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Concerns About OTs: How the College Makes Decisions

You have the right to receive safe, ethical, quality care from an occupational therapist (OT). If that doesn’t happen, you have another right – to complain to the College.

Complaints are addressed by the complaints committee that is officially known as the Inquiries, Complaints and Reports Committee (ICRC).

Learn about how they make their decisions about an occupational therapist’s conduct or practice below.

Download this information in French or English.


Who can complain?

Anyone can make a complaint. That includes patients, clients, their family members, caregivers, colleagues of an occupational therapist, an employer and others.

If there is a concern about an occupational therapist, contact us:

Phone: 1-800-890-6570
Email: investigations@coto.org.

When investigating and reviewing concerns about occupational therapists, the complaints committee looks at the nature of the issue and the possibility of harm to the client or patient.


How does the complaints committee make decisions to protect clients and patients from harm?

The complaints committee uses a risk assessment framework. A framework is a system for evaluating the risk posed by an occupational therapist to:

  • the public
  • client care or safety
  • the reputation of the occupational therapy profession.

All complaints are taken seriously and investigated.

Using a framework helps make sure decisions are consistent. Sometimes, a decision will be made that will not satisfy the person who complained. We understand the process can be frustrating.

Note: The complaints committee uses this risk framework when appropriate. An occupational therapist might have a mental or physical condition or disorder that interferes with their ability to practise as expected. That’s called “incapacity”. Such issues are assessed differently.


Meter labelled 'risk' with increasing levels of risk: none, low, moderate, and high

What factors does the complaints committee consider when making decisions about risk?

Each case is different. The complaints committee considers all information when deciding what to do about an occupational therapist’s conduct or practice.


As part of its duty to protect the public, the complaints committee considers a series of questions, such as:

  • Do the concerns pose a direct risk to client care or safety?
  • Has the occupational therapist (OT) been honest about the situation?
  • Has the OT gained financially from the situation under investigation?
  • Is this situation likely to happen again?
  • Is there evidence supporting the concerns?
  • Does the OT understand how the client is affected?
  • Does the OT understand how their colleagues, employers and others are affected?
  • Does the OT understand they have failed to meet College standards and expectations?
  • Does the OT understand why the concerns are under investigation?
  • Has the OT volunteered to take steps to make the situation better?
  • Has the OT cooperated with the investigation?
  • How long has the OT been practising?
  • Does the OT regret what happened?
  • Does the OT have a history of complaints or concerns on file with the College?

Together, the answers can help establish risk levels, from 'none' to 'high'.

This information will help the complaints committee make its decision.

If the level of risk is low to moderate, decisions are intended to be educational and corrective.

If the level of risk is high, decisions are more serious.


What are the decisions when there is no risk to the public?


Meter labeled 'risk' with needle pointing at 'no risk'

Take No Action

  • The complaints committee might decide the concerns don’t pose a risk to the public, or that there’s no evidence to support the concerns. So the decision may be to take no action.

What are the decisions when the risk to the public is low?


Meter labelled 'risk' with needle pointing at 'low risk'

Advice/Guidance

  • The complaints committee suggests how the occupational therapist can avoid similar issues in the future.

What are the decisions when the risk to the public is moderate?


Undertaking

Meter labeled 'risk' with needle pointing at 'moderate risk
  • These are legally binding agreements. They include terms, like requiring the occupational therapist to practise under another occupational therapist's supervision for a defined period or to take a course on a topic like ethics.
  • By law, a summary of the undertaking is made available until the occupational therapist completes its requirements.

Specified Continuing Education or Remedial Programs (SCERPs)

  • SCERPs can include things like courses or assessment by a peer, to educate the occupational therapist about professional standards and expectations.
  • The goal is to improve or change the occupational therapist’s practice where there are concerns and ensure that similar concerns don’t repeat.

Caution-in-Person

  • The occupational therapist has to appear in front of a panel of the complaints committee at the College.
  • The panel gives a verbal caution to instruct the occupational therapist about appropriate conduct and practice, and emphasize the seriousness of the issues.
  • This way, the committee can directly educate the occupational therapist on the level of ethics, judgement and professional integrity expected from all occupational therapists.

What are the decisions when the risk to the public is high?


Meter labeled 'risk' with needle pointing at 'highrisk'

Undertaking with Restrictions

  • When the complaints committee thinks serious measures must be put in place to protect the public, the committee can put limits on an occupational therapist’s practice that may include:
     
    • an agreement to only practise in the presence of a practice supervisor, or
    • an agreement to only resume practising after working with a College-trained occupational therapist to address identified concerns.

Referral to Discipline Committee

  • A referral results in a formal hearing, where the College Discipline Committee can impose a series of disciplinary measures.
  • Details of a referral to discipline, and a copy of the notice of the hearing, are posted on the occupational therapist’s public profile at Find an Occupational Therapist.

Undertaking to Resign and Agree Never to Practise Again

  • This usually happens when the complaints committee:
    1. determines that a referral to the Discipline Committee is warranted; and
    2. the College would seek a serious penalty at the discipline hearing, up to taking away a license to practise
  • An occupational therapist would offer to enter into this agreement to avoid the discipline hearing. This information is posted on the occupational therapist’s public profile at Find an Occupational Therapist.

Temporary Order

  • The complaints committee can make an order restricting or suspending an occupational therapist’s practice at any time (sometimes as soon as the College receives a complaint). This can happen if the concerns indicate a high risk of exposing clients to harm, for example: allegations of sexual abuse.
  • If a temporary order is issued, the matter is investigated and a decision issued as quickly as is reasonably possible.

To help people make informed decisions about their care, the College publishes a summary of all decisions when the risk to the public is ‘moderate’ to ‘high’.

Summaries appear on the occupational therapist’s public profile.

Check our public register at Find an Occupational Therapist.


Contact us

If you have questions or concerns about an occupational therapist, we can help.

Contact us at 1-800-890-6570 x223 or investigations@coto.org.

To find up-to-date information about anyone who is, or has been, registered with the College, check the public register at Find an Occupational Therapist.


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