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November 2014
Table of Contents
- Take part in Quality Management Partnership’s Phase 2 Consultations
- A warning about using multi-dose vials
- Where to find a refresher course on infection control
- A must-read for Endoscopy/Colonoscopy Premises
- How to report an Adverse Event to us
- What to do if you plan to make changes to your OHP
- If you need to cancel an Inspection-Assessment
- Tell us what you think!
Take part in Quality Management Partnership’s Phase 2 Consultations
In November and December, we are hosting a consultation process on the proposed provincial quality management programs in colonoscopy, mammography and pathology. Online consultations are launching on November 3rd and will run until December 12, 2014. This is your opportunity to tell us what you think of our proposed recommendations for quality management programs. This consultation is open to everyone and will include a survey for each specialty and a discussion forum where you can share your thoughts with others. To participate, visit: www.cpso.on.ca/QMPconsult.
Why are we consulting with you?
We are accountable to the Ministry of Health and Long-Term Care for designing provincial quality management programs for colonoscopy, mammography and pathology through extensive consultation and meaningful collaboration with clinical experts, system partners and other relevant stakeholders.
Your feedback will help shape the Phase 2 Report we will submit to the Ministry of Health and Long-Term Care in March 2015.
Visit the QMP website for more information.
A warning about using multi-dose vials
In early October, we sent a letter to all OHP Medical Directors regarding recent infection control breaches in OHP clinics. One aspect of the letter centred on the use of multi-dose vials.
Specifically, recently updated guidelines from Public Health Ontario recommend against the use of multi-dose vials. If they are used, the following guidelines apply:
 Never re-enter a vial with a used needle/syringe.- Access all vials using a new sterile syringe, needle/cannula for each access and adhere to aseptic technique.
- Read the product leaflet for recommended duration of use after entry of multi-dose vial.
- Clean the access diaphragm of vials using friction and 70% alcohol. Allow to dry before inserting a needle into the vial.
- Mark the product with the date it was first used, to facilitate discarding at the appropriate time.
- Discard opened multi-dose medication vials according to the manufacturer’s instructions or 28 days after opening, whichever is shorter.
- Use multi-dose medication vials for a single patient whenever possible.
- Never leave a needle in a multi-dose vial.
- Discard medication vials if sterility is questioned or compromised.
Where to find a refresher course on infection control
 Many of you have asked for referrals to certificate courses on sterilization and reprocessing. You can access information on such courses offered throughout Ontario by clicking here and referring to Appendix H. Reprocessing and sterilization courses offered by the manufacturer are not sufficient to meet the education requirements outlined by Public Health Ontario.
A must-read for Endoscopy/Colonoscopy Premises
As of September 2014, we have a new companion document to the OHPIP Standards document: Applying the Out-of-Hospital Premises Inspection Program (OHPIP) Standards in Endoscopy/Colonoscopy Premises and Independent Health Facilities (IHFs). It is on our website and you can read it here.
- This document in no way replaces the core OHP 2013 Standards.
- It is a companion document as only those Standards requiring guidance are included.
- Updates have been made in 2014 to incorporate additional quality standards.
- All existing OHPs and IHFs providing colonoscopy procedures are required to be in compliance with the additional quality standards at the time of their next assessment.
- The standards are not intended to replace a physician's clinical judegement or establish a protocol for all patients with a particular condition.
How to report an Adverse Event to us
 We’d like to remind you that all Tier 1 Adverse Events must be reported to us using the Adverse Events Reporting form. These reports are required within 24 hours of learning of the event. In addition to the report, supporting documentation is also required, including the patient record and anesthesia documentation. Any physician who is made aware of Tier 1 events must complete the reporting form. In many circumstances it will be the physician that performed the procedure or the anesthesiologist working in the OHP. Failure to do so may result in an investigation of the member’s non-compliance with the by-law and may be considered an act of professional misconduct.
Once the form has been completed, it must be faxed to Shandelle Johnson, Manager, Practice Assessment and Enhancement Department at 416-967-2635.
General telephone inquiries about reporting can be made to the OHP program staff at 416-967-2600 ext. 718 or 1-800-268-7096 ext. 718.
What to do if you plan to make changes to your OHP
As you know, your premises is permitted to perform only the procedure(s) that were disclosed to us and approved during your initial inspection-assessment process. Any planned changes to your premises following the initial inspection may result in a follow-up site inspection of the premises. You must wait until you receive approval from us prior to implementing any changes to your premises.
You must complete the Status Report Changing form if you are planning to:
- Add new procedures
- Change your OHP level
- Renovate your premises
- Move to a new location
- Rent space to other physicians
- Cease operations
- Install new equipment
You must provide us with notice of these changes in writing with as many details as possible to help us determine the next steps. The form may be completed online, saved, printed and faxed to: ATTENTION: Out-of-Hospital Premises Inspection Program at 416-967-2605.
You will be billed for subsequent assessments outside of the scheduled cycle of assessment. Premises that require a follow-up assessment will also be invoiced the actual costs paid for the Assessors who complete the additional assessment.
If you need to cancel an Inspection-Assessment
 We understand that unexpected events may necessitate cancelling an inspection-assessment. However, the medical director of a premises that has cancelled an assessment without appropriate notice or has cancelled an assessment multiple times will be charged a fee equivalent to the cost of a half-day assessment, which will include preparation time of the nurse coordinator, proceduralist and anesthetist.
Tell us what you think!
 Please complete this brief survey about your IHF/OHP News experience. We appreciate your time and feedback.
For more information, contact Christine Grusys, Supervisor,
416 967 2600 ext. 261.
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