In September 2021, the Ontario Hospital Association (OHA) release the second edition of its Professional Staff Credentialing Toolkit.

There were 8 main updates:

1. Changes to the Public Hospitals Act (“PHA”)
   The toolkit reflects the requirements of section 33 (mandatory reporting of physicians to the CPSO – see pages 43, 84, 95) and section 44 (ceasing to operate or provide services – see page 109).
2. Acknowledgement of comments made by the Auditor General of Ontario in 2016 and 2018.
   The Auditor General of Ontario criticized current appeal processes for credentialing disputes, citing the financial implications on a publicly funded health care system as an impetus for the review of the Public Hospitals Act (see pages 17-18).
3. Acknowledgement of the introduction of the Connecting Care Act, 2019 and the creation of Ontario Health Teams (see pages 9, 11).
4. Inclusion of excerpts from the Health Insurance Reciprocal of Canada (HIROC’s) Risk Reference Sheet. The Inappropriate Credentialing, Re-appointment and Performance Management Risk Reference Sheet is a set of recommendations for credentialing based on commonly occurring claims against hospitals for lapses in the credentialing process (see pages 15-17). It is helpful as a risk prevention and management tool and should be reviewed by hospital leadership.
5. Changes to address the impact of new technology on credentialing, for example: remote consultations such as telehealth and medical assistance in dying (see pages 11-12).
6. Updated case law from cases that have gone before the Ontario Health Professions Appeal and Review Board and courts across Canada (see pages 18, 22, 23, 28-29, 46, 49, 60-61, 98, 114, 119, 142- 145).
7. A summary of advances made with respect to joint credentialing – i.e. when two or more hospitals share credentialed staff (see pages 65-67, 71-72).
8. Integration of the updates made to the OHA/OMA Hospital Prototype Board-Appointed Professional Staff By-Law into the Toolkit.