of died in hospital patients. Knowing if discharge policies can decrease ALC days is not only significant to TGH but also to other health care institutions.