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Government & policy

Ontario demands hospital ‘quality improvement plans’

TORONTO – The government of Ontario has introduced legislation that’s designed to make hospitals and their executives accountable for improving patient care. The Excellent Care for All Act, which was introduced in the legislature earlier this month, will require the following:

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

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

• Executive compensation that is 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 healthcare organization

• Declarations of values that would be developed by healthcare 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.

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 healthcare 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 healthcare services and medical devices

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

“The government is improving the quality of our healthcare system while making it more accountable to patients,” said Deb Matthews (pictured above), Minister of Health and Long-Term Care.  “We want our healthcare system to be focused on patient needs with health services supported by the best evidence and highest standards. Improving quality of care not only means better patient care, it improves the value of our healthcare investment.”

The Ontario government announced in its budget earlier this year that is would be taking steps to overhaul the healthcare system, partly because it believes the system can’t be financially sustained over the long run.

It is now taking steps it says will control the expansion in costs and improve quality.

In a press release, the government said that:

• 20 years ago, 32 cents of every dollar spent on government programs were spent on healthcare. Today, it is 46 cents. In 12 years, it could be 70 cents if appropriate action is not taken.

• Last year, there were 140,000 cases of patients readmitted to hospital within 30 days of original discharge.

Posted May 20, 2010