Annual Report 2015 - Page 38

looking ahead A s a medical regulator, we exist to protect patients from harm. Malcolm Sparrow, author of The Character of Harms and a recognized guru of regulation, describes our central task as identifying the “bads” (risks, threats, hazards, problems or harms) and then controlling them effectively. Focusing on a specific bad thing, says Sparrow, offers regulators the opportunity to think and act like a saboteur: to study the harm’s structure, find a vulnerability of the harm itself, and then devise a tailormade intervention. Key to this success is possessing the agility and flexibility to use the right regulatory tool for the task and acknowledging that different problems require different solutions. Questions about whether a regulator should adopt a harsh or soft approach, whether we should use enforcement or education, or whether 38 we should be reactive or preventive or proactive are all tactical, risk-specific choices, says Sparrow. Determining the right mix of tools for the specific risk is the essence of regulatory craftsmanship. A risk-based approach would change how we measure and report the success of our interventions. A risk mitigation tool would look at the time between when we identified a risk and when it was addressed, as opposed to the duration of time that the matter made its way through the completion of our processes. For example, assume we get information about poor infection control practices in a particular clinic. The risk is mitigated when we get into the office and either stop the doctor from doing the concerning procedure or require him or her to change their practices. This all could happen much earlier than the ultimate resolution of the case. Our performance then becomes focused on risk, rather than case management, with the implicit COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO photo: D.W.Dorken Dr. Rocco Gerace, Registrar