Overview

Colleges are required to develop and maintain practice expectations for registrants. This enables the public and patients to be aware of what behaviours they should expect when receiving high quality care from a regulated health professional. In order to keep expectations current and up-to-date, colleges must have a process in place to identify when standards of practice, policies or guidelines need to be updated or when new guidance is required. When updating expectations, colleges should consider relevant evidence, changing public expectations, risks to the public, and alignment with other relevant health professions. This process should include consideration of feedback from relevant stakeholders, including patients and their families.

Collective strengths

All colleges reported that they regularly monitor the broader health and regulatory environment to assess the need to develop or revise their policies, standards of practice, and practice guidelines. Additionally, the majority of colleges reported using a variety of sources of evidence to inform the development and revision of practice guidance.

The working group identified the principle-based policy development process by the College of Midwives of Ontario (CMO) as a notable practice. The CMO uses a rigorous and structured process for the development and revision of guidance that is based on the principles of good regulation. This ensures that:

  1. regulation is proportionate to the risk of harm being managed
  2. regulation is evidence-based and reflects current best practice
  3. regular and purposeful engagement is undertaken with partner organizations, midwives, and the public throughout the policy making process

The process is intended to encourage use of regulatory tools to mitigate risk only when other non-regulatory options are not able to produce the desired results.

System improvement

All colleges reported that they have processes to develop or update guidance that they provide registrants. In some instances, these processes were formal, whereas in others they were informal. There is opportunity to improve transparency across all colleges by formalizing policies and processes for the review and development of guidance.

There was variability in the process used by colleges to identify the need to revise or develop guidance. Colleges are encouraged to implement a variety of methods, in addition to a regular review cycle, to monitor whether revisions or new guidance is necessary. This would help colleges to provide their registrants with timely, up-to-date and relevant guidance.

Improvement commitments by colleges

Colleges made commitments to improve in the following areas:

  • formalizing policies and processes for policy, standard and guideline review and development, where processes are currently informal
  • incorporation of a risk assessment in the development of standards, guidelines and policies
  • updating review processes to enable timely review of all standards, guidelines and policies to ensure relevancy to current and evolving professional practice, as well as changing public expectations