Improving Transparency in Ontario's Health Care System
In September 2014, Ontario convened a committee of health care experts that was co-chaired by Andreas Laupacis, Executive Director of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, and Angela Morin, Patient and Family Advisor at Kingston General Hospital. The committee was asked to advise the government on ways to improve the Quality of Care Information Protection Act, 2004 (QCIPA) and health sector legislation related to critical incident reviews.
The committee undertook extensive research and interviewed more than 60 health care professionals, patients and their family members who had experience with critical incidents (unintended and serious errors or accidents that harm patients) or service quality issues in hospitals. The committee held a one-day engagement session with 18 patients, received online submissions and reviewed over 90 research and policy documents.
The committee's recommendations are presented in its report QCIPA Review Committee Recommendations. Ontario is implementing all of the committee's recommendations with the following initiatives:
- Intending to introduce the Health Information Protection Act that, if passed, would replace QCIPA with a new bill of the same name (QCIPA 2015) that would:
- Clarify the purpose of QCIPA and reaffirm the right of patients to access information about their health care.
- Clarify that certain information and facts about critical incidents--unintended and serious errors or accidents that harm patients--cannot be withheld from affected patients and their families.
- Allow the Minister of Health and Long-Term Care to make regulations that would require health care facilities to adopt a uniform approach when using QCIPA to review critical incidents.
- Specify that investigations of critical incidents can involve multiple health care facilities.
- Clarify that QCIPA does not prevent health care facilities from properly disclosing information as required by law, or from interviewing patients involved in a critical incident as part of an investigation.
- Require that the Minister of Health and Long-Term Care review the Act every five years.
- Proposing to amend the Public Hospitals Act Regulation 965 to require that hospitals interview patients and families affected by critical incidents and make known the cause of the incident, if known.
- Working with the Ontario Hospital Association and Health Quality Ontario to provide guidance and training to health care facilities on reviewing critical incidents, including those under QCIPA.
- Working with Health Quality Ontario to create a way for public hospitals and health care facilities to share their experiences with critical incidents and improve learning to prevent future incidents.
- Offering patients the option to file complaints about the process or outcome of a critical incident investigation at a hospital. This will be made available through the upcoming Office of the Patient Ombudsman that Ontario is creating for patients to submit complaints about the health care they received.