Private clinic inspections to be made public
College of Physicians move follows infection scare at Ottawa clinic
Patients will be able to see how private surgical clinics fare in inspections after the College of Physicians and Surgeons of Ontario chose to make the results public on its website.
At a meeting in Toronto, the college’s council decided Thursday to post information on the website that includes the results of inspection findings along with detailed reasons for a failed inspection or any conditions placed on a clinic.
The move is part of an attempt by the college to increase transparency after it received authority about three years ago to conduct inspections of “out-of-hospital premises” where procedures such as cosmetic surgery and endoscopies take place and certain types of anesthesia are used.
“The public is much better protected,” said Dr. Rocco Gerace, the college’s registrar.
“The whole focus of this program has been a success in raising the standards of facilities where these procedures are being done.”
The council’s decision also comes after an infection scare at the private clinic operated by Dr. Christiane Farazli in Ottawa that put a spotlight on the college’s inspections.
Farazli’s clinic on Carling Avenue was ordered to stop performing endoscopies in June 2011 after it failed its first inspection by the college, which regulates the province’s doctors. The inspection determined that equipment used to conduct gastroscopies and colonoscopies was not always appropriately cleaned between tests.
The findings caused a scare for 6,800 of Farazli’s former patients, though the city’s public-health unit didn’t end up finding any link between cases of serious illness and her clinic.
Since 2010, the college has had the authority to inspect Ontario’s 270 private surgical clinics, but reports on the inspections weren’t typically made public.
Farazli’s failed one was reported because the infection-control lapses posed a public-health threat, the college said at the time.
It has been investigating Farazli’s clinic, but Gerace would not comment on that.
Increasing transparency through making results public had been identified as one the college’s “key priorities” for improving the inspection program.
The college has inspected more than 250 clinics, according to a report issued in December. Eleven clinics have failed inspections, while about 64 passed with conditions, and about 178 passed.
Reasons for a fail range from lax infection control to staff not having appropriate qualifications to inadequate physical space at a clinic, the college says.
The decision of a premises inspection committee, based on an inspection — not the findings of the initial inspection itself — is what the website will reflect.
Under the college’s inspection program, if a probe determines the potential for patients to be at risk, the clinic is ordered to stop the relevant procedures immediately, and that’s affirmed by the committee, said Gerace. In cases where “deficiencies” are found but there’s no risk to patients (an emergency exit plan isn’t posted by a door, for example) the clinic is told of the problems and is given time to respond to the college, Gerace said. That also gives the clinic an opportunity to address the problems before the committee meets, Gerace said. If the problems are fixed, the committee might indicate that the clinic has passed.
Asked whether that means the public might not learn that a clinic had initially failed if it managed to fix itself up before the committee met and gave it a pass, Gerace said that would be unlikely. “Generally speaking, the issues associated with a failure are such that they are not fixable in a brief period of time,” he said.
A proposed bylaw required to make the results public was sent to college members for consultation, and only 32 of 236 responses received were opposed to making the results public, states a briefing note to the college council, while 59 were in favour “with conditions” and 145 liked the proposal as it was.
Those against making the information public thought that posting the results would punish medical staff and clinics “and is not consistent with the quality improvement focus” of the inspection program, according to the briefing note.
Many of the responses in favour said transparency is needed “to improve patient confidence in the system and in medical regulation,” the note states.
Under the new rules, the college’s website will include the current status of the clinics. Two of the 11 clinics that failed inspections have since met their conditions, so only nine will be identified as having failed, Gerace said, while 17 more will be shown to have conditions.
It’s hoped that the information will go up on the college’s website at www.cpso.on.ca by Friday evening, Gerace said. The college’s council is to consider how long historical details should remain on the website.