Council highlights for November 16, 2017
The 414th meeting of the RCDSO Council was held in Toronto on November 16, 2017.
RCDSO President Ron Yarascavitch opened the proceedings. He spoke to recent concerns about infection prevention and control, and noted the efforts the College had made to address the issue in a timely fashion. “Our response to the IPAC crisis has shown our willingness to work with others and to provide leadership,” he told the meeting. “It has shown our commitment to setting high standards that result in the best care. And it has shown our commitment to putting patients first.” Ron stressed that working with other partners and stakeholders was the best way for the College to meet its mandate to put patients first and work in the public interest.
Registrar Irwin Fefergrad addressed some of the changes that may be on the horizon for our College and all healthcare regulators in Ontario. Irwin mentioned changes to the regulatory system in the UK, where there are proposals to substantially reduce the number of regulators by combining them in a small number of groups. The aim is to ensure regulators focus on preventing patient harm. Irwin noted that these moves are drawing attention from around the world. Here in Ontario, the new regulation-making powers of the Minister of Health and LongTerm Care may mean similar approaches are on the way. Council’s special Education Day, on August 8, 2017, looked at the importance of identifying competencies to ensure all committee members are equipped to do the job at hand. One step may be to create eligibility requirements, including training, for all committee posts.
In Council business
- Council accepted the recommendations of the Delegation Ad Hoc Committee; the Committee includes representatives from the RCDSO, the College of Dental Hygienists of Ontario, the Ontario Dental Assistants Association and the Ontario Dental Association, as well as the College of Physicians and Surgeons of Ontario. The Committee was struck to consider whether some controlled acts might be delegated to 3rd parties to promote greater access to care. The Ad Hoc Committee found that educational standards must be in place for delegation to be possible and an appropriate level of supervision is vital to ensure the procedures are performed safely and competently. Council directed staff to prepare a guideline for Council’s consideration consistent with the recommendations of the Delegation Ad Hoc Committee and to draft a proposed regulation amendment to allow for the delegation of some intra-oral procedures related to orthodontics. The Delegation Ad Hoc Committee report will be sent to the Minister of Health and Long-Term Care.
- Council agreed to amend the By-laws to increase the fees payable by dentists who do not pay their annual fee on or before the due date. As a result of this change, the late fee would increase, for the 2019 registration year, from $100 to $500. A proposed bylaw amendment will be drafted and circulated.
- Consistent with the RCDSO Strategic Communications plan, Dispatch magazine will cease print publication with the February 2018 issue. Council accepted that with the clear benefit of distributing timely information to members and the public via the website. Dispatch content will be posted to the website (as now) and dentists and stakeholders notified via email when important new material is available.
- Council approved the Operating and Capital Budget for 2018 as presented. The budget was described as a “good news story”. Management was directed to aim for a balanced budget for 2018 and did so with no increase in fees. The College has moved to a true “business case” model to ensure all our resources are well spent. The meeting also heard about plans for a new “CRM” database that will replace systems at the College that are 20 years old and no longer have technical support available. The new system will mean better service for the public, dentists, government and stakeholders. A dedicated Reserve Fund has been created for this project.
- Two new standing committees were created at the meeting. The Ad Hoc Committee on Labour Mobility will become a permanent standing committee. In addition, Council agreed to create a new Pension Governance Committee.
- The ICR committee held a full day of training on the Protecting Patients Act on October 18 2017. Committee members were provided with an update regarding new interim order powers, investigation and adjudication of allegations of sexual abuse and rules regarding the posting of SCERPS and Cautions on the Register, among other topics. Committee 3 members also heard about updates to the College’s Risk Assessment Framework to include an assessment tool for use by the ICR Committee when considering whether an interim order is appropriate. A copy of the updated Risk Assessment Framework is available on the College’s website.
- The RCDSO’s rules governing Alternative Dispute Resolution have been revised for consistency with the language in the amended Regulated Health Professions Act. The College will also make changes to the Register to reflect legislative amendments.
- As of January 1, 2018, a person alleging sexual abuse by a dentist while a patient will be eligible for funding for therapy or counselling. The funding can be requested at any point after a complaint has been filed or an investigator has been appointed under s.75(1)(a) of the Code. In addition a revised Practice Advisory on the Prevention of Sexual Abuse and Boundary Violations was approved . The revisions address changes to the legislation.
- Council agreed to support the COA/CDA/AMMI Consensus Statement on Patients with Total Joint Replacements having Dental Procedures and directed the College to advise dentists of Council’s position and ask that they review the COA/CDA/AMMI Consensus Statement and implement it in their offices. Details will be published in Dispatch and on the College website.
- The Quality Assurance Committee continues to review progress reports on the Practice Enhancement Tool (PET). In August 2016, the anonymized results of over 5000 dentists who completed the PET were submitted to Dr. Jack Gerrow, Executive Director/Registrar, National Dental Examining Board (NDEB), and Dr. Vicki LeBlanc, Chair and Associate Professor in the Department of Innovation in Medical Education, University of Ottawa, for statistical analysis. At the August 2017 meeting, Dr. Gerrow and Dr. LeBlanc met with the Quality Assurance Committee. Dr. LeBlanc said the PET is achieving its purpose by motivating members to research information related to the questions and interact with their colleagues. Work continues on the development of new questions for the PET at the level of a specialist. Two working groups of specialists have already met to select questions in the areas of oral & maxillofacial surgery and orthodontics.
- The College has data and statistics on outcomes of complaints in the College’s process but there is little analysis on why the public complain about dentists. The Executive Committee authorized the Registrar to engage Dr. Carlos Quinonez, Associate Professor and an epidemiologist at the Faculty of Dentistry, University of Toronto, to do a pilot project on what causes the public to complain about their dentist and what the issues are. Dr. Quinonez and his team will analyze about 100 randomly selected letters of complaint with the names of the dentist and complainant redacted.