Mailing Address
Health Professions Regulatory Advisory Council
55 St. Clair Avenue West
Suite 806 Box 18
Toronto, Ontario, Canada
M4V 2Y7

Telephone and Facsimile
Toll-Free: 1-888-377-7746
Telephone: 416-326-1550.
Fax: 416-326-1549

PATIENT RELATIONS PROGRAMS - AN OVERVIEW

The quality of health care depends on a commitment to continuously improving the  relationships between patients and those who provide their care.

Statutory Background

Each College of a health profession is required by the Health Professions Procedural Code (Sec. 84 (1)) to have a Patient Relations Program, which is defined in the Code as "a program to enhance relations between members and patients" (Sec. 1 (1)). Colleges are also required to have a Patient Relations Committee (Sec. 10 (1)). Under Sec. 11(2) of the Regulated Health Professions Act, the Health Professions Regulatory Advisory Council has the responsibility to monitor the Colleges' Patient Relations Programs, and to advise the Minister of Health and Long-Term Care about their effectiveness.

Accordingly, Colleges have the obligation to establish strategic goals, standards and directions to ensure a strong patient relations focus.  They are also expected to understand the impact of their activities and to develop and share their best practices.

Variations Among Professions and Colleges

There are important differences among the various health professional Colleges, in terms of size and resources, as well as scopes of practice and controlled acts.  There may also be differences in such abstract matters as culture and tradition. Professionals from some Colleges have vastly more contact with the public than others. In some cases there is little or no direct contact between the professional and the patient; in others, the relationship varies with where and how the professional service is provided.

Nonetheless, there are important similarities in Colleges' ultimate goals and in their functions.  Most important, as set out in Sec. 3(2) of the Code, each College has a duty to serve and protect the public interest. Moreover, under Sec. 3(1)6 of the Code, one of the objects of each College is to develop programs to assist individuals to exercise their rights under the Act and the Code. For these reasons, there are important common elements to Patient Relations Programs.

Goals of a Patient Relations Program

 The goals of the College's Patient Relations Program are:

• to help the health professionals regulated by the College enhance relations with their patients or clients, and by extension, the public;
• to help the public achieve greater understanding of the range and quality of the professional services offered by members of the College;
• to help patients or clients be fully informed of their rights in dealing with members of the profession and the College, including that they will be treated in an ethical, competent, sensitive and respectful manner; 
• to help the public have a greater knowledge of the role of the regulatory College and how to participate in College processes and/or programs.

Implementation of the Patient Relations Program

Each College manages its operational programs in a manner that best responds to the structure and resources of that College, and to the characteristics and requirements of the profession. There is no uniform model to meet the goals of a patient relations program that will be appropriate to all Colleges. Each College will, therefore, carefully determine the administrative structures or operating systems that will be utilized or put into place to respond to the College's patient relations strategic plan. As an essential part of the plan, each College will adopt appropriate mechanisms to monitor, measure, and report on the impact of its program or elements of the program. 

Tactical Approaches

Various mechanisms can be used to ensure that a Patient Relations Program is sound and leads to greater public and member awareness.  Communications techniques might include written materials, website postings, advertising, and public affairs announcements. Process improvements might rely on data collection (for example, relating to complaints), trend analysis, early identification of systemic issues, and monitoring to ensure more efficient human resource allocation.  Quality improvements might require educational programs for staff and members. The determination of the tactical approach will be directly related to the element of the program that is being introduced or expanded. In some cases, tactical choices are prescribed by legislation (e.g. posting of the register on the website under sec. 23 (5) of the Code).

Performance Monitoring, Evaluation and Reporting

It is a truism to say that a program that is not evaluated can't be improved.   Evaluation can take many forms, including quality reviews, performance measurement against targets and benchmarks, internal activity and outcome assessments.  Evaluation of a Patient Relations Program may incorporate a number of measurement tools: e.g. assessing the timeframe to resolve complaints will require different measures than completing an exit survey on patient satisfaction with the complaints process, or measuring awareness of the public register. Additionally, evaluation can lead to decisions about where the tactical elements of a program are not leading to enhanced quality or performance, and need to be replaced with another approach to meet the same goal.

A pre-determined plan for information flow in the monitoring and evaluation program is essential.  The Council of a College must receive regular reports on what works and where enhancements are needed.  Colleges are required to make reports to the Minister on various aspects of their operations, including some matters in the patient relations portfolio.  Colleges are also required, under sec. 84(4) of the Code, to provide HPRAC with regular reports on the progress and effectiveness of their Patient Relations Programs. 

Quality improvement requires evidence and information to lead to the adoption of best practices. The sharing of information between and among Colleges following program  evaluation can also lead to improvement across the health regulatory regime and to best practices that may be emulated.  

Peer Resources

In addition to internal evaluations within each College and monitoring by HPRAC, there is considerable enthusiasm among Colleges for the creation of a specialty, multidisciplinary resource team which could assist with evaluation and share expertise, both with Colleges and with HPRAC. HPRAC will pursue this concept and will advise how best this can be achieved.