Winnipeg Free Press - PRINT EDITION

No stats kept on use of cabs by hospitals

Who pays for the ride on case-by-case basis

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Winnipeg hospitals "frequently" rely on taxis to transport patients home after they're discharged, but the Winnipeg Regional Health Authority could not provide any statistics on their use Monday.

"We don't collect this information specifically, and compiling it will take further time," spokeswoman Bronwyn Penner-Holigroski said.

Fare treatment

EACH province or municipality regulates the taxicab industry differently, particularly in defining the role of drivers providing assistance to customers as part of licensing requirements. Universally, nothing prevents a driver from helping a customer if asked or if there is a need.

 

  • Manitoba: Upon request by the passenger, a driver can assist by placing luggage or packages in and removing them from the taxicab and assist a passenger in and out of a taxicab (as long as he or she believes it is safe to do so).
  • Regina: Extend taxi service to all ambulatory persons with physical disabilities, provided that such persons are able to reach the curbside, and enter and leave the taxicab with minimal assistance from the driver, subject to any prior special arrangements or agreements made between a taxicab broker or owner and such persons.
  • Calgary: If a passenger requests the assistance of a driver, including the loading or unloading of a mobility aid and provided that the request for assistance is reasonable, the driver shall provide such assistance.
  • British Columbia: Passengers may need assistance entering or exiting the taxi and storing items. Taxi drivers may not add charges to the fare for handling luggage.
  • Ottawa: Help a disabled person from the curb to the cab.
  • Montreal: Help passengers get in or out of the vehicle safely when they obviously need assistance because of age, apparent state of health or a handicap.
  • Halifax: No taxi driver shall demand any additional fare for the transportation of wheelchairs, walkers or dog guides accompanying disabled passengers, or for escorting disabled passengers to and from the first accessible door of their pickup or destination.

 

What CARP has to say

THE Canadian Association of Retired Persons says each province should provide greater assurances hospital patients get home safely.

In a letter to provincial health ministers, CARP says the two recent incidents in Winnipeg highlight a problem across the country.

"This is not the first time we've heard this story," CARP spokeswoman Susan Eng said. "Either there are no protocols for ensuring that patients are accompanied or otherwise get home safely, or the protocols are not followed. Either way, patients are left to fend for themselves."

 

Sometimes a hospital will pay for the cab and sometimes it doesn't, depending on the circumstances, she said.

The WRHA could not immediately say Monday how much a given hospital -- or the region as a whole -- spends on taxis for patient transport in a given month or year.

"We are working on extrapolating what we can but do not have that information readily available at this point," Penner-Holigroski said via email.

Medical officials have a responsibility to ensure patients discharged from hospital are fit to be sent home and can leave the hospital safely.

"The decision to discharge is done in consultation with patients and is done based on clinical judgment. All significant safety concerns raised by patients, families, team members or others must be addressed prior to discharge," Penner-Holigroski said.

If a patient has been cleared for discharge but has no way home, a taxi will be called as long as the person is physically able to get in and out of the vehicle. If not, a wheelchair van or stretcher service may be used.

The WRHA's patient discharge guideline says: "In all cases, patients who require assistance with transportation or to get into their homes and remain there safely must have a named and available support person contacted, confirmed and documented by the ED (emergency department) nurse or emergency physician/nurse practitioner before being discharged."

Penner-Holigroski said "in some instances" where a patient fit for discharge is sent home in a taxi, the health system covers the expense. "If the patient is able to pay for the cab they do, and we provide the taxi voucher in cases where the person either doesn't have money with them or where they would be unable to afford the cost of a taxi."

The WRHA is investigating the late-December deaths of two men who were taken home by taxis after being discharged from the Grace Hospital. Both died before they were able to get inside their homes.

Penner-Holigroski said hospital staff check to make sure patients have their keys. It's the WRHA's "preference" there be someone at home to meet the patient, but that's not always possible, she said. If nobody is available to help out, that risk "needs to be assessed" in relation to whether a discharge is safe, she added.

The region's safe patient discharge guidelines do not currently consider weather conditions as a factor.

However, the WRHA is currently reviewing that policy. Both patient deaths occurred during a severe cold snap.

larry.kusch@freepress.mb.ca

Republished from the Winnipeg Free Press print edition January 14, 2014 A4

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