Professionalism

Incident Processing

Process for the Triaging of an Incident Report

When a concern of lapse in professional behaviour or student mistreatment is made through the Professionalism Button, a number of steps are taken.

1. The triage officer on duty sends an initial contact email to the creator of the report. This is generally done within three business days of the concern being received.
2. If the matter is felt to be urgent (e.g. patient or learner safety is imminently at risk), then the officer contacts the Chair of the Committee, immediately, to discuss expeditious management.
3. If the matter does not require immediate action, then the triage officer offers to meet with the creator of the report, in order to gain further understanding into their perspective of the situation, and their goals in reporting this incident.
4. The triage officer and the Professionalism Triage Committee do NOT investigate the matter at hand (ie they do NOT meet with the individual named in the incident report). This is regarded to be the purview of the appropriate, designated administrative lead.
5. The triage officer will make a recommendation regarding level of escalation for the incident, based on their assessment of the details. This will be presented for approval to either the Chair of the Committee (for straightforward cases), or the Professionalism Triage Committee (for more complex situations).
6. The Chair or the Professionalism Triage Committee will decide to agree or disagree with the recommended level of escalation.
7. In the case of consultation between the triage officer and the Chair of the Committee, if the Chair disagrees with the recommendation, the Professionalism Triage Committee will be consulted.
8. In the case of Professionalism Triage Committee consultation, if the level of escalation is not unanimous, a majority decision will be upheld. Decision-making will be by open vote rather than secret ballot.
9. If the Chair is performing triage duty, then she/he will consult with the Professionalism Triage Committee prior to finalizing the level of escalation.
10. Once the level of escalation is determined, the Triage officer and the Chair of the Professionalism Triage Committee will jointly create and send a confidential letter to the identified administrator.
11. The Chair of the Professionalism Triage Committee will follow up with the identified administrator every 4weeks, until there is a mutually agreed upon resolution and action. The outcome is then summarized and sent to the Assistant Dean, Professionalism.
12. If no response is received after 3 months of the initial letter being sent, the Assistant Dean, Professionalism will be notified of the lack of response, and will follow up with the concerned administrator. The Vice Dean, Faculty Affairs, may be involved at this time, at the discretion of the Assistant Dean, Professionalism.
13. Upon resolution of the case and receipt of a summary of outcome, the Professionalism Triage Committee will review the case, and close the incident report, if the majority of the committee feels that it has been adequately addressed.
14. Records of incidents are retained in the same fashion, and for the same time period, as for all Human Resource records at the University of Alberta.

The table below represents examples of assignment of escalation, only. Individualized decisions are made on a case-by-case basis by the Triage Officer and the Professionalism Triage Committee. Levels of escalation and response reflect the recommendations of the Health Quality Council of Alberta.

Level 1: A letter would be sent to one of the following appropriate, immediate administrative leads, based on the individual’s role within the Faculty of Medicine & Dentistry. [e.g. divisional director (Academic Faculty), site lead for a division (Clinical Faculty), Director of Professionalism, UME (UME student), Program Director (post-graduate trainee)]

Level 2: A letter would be sent to one of the following appropriate, senior administrative leads, based on the individual’s role within the Faculty of Medicine & Dentistry. [e.g. Department Chair (Academic and Clinical Faculty), AHS Site Lead (Nursing Colleague), Associate Dean, UME (UME student), Associate Dean, PGME (post-graduate trainee)]

Level 3: Individual cases where
a) recurrent incidents continue to occur, after Level 2 administrative involvement, or
b) an individual is not cooperative with required remediation, or
c) at the recommendation of the Professionalism Triage Committee,
then involvement of the Vice Dean, Faculty Affairs and/or the College of Physicians & Surgeons may be employed to help address the concerns.

Level 4: If there is felt to be a threat
a) to the safety of patients and/or staff,
b) of criminally liable behavior, or
c) to the safety of self or others,
then immediate involvement of the Vice Dean, Faculty Affairs and/or the College of Physicians & Surgeons can be employed.

References