Addressing Hospital Gridlock Through Seniors' Care

Endoresed in:

April, 2019

Paper Type:

Position Paper


  • David Bobrowski (University of Toronto)
  • Adam Bobrowski (University of Toronto)


Hospital gridlock, defined as the stasis of patient services in hospital due to overcapacity, is predicted to worsen in tandem with Canada’s aging population. Approximately 75-80% of Canadian seniors live with one or more chronic diseases, and hence seniors are significantly more likely than the general population to access acute care services. Fragmentation in the continuity of healthcare services often result in patients with chronic diseases not receiving the right care at the right time. The sequence of late diagnosis and treatment, and a subsequent exacerbation of symptoms results in a more ill and vulnerable patient population being unloaded onto acute care institutions. Once in hospital, seniors are at increased risk of developing delirium, nosocomial infections, and deconditioning resulting in an increased hospital stay. This gridlock on hospital wards is in large part due to a lack of availability, as long-term care homes are currently at 98% capacity, with around 78,910 residents in 627 long-term care homes across Ontario. Concurrently, community resources are not expanding at a sufficient rate, which is evidenced by the 20% of seniors admitted to residential care that could have remained at home given appropriate supports. Ultimately, this gap in the transition of care contributes to the current status quo in Ontario: at least 1000 patients everyday waiting for a hospital bed in an unconventional space or emergency department stretcher during 2018.


  • The Ontario Ministry of Health and Long-Term Care (MOHLTC) should develop a standardized, province-wide system of evidence-based performance measurement for virtual elderly care to allow seniors to stay in their homes.
  • The Association of Faculties of Medicine of Canada should increase medical student and resident exposure to the practice of house calls.
  • The Ontario government should develop an actionable timeline for the construction of 30,000 new long-term care beds over the next decade and an allocation strategy to ensure the equitable distribution of beds across the province according to anticipated demand.