In late July of this year, the inquiry report in response to the Wettlaufer case was made public (Public Inquiry into the Safety and Security of Residents in the Long-Term Care Homes System). The recommendations contained within the report are intended to address the factors that contributed to this tragedy, and although its focus is on long-term care, there are lessons in there for all of us.
One of the report’s key recommendations is for regulatory colleges to ensure members understand their reporting requirements. The CRTO has a Mandatory Reporting by Members Fact Sheet on its website and, for the most part, RTs in Ontario appear to understand what their reporting obligations are regarding themselves (i.e., the requirement to report offenses, finding or professional negligence/misconduct and information regarding professional registration and conduct). But did you know that you are also required to “report to relevant authorities any unsafe practice, unprofessional conduct or incapacity by other healthcare team members”? (CRTO Standards of Practice – STD 13 Professional Responsibilities).
Looking at the above reporting requirement, the first thing we need to consider is the term “relevant authority”. If the healthcare team member is not a regulated healthcare professional (e.g., PSW, PA), then the relevant authority is their employer. However, if the healthcare team member is a regulated healthcare professional, then the relevant authority is their regulatory body (e.g., CRTO, CNO, CPSO, etc.). In the case of a regulated healthcare professional, it may be appropriate to first inform your manager or the manager of the person in question and have them contact the applicable regulatory body. However, you have an obligation to ensure the regulatory body is contacted,and if you have reason to believe that this did not happen, it is incumbent upon you to make the call yourself.
Regarding “unsafe practice, unprofessional conduct or incapacity”, this includes (but is not limited to) such incidences as:
- Sexual, verbal, emotional, psychological financial or physical abuse of a patient, student, other healthcare team member (please note that there are specific reporting requirements pertaining to sexual abuse, which are outlined in the CRTO’s Abuse Awareness & Prevention Professional Practice Guideline);
- Improper, incompetent, unsafe or unethical patient care;
- Unprofessional conduct (e.g., practising outside of one’s scope of practice, practising while impaired by a substance or other condition).
You will note that the above description of what may potentially constitute “unprofessional conduct” does not include “interpersonal conflicts”. From time to time, the CRTO receives complaints from one RT about another RT that they are having an ongoing personal disagreement with. Such challenges are best dealt with within the workplace setting, and should not be reported to the CRTO unless it is impacting (or has the potential to impact) patient care negatively.
RTs who are are employers have additional reporting requirements, which are outlined in the CRTO’s Mandatory Reporting by Employers/Facilities Fact Sheet. These obligations include reporting an RT who has received disciplinary actions, suspensions, or termination. It is important to note that there are substantial financial penalties for an employer who fails to report a healthcare professional to the appropriate regulatory body.
Cases such as the one involving Elizabeth Wettlaufer are, fortunately, quite rare. However, there was a significant number of infraction throughout her career (many of them relatively minor) that, had all been reported to her regulatory body, could have resulted in her license being removed before she had the chance to harm so many innocent people. All of us have a part to play to ensure nothing even remotely like this ever happens again.