Nova Scotia Health's ALC definition and criteria were developed through research, benchmarking, and collaboration with operational leaders and the Zone Medical Executive Directors, who played a pivotal role in the decision-making process.
They were approved collectively by the Clinical Operations Council on October 5, 2023.
Definition of Alternate Level of Care
Alternate Level of Care (ALC) is used to identify patients who no longer require inpatient acute care services provided at their current facility.
Patients must meet all of the following criteria:
- Clinical status is at baseline or new baseline supported by the patient’s goals of care.
- Medical issues are at baseline or new baseline with a stable treatment plan and care plan established.
- Mental Health is at baseline or could be managed effectively in community with supports.
- Medication titration and changes are largely complete or could be managed effectively in community with supports, and discharge scripts could be written if patient was being discharged.
- No additional medical diagnosis is being sought or investigated that would require acute care services.
- Palliative care treatments, if required could be provided in the community.
- Nursing assessments are stable.
- No test results are pending that could influence the discharge plan (to community or transfer to another hospital).
- All necessary inpatient physician consults are completed and arrangements are made for any non-urgent consults to be followed up in the community.
Once the patient fulfills above criteria, the patient must be designated as ALC by their care team within 24 hours.
