Ontario changing how hospitals investigate critical incidents

The fact that the provincial government is changing a controversial law allowing Ontario hospitals to investigate medical errors in secrecy means that health care organizations should review the legislation to ensure they are using it properly in the interim, says Toronto health lawyer Elyse Sunshine.

“They should begin to try to understand the concerns that have been expressed to date about the Quality of Care Information Protection Act (QCIPA) and the recommendations that have been made to change the legislation. Hospitals need to look at how they’ve been using the act," she tells

Once amended, the legislation will no longer permit hospitals to leave families in the dark about what happened to their loved ones, Health and Long Term Care Minister Dr. Eric Hoskins told the Toronto Star.

The province has announced changes to QCIPA after a series of Star investigations into hospital secrecy under the legislation. The health minister called together an expert panel to review the act last summer; that panel brought forward several problems with the system and called for legislative change, says the newspaper.

The minister says in the article that the government will be implementing all of the panel’s 12 recommendations.

It means that families will become more involved in the review of medical errors and that those families will have the right to call for an independent investigation into a medical mistake; the province will also create a public registry of all critical-care incidents that occur in Ontario hospitals, says The Star.

Sunshine, partner with Rosen Sunshine LLP, notes that QCIPA was enacted as a patient-focused legislation in 2004 to encourage health professionals to share information about medical errors without fear of reprisal in order to improve the quality of care patients receive in public hospitals and other similar types of organizations.

Despite this intended purpose, the perception by patients and their families seems to be completely the opposite about a decade later.

“I think this was challenging legislation as is reflected by the fact that there appears to be no consistency in how it is actually being used," says Sunshine. “It wasn’t meant to be a shield from prosecution or lawsuits but I gather that either some hospitals have been using it that way or it has been interpreted by the public that it's being used that way.”

In fact, the health minister says in The Star article that he was seriously concerned about the major differences from hospital to hospital in how they were using the legislation – some were using it after every critical incident and others never invoking it.

He was also shocked about how the patients saw QCIPA – that hospitals weren’t being transparent and that they felt hospitals were intentionally leaving them out of the review process.

There is a need to be “open and honest and human about admitting when mistakes happen, and they do,” Hoskins says in the newspaper.

Sunshine says the legislation as it’s written is difficult in its practice and she suspects that some hospitals will find it even more challenging with the changes that are coming.

She says the purpose of the legislation, in essence, is to give hospitals the opportunity to investigate critical incidents and ascertain whether there is something that can be done differently to prevent or minimize the risk of a critical incident occurring.

Sunshine says the changes that are coming to QCIPA are really just a reflection of a move toward more transparency on the part of health professionals in general and the regulatory environment in which they practise.

“I think it is simply another layer of that,” she says.

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