Modernization of Out-of-Hospital Premises Inspection Program

Physicians having a conversation while walking

Consultation feedback reflected in new standards

Following extensive consultation, Council approved a redesigned and revised set of new Standards for Out-of-Hospital Premises (OHPs).

The new Standards are part of a larger effort to re-evaluate CPSO’s Out-of-Hospital Premises Inspection Program (OHPIP) with the intent to modernize and align the program with a right-touch regulation approach, and ensure the public interest is being effectively served.

The OHPIP enforces Standards which outline the core requirements that must be met when performing specific procedures in OHPs. These Standards include details about the inspection regime and set out specific standards in relation to, for example, infection-prevention and control, quality assurance, and physical infrastructure.

Generally, the draft Standards met with broad support and approval on a number of different fronts. Respondents were in favour of the clearer and more concise format of the standards. Instead of a single, long, dense, detailed document, the Standards are now a set of 10 separate, succinct, standalone documents that more clearly convey the expectations of OHPs and the members who work within them.

The Standards also adopted a more principle-based approach with a less prescriptive tone.

“Rather than being overly prescriptive when it comes to clinical care, we want to support physicians in using their professional judgment and point to existing guidelines for clinical practice where possible,” said Ms. Laurie Reid, Director of Investigations and Accreditations at CPSO.

Changes to the Medical Director Standard were generally met with approval from respondents. The standards elevate and leverage the role of the Medical Director by more clearly articulating existing requirements and adding new requirements relating to both eligibility and responsibility. Many described the changes as reasonable and clear.

“Given that Medical Directors are responsible for overseeing OHPs and have such an important role, we wanted to emphasize the Medical Directors’ accountability for the care provided within the OHP,” said Ms. Reid.

Some of the key changes that have been made to the Standards include:

  • A Program Overview document has been created to outline key elements of the Program, including the scope of the Program and example of procedures that are and are not captured.
  • New requirements for the Medical Director, including for credentialing and overseeing staff.
  • A move away from a required list of drugs and equipment, instead outlining conditions and situations that need to be able to be appropriately managed.
  • A new Patient Selection Standard to guide physicians in making appropriate determinations about which patients can undergo procedures in OHPs.
  • A more robust quality assurance framework, with increased focus on appropriately managing, and learning from adverse events.