CLEAR Annual Conference

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• CLEAR Annual Conference
• Las Vegas, NV Sept. 2002
• Ensuring Quality Practice with
• Public Participation
• Presented by
• Carolyn A. Hubble
• College of Occupational Therapists of Ontario

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Health Care RegulationOntario, Canada

• Regulated Health Professions Act (RHPA)

• Health Professional Colleges
• Occupational Therapy Act
• Quality Assurance Programs legislated

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College of Occupational Therapists of Ontario

• Public protection mandate

• Regulates use of title and practice of OT
• Sets entry to practice requirements
• Establishes and monitors standards of practice
  for about 3600 registrants
• Manages public concerns and complaints

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Quality Assurance Program

• Multi - component program

• Promotes continuing competence
• Monitors continuing competence

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Structure of Program

• Competency Enhancement
• Competency Review and Evaluation
• Competency Improvement

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Competency Review

• Screens for continuing competence

• OTs randomly selected to participate
• Input from clients and colleagues
• OT also sends information

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Practice Feedback Surveys

• Registrant identifies clients and colleagues to
  provide feedback
• College sends and receives confidential surveys

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Who is surveyed?

• Six recently discharged or current clients
• Family members/care givers may assist
• Four colleagues (OTs or others)

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Survey Content

• Survey Items are statements of behaviour.
• that could be observed during professional
  interactions
• that demonstrate competence as described in the
  standards

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Sample Statements (Clients)

• The OT explained things in a way I could
  understand.
• The OT respected my privacy.
• The OT helped me set reasonable and clear goals.
• The OT followed through with plans.

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Sample Statements (Colleagues)

• The OT keeps current in his/her knowledge and
  skills relevant to his/her scope of practice
• The OT ensures the safety of clients
• The OT complies with relevant record keeping
  policies and guidelines

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Rating Scale

• Response scale of 1 to 6
• Individual rates consistency and appropriateness
  of the OTs behaviour
• DO NOT KNOW or NOT APPLICABLE Response Options

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How Results are Used

• Scores are calculated
• Experienced occupational therapists recommend the
  minimum score
• Scores below the cut-off are reviewed by Quality
  Assurance Committee

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What happens next?

• Therapist receives feedback
• Concerns trigger detailed Evaluation of the OTs
  practice

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Overall Results to Date

• 115 OTs have participated in a Review
• 921 surveys distributed
• 827 surveys returned
• Overall response rate of 89
• 3 OTs referred for further evaluation

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Benefits

• Clients are significant stakeholders
• Clients and colleagues see performance in real
  practice context
• Information based on many professional
  interactions

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Limitations

• Registrant selects respondents
• Survey scores high and lack variability overall
• BUT. more variable ratings are seen for some
  questions

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Application

• Reviews usual pattern of an OTs behaviour in
  practice
• Suitable for low stakes review of competence
• Provides feedback helpful for QA purposes

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Next Steps

• Implement process with 5 of OTs in 2002
  (2000 surveys)
• Ongoing survey development
• Evaluate effectiveness of process as a screening
  tool

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Questions
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Carolyn Hubble, B.SC. (OT), OT Reg.
(Ont.) College of Occupational Therapists of
Ontario Telephone [phone] extension
227 Fax [phone] Email
chubble_at_coto.org Website www.coto.org
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• Document 31261