Life or Limb
A collaborative policy that ensures accountability for the most vulnerable patients
The Ministry of Health and Critical Care Services Ontario (CCSO) developed the Life or Limb Policy (2013) in response to recommendations from the Office of the Chief Coroner for a provincial “no refusal” policy when critical injuries or conditions of threatened life or limb are involved. The purpose of the Life or Limb Policy is to facilitate timely access and transfer of patients, who are life or limb threatened, to an appropriate level of acute care services for interventions that would improve patient outcomes (loss of life or limb is certain if transfer does not occur within 4 hours).
The Life or Limb Policy ensures accountability for access to care for the sickest, most vulnerable critically ill patients, and promotes the patient’s clinical condition as a priority. No patient with a life or limb threatening condition who might benefit from transfer to a centre capable of providing an appropriate intervention will be refused care.
CCSO provides oversight, with multi-stakeholder review and input through the Provincial Life or Limb Advisory Committee, for policy updates and evaluation, as well as leadership for performance management of the Life or Limb Policy, which includes the dissemination of the Life or Limb Performance Dashboard (bi-annually).
Life or Limb Dashboards
The Life or Limb Dashboard*, disseminated bi-annually to hospital CEOs, presents hospital site level data providing an at-a-glance view of the hospital’s Life or Limb acceptance performance, intended to improve outcomes for patients who are life or limb threatened. Broad sharing of the Dashboard to those who are directly or indirectly involved with patient care is encouraged across acute care programs including senior leaders, managers, health care providers, such as clinicians and transport providers (Emergency Medical Services and Ornge), and decision support/quality improvement specialists.
*All data analysis and reports are prepared the CCSO Data Analytics team.