My Role in the Canadian Healthcare System

Nursing practice in Ontario is legislated under two provincial acts. The Nursing Act, 1991 and the Regulated Health Professions Act, 1991. The Regulated Health Professions Act (RHPA) serves and protects the public by providing a framework outlining what a professions scope of practice entails, defines controlled acts, regulates how a College governs its members, and provides an appeal and review board that reviews complaints and decisions made by a regulatory College (OMHLTC, 2016). The Nursing Act (1991) defines controlled acts that are delegated to nurses in the province and regulations that are specific to nurses (CNO, 2016). It also outlines the different classes of practicing nurses and defines regulations to the use of controlled acts (CNO, 2016). Together these to regulatory acts define the ways in which nurses may practice in Ontario, creates the framework for establishing a self-regulating nursing college and protects the public safety by ensuring nurses providing their health care are adequately trained and monitored.

As a registered nurse in Ontario I am governed directly by the College of Nurses of Ontario (CNO). The CNO is the governing body for RN’s, RPN’s, and NP’s in Ontario (CNO, 2017). The College is a self-regulating body that establishes and enforces practice competencies, participates in the legislative process and administers a process for quality assurance of nursing practice in the province of Ontario (CNO, 2017). The College allows nurses to be a self-regulating body that defines entry level practice skills for nursing, reviews ongoing nurse competency and protects the public through judicious review of nurses practice and client complaints.

Healthcare Funding in Ontario

Regionally healthcare in Ontario is managed by Local Health Integration Networks since enacting the Local Health System Integration Act 2006 . In my region this is the Waterloo-Wellington LHIN. The WWLHIN began managing the healthcare needs of those in our region in 2007, their responsibility is managing the integrated health system with the goal of improving the quality and availability of local healthcare (LHIN, 2014). The LHIN connect local health services including hospitals, homecare, public health and primary care for clients and hold providers accountable for providing quality and fiscal responsibility (LHIN, 2014). The LHIN also collaborates with key community stakeholders to identify how healthcare dollars are spent within the community and are then responsible for reporting spending and efficiency back to the province (LHIN, 2014).

In my current role as a Resource RN in the emergency department, I am aware everyday of our responsibility to report our efficiency to the WWLHIN. An example is in tracking the time that ambulances are delayed in our hospital while waiting to transfer patients. Standard targets are set provincially and we are required to record the time paramedics spend transferring care of patients, report that data back to the WWLHIN and a portion of our funding is determined by these results. These types of data are reviewed with us at monthly meetings so we can see where we can improve in terms of ambulance offload delay times, target times to see physicians and length of time until discharge in the emergency department.

Reference

College of Nurses of Ontario. (2017). About the College of Nurses of Ontario. Retrieved from

http://www.cno.org/en/what-is-cno/

Local Health Integration Network. (2014). Your Local Health Integration Network. Retrieved May 15, 2018 from http://www.waterloowellingtonlhin.on.ca/aboutus.aspx

Ontario Ministry of Health and Long-term Care. (2016). Health Workforce Planning and

Regulatory Affairs Division. Retrieved May 15, 2018 from

http://www.health.gov.on.ca/en/pro/programs/hhrsd/about/rhpa.aspx