About Excellent Care for All
Update - as of January 2016
In 2014, amendments were made to the Excellent Care for All Act, 2010 (ECFAA) under the Public Sector and MPP Accountability and Transparency Act, 2014 to establish a Patient Ombudsman in Ontario. Once these amendments come into force, the Patient Ombudsman will be able to investigate, facilitate the resolution of, and report on complaints made by patients, former patients, and their caregivers that relate to the care or health care experience of the patient or former patient at a hospital, long-term care home, or community care access centre. This will help to strengthen complaints management processes across the health system and allow patient voices to be better heard.
The Patient Ombudsman is a Lieutenant Governor in Council (LGIC) appointment and will be an employee of Health Quality Ontario. The Patient Ombudsman will be supported by an Office of the Patient Ombudsman, which will be a part of Health Quality Ontario. Situating the office within Health Quality Ontario will help to strengthen the linkages between the Patient Ombudsman's work and Health Quality Ontario's ongoing efforts related to province-wide health care system quality improvement.
In order to support the Patient Ombudsman role, and to enhance the clarity of ECFAA, the following regulatory changes are being proposed:
- Defining the term 'caregiver' in regulation
- The ministry is proposing to provide a meaning for the term 'caregiver' that would apply to all references in ECFAA and its regulations.
- The intent is to further define who is able to bring forward a complaint to the Patient Ombudsman and to enhance the clarity and consistency of provisions under ECFAA.
- The proposed definition would apply to any provisions pertaining to caregivers under ECFAA. These include surveying caregivers concerning their satisfaction with services provided by a health care organization (2010, c. 14, s. 5); engaging caregivers in the development of Quality Improvement Plans for health care organizations (O. Reg. 187/15); and requirements related to the patient relations process in health care organizations (O. Reg. 188/15).
- In order to have one definition of caregiver that applies across all of ECFAA, the ministry is also proposing to amend O. Reg. 188/15 to remove an existing definition of caregiver that applies only to the patient relations process in hospitals.
Draft regulations can be downloaded here:
- Clarify references to personal health information.
- Regulation under ECFAA (O. Reg. 445/10 'General') includes a provision which states that Health Quality Ontario "may only collect de-identified personal health information for the purposes of carrying out its functions and making its reports" (s. 11).
- This provision would be made superfluous once the amendments to ECFAA that relate to the Patient Ombudsman come into force. This is because the amendments to ECFAA state that, "Despite any other Act, the Council [Health Quality Ontario] may only collect personal health information where the patient ombudsman collects that information in exercising his or her powers under this Act."
- To ensure clarity regarding Health Quality Ontario's specific permissions with respect to collecting personal health information, the ministry is proposing that the superfluous provision be removed (i.e., removal of s. 11 of O. Reg. 445/10 'General').
Draft regulation can be downloaded here:
In accordance with relevant Government of Ontario standards, the Ministry is seeking comments on the proposed regulations from January 29, 2016 until March 14, 2016. All comments received during the consultation period will be considered. Content of final regulations are at the discretion of the Minister of Health and Long-Term Care or the Lieutenant Governor in Council, who may make changes as appropriate.
Comments on these draft regulatory amendments can be submitted through Ontario's Regulatory Registry, emailed to firstname.lastname@example.org, or sent to the following mailing address:
Policy & Innovation Branch
Health System Quality & Funding Division
Ministry of Health and Long-Term Care
5th Floor Hepburn Block,80 Grosvenor Street
Toronto ON M7A 1R3
The draft regulations and descriptions of the draft regulations will be available on the Ministry website and on the Ontario Regulatory Registry until March 14, 2016.
Update - as of September 2015
The Ministry of Health and Long-Term Care (MOHLTC) has introduced two new Minister's regulations under the Excellent Care for All Act, 2010. Both regulations came into force on September 1, 2015 and currently apply to hospitals as defined by the Public Hospitals Act.
On June 8, 2010, the Excellent Care for All Act, 2010 (ECFAA) received Royal Assent and most requirements in the Act came into force. The Act requires health care organizations, beginning with public hospitals, to :
- Develop and post annual quality improvement plans.
- Implement patient and employee satisfaction surveys and a patient relations process.
- Link executive compensation to achievement of quality plan performance improvement targets.
- Develop declarations of values after public consultation.
- Create quality committees to report to each hospital board on quality related issues.
New Regulations introduced to strengthen Patient Relations Processes and ensure patients and their caregivers are engaged as part of the Quality Improvement Plan process.
The MOHLTC introduced two new regulations under ECFAA to enhance complaints management processes and expand patient engagement in hospitals. These new regulations were announced on July 7, 2015 and came into effect on September 1, 2015. As of this writing, the requirements under ECFAA apply to health care organizations, defined as hospitals within the meaning of the Public Hospitals Act.
As of September 1, 2015, under O. Reg. 188/15: Patient Relations Process, health care organizations are required to:
- Have practices in place for handling patient complaints as part of the organization's overall patient relations process. As part of these practices, health care organizations are be required to :
- have processes in place for reviewing and resolving complaints made by patients and caregivers
- record, monitor, and analyze key information about each complaint, including the name of the person who made the complaint (except in the case of an anonymous complaint), the date the complaint was made, the subject matter, whether the complaint was resolved, and if so, when and how the complaint was resolved
- inform the person who made the complaint of its review status, within five days of the date the complaint was made and whenever the person who made the complaint reasonably requests further information
- Designate an individual as its patient relations process delegate and to make that individual's contact information available to the public. This individual is responsible for :
- overseeing the patient relations process
- presenting aggregate data related to the organization's patient relations process to the organization's quality committee at least twice a year
- Engage patients in designing, reviewing, and maintaining an organization's patient relations process.
As of September 1, 2015, under O.Reg. 187/15: Annual Quality Improvement Plan, health care organizations are required to:
- Engage patients and their caregivers in the development of its annual quality improvement plan
- Contain a description of the organization's patient engagement activities in their annual quality improvement plan and include an explanation of how these activities inform the development of the quality improvement plan
The full text of these Regulations under ECFAA is available on the e-laws website site at:
Supports and Resources
Supports and resources for improving patient relations practices in Ontario's hospitals and engaging with patients and caregivers about patient relations are available on Health Quality Ontario's website at:
The Ontario Hospital Association (OHA) has developed a patient relations toolkit to support the ongoing work of hospitals in enhancing patient relations processes. The OHA patient relations toolkit is available on the OHA's website:
Overview of Regulations
The text of ECFAA and all of its subordinate regulations is available on the e-laws website at:
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