Regulation - LGIC

Proposed amendments to Public Hospitals Act Regulation 965

Regulation Number(s):
Instrument Type:
Regulation - LGIC
Bill or Act:
Public Hospitals Act
Summary of Decision:
Made: December 7, 2016
Approved: December 14, 2016
Filed: December 20, 2016
Published on e-Laws: December 21, 2016
Printed in The Ontario Gazette: January 7, 2017
Analysis of Regulatory Impact:
No new administrative cost for business.
Further Information:
Proposal Number:
Posting Date:
September 17, 2015
Summary of Proposal:
The Quality of Care Information Protection Act, 2004 (QCIPA) allows health professionals to share information and have discussions about improving patient care. The Act protects this information from being disclosed in legal proceedings (e.g. courts, tribunals, coroner inquests/inquiries, regulatory colleges) unless specified under the legislation, or disclosed to anyone, including patients and families, under the Personal Health Information Protection Act, 2004, or the Freedom of Information and Protection of Privacy Act. The Act may be used to have discussions about general quality improvement matters or when there is an unintended and serious accident or error that harms a patient and the cause is unclear. However, QCIPA cannot be applied to specific information pertaining to an individual patient's health care, including factual information regarding critical incidents, and any information required by law to be recorded.

In recent years, some patients and their families have expressed concern about the use of QCIPA by hospitals. In addition, the 10 year milestone since the introduction of the legislation represented an opportunity to reflect on the use of QCIPA in the context of the evolution of the provincial health system, international practices, and trends related to quality improvement, information protection and disclosure.

In 2014, the Minister of Health and Long-Term Care convened a QCIPA Review Committee, who submitted their report on December 23, 2014. On July 1, 2015 the Minister announced that he would implement all 12 of the Review Committee's recommendations related to QCIPA, the PHA and critical incidents more broadly.

In order to implement the Review Committee's recommendations, amendments to Regulation 965 under the Public Hospitals Act are required. The proposed amendments to this regulation would require that hospitals:

- Establish a system for ensuring that a committee appointed by the hospital reviews every critical incident, as soon as is practicable after the critical incident occurs.
- Interview patients and their authorized representatives about the critical incident;
- Inform them of its causes where possible, in addition to already existing disclosure requirements; and
- Include a staff person responsible for patient relations in the committee conducting the review (including where a committee under QCIPA is used to conduct the review).

These amendments are intended to increase accountability and transparency in the health system by ensuring that hospitals use consistent processes when involving patients and their families in critical incident reviews and disclosing information about a critical incident review.

Through this posting the Ministry is soliciting feedback from the public about the proposed amendments to Regulation 965 under The Public Hospitals Act. The Health Information Protection Act was introduced in the Ontario Legislature on September 16, 2015 and includes amendments to QCIPA that are consistent with amendments to Regulation 965.
Contact Address:
Nivedita Ravi
80 Grosvenor Street, 8th Floor
Toronto, Ontario
M7A 1R3
Effective Date:
July 1, 2017