Proposed Excellent Care for All Act

Ontario is introducing the proposed Excellent Care for All Act that is intended to make health care providers and executives accountable for improving patient care. The aim of the legislation is to foster a culture of continuous quality improvement where the needs of patients come first.

Continuous Quality Improvement in Hospitals

The hospital sector would implement these proposed legislative changes first, and results from hospitals would be assessed before extending the requirements to other health sectors.

The proposed legislation includes requirements for:

• Quality committees, which would report to the hospital board of directors on quality-related issues

• Annual quality improvement plans where each hospital would be required to create and publicly post a plan

• Executive compensation which would be required to be linked to achieving improvements set out in the annual quality improvement plan

• Patient relations process to address patient, client and caregiver relations

•  Patient/client/caregiver surveys to assess satisfaction with services

• Staff surveys to assess satisfaction with employment experience and views about the quality of care provided by the health care organization

• Declarations of values that would be developed by health care organizations after public consultation.

Critical incident reporting would also be strengthened through regulatory amendments by requiring critical incidents in hospitals to be reported to the Medical Advisory Committee and the hospital administrator, in addition to the affected patient. Action plans would be required for every critical incident.

Regulations would require that the Medical Advisory Committee report, at least annually, a summary of all critical incidents to the quality committee. Regulations would also require the Medical Advisory Committee report to the quality committee regarding clinical and general rules respecting regulated health professionals.

The following persons would not be allowed to be voting members of hospital boards: any member of the medical staff, dental staff, nursing or midwifery staff of the hospital, and any employee of the hospital.

Expanded Mandate for Ontario Health Quality Council

The Excellent Care for All Act would also expand the mandate of the Ontario Health Quality Council (OHQC) to promote evidence-based care in the health care system.

The current OHQC mandate is to:

• Monitor and report to Ontarians on access to publicly funded health services, health human resources in publicly funded health services, consumer and population health status, and health system outcomes

• Support continuous quality improvement.

The proposed legislation would expand the OHQC's mandate to include:

• Providing recommendations to the health system on clinical practice guidelines and protocols

• Providing recommendations, in consultation with the public, to the Minister concerning the Government of Ontario's provision of funding for health care services and medical devices

In a related initiative, the ministry will also be developing a plan to strengthen the public reporting of quality indicators.