Clinical Risk, Negligence and Claims Management in Healthcare

Patient Safety and Risk Management
• Overview of key patient safety concepts
• Effective error reduction strategies; challenges and best practices for improving patient safety
• The link/association between patient safety, adverse events, incident reports and claims: the role of the risk manager in patient safety
• Post‑incident investigations and reviews: overview of best practices
• Understanding the importance and role of quality reviews
• The legal and regulatory context including adverse events and apologies

The Role of the Coroner in Enhancing Public and Patient Safety

Instructors:

• Lori Borovoy, Bsc.OT Reg. (Ont), MSc., Senior Healthcare Risk Management Specialist, Healthcare Insurance Reciprocal of Canada (HIROC)
• Keegan Boyd, Borden Ladner Gervais LLP
• Dr. Trey Coffey, FAAP, FRCP(C), Staff Paediatrician and Medical Safety Officer, SickKids and Associate Clinical Director, Solutions for Patient Safety
• Dr. Dirk Huyer, Chief Coroner for Ontario, Office of the Chief Coroner
  Brent F. Windwick, QC, Chair, Health Quality Council of Alberta

Understanding and Responding to Categories of Risk

An Overview of Medical‑Legal Claims in Canada and Promoting Quality Improvement

Clinical Decision Making in Medicine

Best Practices for Reducing and Managing Risk in the Following Areas:
• Emergency
• Medical treatment/monitoring
• Diagnosis
• Surgery
• Intensive Care
• Mental Health
• Suicide Risk
• Social Media
• Anesthesia

Understanding and Managing the Risky Nature of Critical Care Medicine

Instructors:

• Dr. Stephen Brown, BSc, MD, FRCPC, Staff Anesthesiologist – William Osler Health System
• Dr. Peter I. Collins, CD, MD, MCA, FRCP(C), Forensic Psychiatrist, Complex Mental Illness Program, CAMH, Operational Forensic Psychiatrist, Criminal Behaviour Analysis Unit, Ontario Provincial Police and Associate Professor, Division of Forensic Psychiatry, University of Toronto
• Dr. Pat Croskerry, Continuing Professional Development and Medical Education, Faculty of Medicine, Dalhousie University
• Dr. Laura Hawryluck, MSc, MD, FRCPC, Associate Professor, Critical Care Medicine; Physician Lead, Critical Care Rapid Response Team, Toronto Western Hospital; Corporate Chair, Acute Resuscitation Committee, University Health Network; University of Toronto
• Michelle Thomarat, Cavalluzzo LLP
• Sarah Virani, Senior Counsel, Kate Dewhirst Health Law

Clinical Negligence, Liability Claims and Litigation

Risk Management Issues with Health Records, Privacy and New Health Information Technology

The Rise of Human Rights Code Claims and Their Implications for Healthcare Administrators
• Tests for clinical negligence – duty of care,breach of the duty of care, causation and damages

Overview of a Medical Malpractice/Liability Claim
• Content
• Limitation periods

Overview of the Litigation Process
• Roles of claims examiners, adjustors, risk managers, defendants (named and not known), and expert witnesses
• Steps involved – statement of claim; accepting service; notifying insurer; statement of defence; investigation; oral and documentary discoveries; trial
• Role played by contingency fees
• Settlement decisions; assessing damages; actuarial assessments
• Total costs including legal fees, awards and settlements

Defence Best Practices/Mitigation Strategies
• The importance of consent
• The importance of documentation:
the health record
• Preservation of evidence
• Insurance (healthcare organization and staff, physicians)
• Learning from past claims, audits, self‑assessments, inspections

Instructors:

• Kate Dewhirst, Kate Dewhirst Health Law
• Michael B. Fraleigh, Fogler, Rubinoff LLP
• J. Mark Jackson, QC, Field Law
• Risa Kirshblum, Lenczner Slaght Royce Smith Griffin LLP
• Stephanie Young, Borden Ladner Gervais LLP

Lessons Learned from the Pandemic: Legal Risk Management and Planning for the next Public Health Crisis
• What is the role and perspective of public health?
• What are the most pressing challenges?
• Working with different stakeholders
• Communication with the public in this ever‑changing environment
• Risks of triage: do you know enough to mitigate risks?
• Has The Fixing Long-Term Care Act, 2021 and its Regulation better equipped the LTC sector for a pandemic?
• Pandemic impact on mental health
• Effect on marginalized communities
• The crisis affecting healthcare workers

Instructors:

• Lisa Corrente, Torkin Manes LLP
• Tracey DasGupta, Director of Interprofessional Practice, Sunnybrook Health Sciences Centre
• Dr. Laura Hawryluck, MSc, MD, FRCPC, Associate Professor, Critical Care Medicine; Physician Lead, Critical Care Rapid Response Team, Toronto Western Hospital; Corporate Chair, Acute Resuscitation Committee, University Health Network; University of Toronto
• Ru Taggar, Executive Vice President, Chief Nursing and Health Professions Executive, Sunnybrook Health Sciences Centre

Understanding and Dealing with the Litigation Process

Morning Session
It is very likely that healthcare professionals will, at one time in their career, be sued or be involved in the legal process as a witness when their organization and/or one of their colleagues find themselves involved in a lawsuit. Hear first hand the Judicial perspective of these claims. Then, using a case study, this interactive session is designed to give you practical insights into the litigation process and highlight the issues that come into play.

Live Demonstrations
• Examination and cross‑examination of an expert witness
• Examination and cross‑examination of a defendant doctor
• Examination and cross‑examination of a defendant nurse

Afternoon Session

Individual, Team and Organizational Strategies for Managing the Stress of Litigation
There is no doubt that working under the cloud of litigation causes significant individual, team and organizational stress. In this interactive session, participants and faculty will discuss how they manage to deal with the pressure of risk and litigation and still function effectively. Individual and team strategies will be discussed.

Instructors:

• Nina Bombier, Lenczner Slaght Royce Smith Griffin LLP
• Kate Cahill, Thomson, Rogers
• Dr. David A. Cameron, MD, LLB, CCFP, Regional Supervising Coroner, Office of the Chief Coroner
• Michael B. Fraleigh, Fogler, Rubinoff LLP
• Anna L. Marrison, Borden Ladner Gervais LLP
• The Hon. Justice Michael McKelvey, Ontario Superior Court of Justice
• Jon S. Novick, MDCM FRCPC MRO, Medical Director, Physician Health Program, Ontario Medical Association
• The Hon. Justice Darla A. Wilson, Ontario Superior Court of Justice

NOTE: There will be a multiple‑choice exam circulated following Day 5. Students must attend all 5 days (live or watch via archive) and achieve an 80% pass rate on the exam in order to receive the Osgoode Certificate in Clinical Risk, Negligence and Claims Management in Healthcare.