Section A:

Factors affecting patients

Section Contents Page Number

Indicator Group 1: Respecting the needs and rights of patients

Indicator A.1.1 A3

The practice demonstrates its commitment to respecting the needs and rights

of its practice population

Indicator A.1.2 A7

The practice maintains the privacy of patient information in accordance with Bill 31

Indicator A.1.3 A11

The practice encourages patient suggestions and feedback into service planning

Indicator A.1.4 A14

The practice respects patients’ rights to formally complain

Indicator A.1.5 A16

The practice honours its commitment to recognising the diversity of its patients

Indicator A.1.6 A19

Mandatory reporting occurs in accordance with legislation in the family practice

Indicator Group 2: Access and availability

Indicator A.2.1 A21

Information about practice services is available for patients

Indicator A.2.2 A24

The practice makes provision to ensure patients are able to access 24-hour care,

7 days a week

Indicator A.2.3 A27

The practice has an effective system to monitor waiting times for investigations and

referrals to ensure that patients are receiving them in a timely manner

Indicator A.2.4 A29

The practice uses a system that assists the practice team to identify and provide an

appropriate response to emergencies/urgent medical conditions

Indicator A.2.5 A31

The practice team ensures that patients are provided with information to enable

them to make informed decisions about their care

Section Contents Page Number

Indicator A.2.6 A34

The practice provides educational information on health promotion and

disease prevention to patients

Indicator A.2.7 A36
Initial and repeat prescribing in the absence of a visit is accurate, appropriate
and timely
Indicator Group 3: There are no barriers to access

Indicator A.3.1 A39

Patients can easily access the practice using the telephone system

Indicator A.3.2 A41

Patients can access the practice for advice or appointments appropriately

Indicator A.3.3 A43

Patient visits are effective and efficient

Indicator A.3.4 A45

The practice premises are clearly signposted and physically accessible

Indicator Group 4: Promoting patient-centredness

Indicator A.4.1 A48

The practice promotes quality provider-patient relationships

Indicator A.4.2 A51

The practice is patient-centred

Section A

Factors affecting patients

Indicator Group 1 Respecting the needs and rights of patients

Indicator A.1.1 The practice demonstrates its commitment to respecting

the needs and rights of its practice population

Criteria A.1.1.1 êê The practice has a written policy that describes how

it provides services to patients

A.1.1.2 êê The practice team is familiar with the Canada Health Act,

Professional Codes of Ethics, Geneva Declaration, and Four

Principles of Family Medicine

A.1.1.3 êê The practice team is familiar with its contractual requirements

(the model of practice of family medicine)

A.1.1.4 ê The patient has the right to have someone else in the room

during an examination or consultation

A.1.1.5 ¶ The practice demonstrates its dedication to comprehensive care

by providing the full basket of services as outlined in the

PCCCAR Report

A.1.1.6 ê The practice complies with guidelines regarding new patients

Section A – Factors affecting patients

Indicator Group 1 – Respecting the needs and rights of patients

Indicator A.1.1

The practice demonstrates its commitment to respecting the needs and rights of its practice population

The purpose of this indicator is to establish evidence of the practice commitment to servicing its practice population and its recognition of its legal obligations, contractual requirements, ethical duties and dedication to comprehensive care

Criteria:

A.1.1.1 êêThe practice has a written policy that describes how it provides services to patients

Interpretation

·  The practice has a written policy regarding service hours, after hours service, types of service, etc. (see Indicator A.2.1 for information about practice services available to patients)

·  The practice has clearly posted guidelines and policies about payment for uninsured services

A.1.1.2 êêThe practice team is familiar with the Canada Health Act, Professional

Codes of Ethics, Geneva Declaration and Four Principles of Family Medicine

Interpretation

·  The practice understands and implements the elements of the Canada Health Act with respect to Universality and Portability, and ensures that patients are aware of their health insurance coverage. In the Canada Health Act there are specific instructions about Universality (eligibility for OHIP coverage, registration requirements, and other categories of individual coverage) and Portability (minimum waiting periods, coverage during absences in Canada and absences outside Canada )

A.1.1.3 êêThe practice team is familiar with its contractual requirements (the

model of practice of family medicine)

Interpretation

·  The practice understands the model of family practice within which it works, and communicates its contractual obligation for the model of practice with the patients. Patients should know whether they have signed a contract or agreement. This would include Fee-For-Service, Health Service Organization, Family Health Team, Primary Care Network, Family Health Network, Family Health Group, Community Health Centre, Community Service Contract, Northern Group Funding Plan (see Glossary).

A.1.1.4 êThe patient has the right to have someone else in the room during an

examination or consultation

Interpretation

·  The patient is informed of the right to have a third party present during an examination or consultation

·  When a patient is accompanied to the practice by a third person, it is important to ensure that the patients consents to the presence of that person in an examination or consultation

·  The clinic room is furnished to accommodate family members

·  Female staff are available to assist with examinations or consultations

A.1.1.5¶The practice demonstrates its dedication to comprehensive care by

providing the full basket of services as outlined in the PCCCAR Report

Interpretation

·  All members of the practice are familiar with the practice’s dedication to provide the full basket of services as outlined in the PCCCAR Report

·  If a practice limits its scope, there are arrangements with other providers and patients can be referred to these providers for these services, e.g. obstetrics, palliative care, hospital care, etc.

A.1.1.6êThe practice complies with guidelines regarding new patients

Interpretation

·  Newly registered patients are offered a consultation to ascertain details of their past medical and family histories, social factors including occupation, lifestyle, and measurements of risk factors

·  Those findings are recorded in the medical records, and patients with significant medical conditions are reviewed

Further Information

CMA Code of Ethics 2004

http://www.cma.ca/multimedia/staticcontent/HTML/N0/l2/where_we_stand/CodeofEthics04.pdf

1996 CMA Code of Ethics Annotated for Psychiatrists

http://www.cpa-apc.org/Publications/Position_Papers/annotatedCodeOfEthics/codeOfEthics.html

Provincial and Territorial Health Care Insurance Plans 2002-2003

http://www.hc-sc.gc.ca/medicare/Documents/CHA0203-prov-all.pdf

Canada Health Act (5 criteria)

http://www.hc-sc.gc.ca/medicare/home.htm

Health Card requirements

http://www.health.gov.on.ca/english/public/program/ohip/ohipfaq_mn.html

MOHLTC website: Questions and answers re OHIP eligibility

Paths to Equal Opportunity

http://www.equalopportunity.on.ca/eng_g/index.asp

Ontario Association of the Deaf

http://deafontario.ca/oad/

Good Medical Practice for Physicians (Revalidation UK)

http://www.rcpe.ac.uk/news/gmpfp/good_mpfp_rev.pdf

Ontario Human Rights Commission has Policy and Guidelines on Disability and the Duty to Accommodate

http://www.ohrc.on.ca/english/publications/disability-policy.shtml

Cultural competence: Essential measurement of quality for managed care organizations

Annals of Internal Medicine.1996:124;10;919-921

http://www.annals.org/cgi/content/full/124/10/919

OCP – Labelling Prescriptions for the Visually Challenged

http://www.ocpinfo.com/client/ocp/OCPHome.nsf/web/Labelling+Prescriptions+for+the+Visually+Challenged!OpenDocument

Section A: Factors affecting patients

Indicator Group 1 Respecting the needs and rights of patients

Indicator A.1.2 The practice maintains the privacy of patient information

in accordance with Bill 31

Criteria A.1.2.1 êê The practice team have had training to implement Bill 31- the

Health Information Protection Act and the Quality of Care Information Protection Act

A.1.2.2 êê The practice has a designated contact person responsible for

monitoring privacy issues

A.1.2.3 êê Patient consent is obtained and recorded for the disclosure of

personal information and the release of notes to another party

A.1.2.4 êê The practice follows reasonable steps to ensure records are

protected

A.1.2.5 êê The practice has established and maintains appropriate

information practices and informs its patients about these

practices

A.1.2.6 êê The practice has a written statement and/or privacy policy

A.1.2.7 êê The practice collects and stores patients’ personal information in

compliance with the law

A.1.2.8 êê The practice takes reasonable steps to protect personal health

information that is transferred to others

A.1.2.9 êê Members of the practice team who have access to medical

records have signed a confidentiality agreement

Section A – Factors affecting patients

Indicator Group 1 – Respecting the needs and rights of patients

Indicator A.1.2

The practice maintains the privacy of patient information in accordance with Bill 31

The purpose of this indicator is to identify how the practice system maintains patient privacy in accordance with Bill 31

Criteria:

A.1.2.1 êêThe practice team has had training to implement Bill 31- the Health

Information Protection Act and the Quality of Care Information Protection Act

Interpretation

·  All members of the practice team must be familiar with Bill 31 and have taken the necessary steps to ensure that they are abiding by the intent of the law

A.1.2.2 êêThe practice has a designated contact person responsible for monitoring

privacy issues

Interpretation

·  Designated contact person

·  Process is identified for collection, use and disclosure of personal health information

A.1.2.3 êêPatient consent is obtained and recorded for the disclosure of personal

information and the release of notes to another party

Interpretation

·  The purpose of this criterion is to determine that appropriate consent has been obtained

·  Use the sample consent form in the Physician Privacy Toolkit to confirm that consent is recorded in the chart

A.1.2.4 êêThe practice follows reasonable steps to ensure records are protected

Interpretation

·  Records are protected against theft, loss and unauthorized access, copying, modification, use, disclosure and disposal

A.1.2.5 êêThe practice has established and maintains appropriate information

practices and informs its patients about these practices (see OMA toolkit

http://www.oma.org/phealth/privacymain.htm)

Interpretation

·  The practice posts a policy about how it has it has established and maintains appropriate information practices

A.1.2.6 êêThe practice has a written statement and/or privacy policy

Interpretation

·  There is a written policy made available to all patients on:

- the information practices

- the contact person information

- the access, correction, inquiry and complaints procedure

·  There are procedures to:

- Identify when a use or disclosure of personal health information is beyond what is described in the written statement

- Notify affected patients about such a use or disclosure make and keep notes of such a use or disclosure in or linked to the affected personal health record

A.1.2.7 êêThe practice collects and stores patients’ personal information in compliance with the law

Interpretation

·  The practice defines scopes of practice and job responsibilities for health care professionals and staff to identify who requires personal health information, what information they require, and for what purpose

·  The practice is aware of who collects what personal health information (to limit duplication of collection); about the consent requirements for collection; about restricting the collection of personal health information to the purposes for which you have consent or which are permitted or required by law; and about restricting the collection of personal health information to the information that is required

·  The practice regularly reviews collection practices to ensure compliance with the Act

·  The practice is aware of how records are protected against theft, loss and unauthorized access, copying, modification, use, disclosure, retention and disposal

A.1.2.8 êêThe practice takes reasonable steps to protect personal health

information that is transferred to others

Interpretation

·  The practice can describe and show what reasonable steps are taken to protect health information transferred to others

A.1.2.9 êêMembers of the practice team who have access to medical records have signed a confidentiality agreement

Interpretation

·  A practice log that records team members & others signed commitment to confidentiality of patient records

·  The log should record: name, date employment commenced, signed agreement

Further Information

Ontario’s Bill 31 received third reading in the legislature on May 17, and will be proclaimed into law effective November 1, 2004. Bill 31 consists of two schedules — the Health Information Protection Act (HIPA), and the Quality of Care Information Protection Act (QCIPA).

http://www.oma.org/phealth/privacy/b031ra.pdf

Ontario Medical Association provides guidance in the Physician Privacy Toolkit and a Physician Privacy Statement September 2004

http://www.oma.org/phealth/privacymain.htm

http://www.oma.org/phealth/privacy/PrivacyStatement04.pdf

CPSO - A Guide to Current Medical Record-Keeping Practices

http://www.cpso.on.ca/Publications/medrecbk.htm

CPSO Policy on Confidentiality and Access to Patient Information

http://www.cpso.on.ca/Policies/confidentiality.htm

CMA PrivacyWizardTM

Create handouts for your patients, review and enhance office privacy practices and better understand your privacy obligations.

www.cma.ca/privacywizard.htm or call 1888 855 2555

OHA’s Quality of Care Information Protection Act Toolkit

http://oha.com/client/OHA/OHA_LP4W_LND_WebStation.nsf/resources/QCIPAToolkit/$file/QCIPAToolkit.pdf

CMPA - Protecting personal health information: An overview for physicians

http://www.cmpa-acpm.ca/portal/pub_index.cfm?LANG=E&URL=cmpa%5Fdocs%2Fenglish%2Fresource%5Ffiles%2Fon%5Fthe%5Frecord%2Fcommon%2F2002%2F09%2Fcom%5Fon%5Fthe%5Frecord%5F2002%5F09%2De%2Ehtml

Canadian Consumer Information Gateway

http://consumerinformation.ca/app/oca/ccig/abstract.do?language=eng&abstractNo=OR000029&text=personal+health+information+privacy+act&topic=CAT6.TOPICS.ROOT&language=eng

College of Dietitians of Ontario – Privacy Code

http://www.cdo.on.ca/en/home%20pop-ups/Privacy/PRIVACY%20CODE%20revised%20Jan%202005.htm

College of Nurses of Ontario – Privacy Code

http://www.cno.org/prac/privacy/index.htm

Canadian Pharmacists Association – Pharmacist’s Personal Information Privacy Code

http://www.pharmacists.ca/content/hcp/resource_centre/practice_resources/pdf/Pharmacist_PIPCode.pdf

Ontario College of Social Workers and Social Service Workers - Code of Ethics, Principle V: Confidentiality

http://www.ocswssw.org/sections/pdf/1.6B%20code%20of%20ethics%20english.pdf

Section A: Factors affecting patients

Indicator Group 1 Respecting the needs and rights of patients

Indicator A.1.3 The practice encourages patient suggestions and

feedback into service planning

Criteria A.1.3.1 ¶ The practice encourages patient suggestions and feedback on

services provided

A.1.3.2 ¶ Suggestions, feedback and follow-up changes and improvements

are incorporated in the practice quality improvement process

A.1.3.3 ¶ Information about use of patient suggestions and feedback is

communicated back to the practice team and patients

A.1.3.4 ¶ The practice has carried out a patient satisfaction questionnaire

within the last three years

Section A – Factors affecting patients

Indicator Group 1 – Respecting the needs and rights of patients

Indicator A.1.3

The practice encourages patient suggestions and feedback into service planning

The purpose of this indicator is to create opportunities for patients to provide suggestions and feedback for improving and planning services

Criteria:

A.1.3.1¶The practice encourages patient suggestions and feedback on services

provided

Interpretation

·  Information about encouragement and methods used to invite patient suggestions and feedback on services provided, e.g. suggestion boxes

A.1.3.2¶ Suggestions, feedback, follow-up changes and improvements are

incorporated in the practice quality improvement process

Interpretation

·  The practice documents all suggestions, feedback, follow-up changes and system improvements

A.1.3.3¶Information about use of patient suggestions and feedback is

communicated back to the practice team and patients

Interpretation

·  How patient feedback is communicated back to the practice team is documented