Health Quality Council of Alberta releases terms of reference for an independent review of the quality of care and safety of patients requiring access to emergency department care and cancer surgery and the role and process of physician advocacy

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CALGARY, March 17 /PRNewswire/ - The Health Quality Council of Alberta (HQCA) today released the terms of reference for an independent review of the quality of care and safety of patients requiring access to emergency department care and cancer surgery and the role and process of physician advocacy. The purpose of the review is to identify and analyze issues related to these two important services and make recommendations to improve system performance. The independent review will be provincial in scope and will be conducted under Section 9 of the Alberta Evidence Act to maintain evidentiary privilege over the provision of documents and evidence of participants. Alberta Health and Wellness Minister Gene Zwozdesky requested the review under Section 13 of the Health Quality Council of Alberta Regulation.

In making the terms of reference public, HQCA Chief Executive Officer Dr. John Cowell noted that while the HQCA has conducted many reviews in the past, this review is unprecedented in that it is the first time the organization has initiated its own terms of reference. "We are committed to transparency throughout the review process and Minister Zwozdesky supports this transparency," says Cowell. "That is why the terms of reference are being made public now and the findings and recommendations will be made public once the report is complete."

According to HQCA Council Chair Dr. Lorne Tyrrell, Minister Zwozdesky has directed the HQCA to establish its own processes and procedures for the review, including the selection of individuals that may be needed to assist throughout the process. "There will be a panel of experts appointed to assist and advise the HQCA Council in this review," says Tyrrell.

"Our goal in conducting this and any other review is not to lay blame on any one individual or organization but to look at system-wide issues and opportunities for improvement," adds Dr. Cowell. A full report of the findings and recommendations will be made public within nine months. Progress reports will be publicly released three and six months into the review.

As an independent organization legislated under the Regional Health Authorities Act, the Health Quality Council of Alberta gathers and analyzes information and collaborates with Alberta Health and Wellness, Alberta Health Services, health professions and other stakeholders to translate that knowledge into practical improvements to health service quality and patient safety in the health care system.

The terms of reference are attached and are available at www.hqca.ca.

Review of the Quality of Care and Safety of Patients Requiring Access to Emergency Department Care and Cancer Surgery and the Role and Process of Physician Advocacy

Objectives and Scope

Pursuant to section 13 of the Health Quality Council of Alberta Regulation 130/2006 (the "Regulation"), the Health Quality Council of Alberta ("HQCA") will, through a quality assurance committee, conduct a full and thorough review of:

Part A: Quality of Care and Safety of Patients requiring Emergency Department Care and Cancer Surgery

1. To determine whether the quality of care provided to and the safety of:
   
   a. a group of 321 patients that accessed emergency department services at the University of Alberta Hospital (UAH) during 2008, and
   
   b. a group of 9 patients that accessed emergency department services at the UAH during 2010
   
   was significantly compromised due to extended lengths of stays awaiting diagnosis and treatment in the emergency department. These cases were identified publicly on October 22, 2010. The cases had been collected by the emergency department physicians serving in the role of triage physicians at the UAH.
   
   
2. To determine whether the quality of care and the safety of a group of 250 cancer patients on a surgical wait list of 1,200 from 2003 to 2006, were seriously compromised due to delayed access to surgery as alleged in a document tabled in the Alberta Legislature on February 28, 2011.
   
   
3. Based on the findings and analysis of the investigation and an analysis of current practices, make recommendations for system-level improvements in access and wait times for emergency department care and cancer treatment.

Part B: Role and Process of Physician Advocacy in Patient Safety and Health Service Quality

1. To investigate the role and ability of physicians to advocate for patients whose quality of care and safety the physicians believe is or could be compromised due to system resources or policies.
   
   
2. Based on the findings and analysis of the investigation and an analysis of current practices, make recommendations for system-level improvements in the policies and practices relating to physician advocacy intended to serve the best interests of patients.

The Council has established a quality assurance committee under section 10(2) of the Regulation for the purpose of conducting the planned and systematic study, assessment and evaluation of the matters set out above.  The quality assurance committee must conduct the review as a quality assurance activity under section 9 of the Alberta Evidence Act.  A team of health professionals and system review experts who have no known association with the specific matters under review will be appointed to the quality assurance committee.

A panel of experts will be appointed to assist and advise the Council in this review.

Under section 10 of the Regulation the HQCA has access to information held by health authorities for the purpose of carrying out its objects.  The HQCA, which is a custodian of health information, can support the quality assurance committee's work by providing necessary health information to the Committee in accordance with section 35 of the Health Information Act. 

Deliverables and Timeline

John W. F. Cowell M.Sc, MD, CCFP, FRCP, the CEO of the HQCA is the review sponsor.

A full report of the findings and recommendations will be made public as soon as is feasible but is expected to be released within 9 months.   A progress report will be released publicly at 3 months and 6 months.

Approved by the Council of the Health Quality Council of Alberta

[Original signed by D. Lorne J. Tyrrell]
___________________________________________  March 17, 2011
D. Lorne J. Tyrrell, OC, AOE, MD/PhD, FRCP    
Chair

SOURCE Health Quality Council of Alberta