Regulation - LGIC

Proposed amendment to Reg. 965, s.31 under the Public Hospitals Act, 1990 to remove the regulatory requirement to conduct laboratory examinations of tissues removed during hip and knee replacement surgeries

Regulation Number(s):
Instrument Type:
Regulation - LGIC
Bill or Act:
Public Hospitals Act, 1990
Summary of Proposal:
Regulation 965: Hospital Management ("regulation") under the Public Hospitals Act sets out a clinical requirement to send all tissues removed during surgery to a laboratory for pathological analysis, unless the tissue is explicitly exempt under the regulation (see section 31). Generally, this provision is a quality assurance practice to support the identification of new information relevant to a patient's diagnosis and treatment. While this provision remains appropriate for certain surgical procedures, the latest evidence demonstrates that this routine practice is outdated and unnecessary for hip and knee replacement surgeries, yielding no proven value to patient care or outcomes.

The proposed regulatory amendment, if approved, would eliminate the requirement to perform a laboratory examination of tissues removed during hip and knee replacement surgeries, while still allowing operating surgeons to retain the authority to submit any specimens for examination at their discretion.

This proposed change would support and enable government's commitment to surgical recovery by enhancing hospital surgical unit, laboratory, and health human resource capacity without impacting patient care and allowing any potential hospital specific cost savings to be redirected towards other public hospital programs.
Analysis of Regulatory Impact:
The proposed regulatory amendment seeks to remove an unnecessary compliance requirement, and as such, it is not expected to impose any increased administration or compliance costs to hospitals.

Rather, it is anticipated that this proposed regulatory amendment will result in reduced burden for surgical staff, pathologists, and other laboratory staff, enhancing their capacity to perform other essential and high-value pathological investigations.

To further inform this analysis, we encourage you to provide any relevant feedback on the anticipated cost and/or time savings this proposal may bear.
Further Information:
Proposal Number:
Posting Date:
November 23, 2022
Comments Due Date:
January 9, 2023
Contact Address:
Priority Policy Unit, Strategic Policy Branch
Strategic Policy, Planning and French Language Services Division
Ministry of Health
438 University Ave, 10FL
Toronto ON M5G 2K8