Fair Registration Practices Report

Nurses (2017)

The answers seen below were submitted to the OFC by the regulated professions.

This Fair Registration Practices Report was produced as required by:

  • the Fair Access to Regulated Professions and Compulsory Trades Act (FARPACTA) s. 20 and 23(1), for regulated professions named in Schedule 1 of FARPACTA
  • the Health Professions Procedural Code set out in Schedule 2 of the Regulated Health Professions Act (RHPA) s. 22.7 (1) and 22.9(1), for health colleges.

Index

  1. Qualitative Information
  2. Quantitative Information
  3. Submission

1. Qualitative Information

a) Requirements for registration, including acceptable alternatives
i. Describe any improvements / changes implemented in the last year.

No changes this year

ii. Describe the impact of the improvements / changes on applicants.

No changes this year

iii. Describe the impact of the improvements / changes on your organization.

No changes this year

b) Assessment of qualifications
i. Describe any improvements / changes implemented in the last year.

No changes this year

ii. Describe the impact of the improvements / changes on applicants.

No changes this year

iii. Describe the impact of the improvements / changes on your organization.

No changes this year

c) Provision of timely decisions, responses, and reasons
i. Describe any improvements / changes implemented in the last year.

In July 2017, the College implemented the initial phase of a new customer information system. As well, processes were changed as follows:

  • Implemented a document-imaging process, leading to scanning incoming documents and correspondence, and  
  • Streamlined our application management process so that documents and applications are reviewed in order of receipt by the first available Registration Administrator rather than an assigned Registration Administrator.

Our end goal is to streamline, automate and enhance the customer experience with the College. 

ii. Describe the impact of the improvements / changes on applicants.
  1. Document imaging: This change has reduced the time it takes documents and applications to reach College staff after receipt.
  2. Centralized application management: This change has enhanced continuity of service for applications and document review when staff are absent.
  3. New customer information system:This change will pave the way for the future development and implementation of an applicant portal in 2018.

Following the launch of the new customer information system in July 2017, applicants experienced challenges in:

  • contacting the College by telephone and email
  • obtaining timely status updates on their applications, and
  • receiving timely responses to requests for information

Applicants and stakeholders were advised about potential delays through the College’s website and Facebook. To address these concerns the College has added additional staff to support the registration process. 

We continue to monitor the impact of these changes on our registration processes.  

iii. Describe the impact of the improvements / changes on your organization.

The College experienced the following impacts after the launch of the first phase of the new customer information system:

  • learning to work with and manage a new customer information system,
  • working with scanned images,
  • managing increased volume of calls and emails from applicants requesting assistance, and
  • delays in our ability to process new applications, follow-up on correspondence, and respond to requests for information.

To address these concerns the College has added additional staff to support the registration process.

d) Fees
i. Describe any improvements / changes implemented in the last year.

The College implemented the following change to assessment fees (reflected as by-laws changes):

  • A new $500 fee for RN applicants who need to be evaluated directly by the College because the third party evaluator, Touchstone Institute, cannot offer its evaluation in French and/or meet certain accommodation needs for purposes of the evaluation.  It reflects the College’s cost of doing an additional in-depth evaluation of these applicants.
  • An increase from $200 to $225 for evaluating both English and French language RPN and NP applicants’ nursing knowledge, skills and judgment – this is for the Competency Assessment Supplement. The fee change covers the cost changes associated with the College’s use of a plagiarism software program and inflation costs over the three years since the former fee was set.
ii. Describe the impact of the improvements / changes on applicants.

The College sets the fees for these evaluations with the aim of cost recovery and fairness to all applicants. As a result:

  • Only those RN applicants who are unable to complete the Touchstone evaluation and who must complete an alternative evaluation by the College will be impacted by this new fee.
  • All RPN and NP applicants who must complete the Competency Assessment Supplement will pay the increased fee. 
iii. Describe the impact of the improvements / changes on your organization.

The change reflected the need to cover the College’s increased administrative costs related to directly assessing applicants.

e) Timelines
i. Describe any improvements / changes implemented in the last year.

No changes this year

ii. Describe the impact of the improvements / changes on applicants.

No changes this year

iii. Describe the impact of the improvements / changes on your organization.

No changes this year

f) Policies, procedures and/or processes, including by-laws
i. Describe any improvements / changes implemented in the last year.
  • Fee by-law changes as described in section (d) about fees.
  • Process change related to controlled substances education requirement – In April 2017, NPs who completed approved education requirements became authorized to prescribe controlled substances. NP applicants who do not complete the required education before they register will have terms, conditions, or limitations (TCLs) placed on their registration once registered. The summary of the restriction says “Entitled to Practise with Restrictions –This member cannot prescribe controlled substances.  They have not completed the education needed to do so.”
ii. Describe the impact of the improvements / changes on applicants.
  • See section (d) about fees.
  • NP applicants who have not completed the required controlled substances education will be registered with terms, conditions or limitations according to legislation.
iii. Describe the impact of the improvements / changes on your organization.
  • See section (d) about fees.
  • The College is tracking information related to completion of controlled substances education: updating, and placing or removing terms, conditions or limitations on NP registration as needed.
g) Resources for applicants
i. Describe any improvements / changes implemented in the last year.

The College updated information for applicants on its website (www.cno.org) about the following:

1. In relation to phasing-in the new customer information management system mentioned in section (c) above, we provided the following information to address applicants’ concerns about system changes and potential delays by:

  • an email to applicants with open applications, information on our news page: http://www.cno.org/en/news/2017/july-2017/cno-upgrading-systems/ and
  • information on our Facebook page with this message “Are you waiting for your application to CNO to be processed? For the next week, there will be a temporary delay in processing applications due to a major systems upgrade. Read more about it on our website. We apologize for this inconvenience”,
  • messaging on our dedicated webpage for applicants: http://www.cno.org/en/for/applicants/ and a link to the message from: http://www.cno.org/en/become-a-nurse/, and
  • an update on our news page about our busy phone lines: http://www.cno.org/en/news/2017/november-2017/busy-phone-lines/

2. Evaluation fees – After evaluation fee by-law changes were approved as per section (d) above, we updated related information on our fees page: http://www.cno.org/en/become-a-nurse/application-membership-fees/

3. Controlled substances education requirement – Prior to implementing this change as per section (f) above, we sent an email about the new requirement to all Nurse Practitioner (NP) applicants with an open application. We also developed Q&As to help answer questions from applicants wanting to become NPs: http://www.cno.org/en/trending-topics/nps-and-prescribing-controlled-substances/qas-controlled-substances-education-requirement/

4. Police Criminal Reference Check process – In response to applicant feedback that the information was not easy to find on the website, we updated the following pages:

  • http://www.cno.org/en/become-a-nurse/registration-requirements/past-offences-and-findings--health-and-conduct/past-offences-and-findings/
  • http://www.cno.org/en/become-a-nurse/registration-requirements/past-offences-and-findings--health-and-conduct/past-offences-and-findings/police-criminal-record-check/
  • http://www.cno.org/en/become-a-nurse/new-applicants1/temporary-class/applying-to-the-temporary-class/
  • http://www.cno.org/en/become-a-nurse/new-applicants1/ontario/initial-registration/
  • http://www.cno.org/en/become-a-nurse/new-applicants1/ontario/registration-requirements-for-rns-and-rpns/
ii. Describe the impact of the improvements / changes on applicants.

The resources we provided to communicate improvements and changes were aimed at improving applicants’ understanding of College processes (and any changes to the processes) through consistent and clear communication. This helped to ensure we were transparent about the changes.

iii. Describe the impact of the improvements / changes on your organization.

The additional information and changes helped the College to support effective and transparent communication with applicants.

h) Review or appeal processes
i. Describe any improvements / changes implemented in the last year.

No changes this year

ii. Describe the impact of the improvements / changes on applicants.

No changes this year

iii. Describe the impact of the improvements / changes on your organization.

No changes this year

i) Access to applicant records
i. Describe any improvements / changes implemented in the last year.

No changes this year

ii. Describe the impact of the improvements / changes on applicants.

No changes this year

iii. Describe the impact of the improvements / changes on your organization.

No changes this year

j) Training and resources for registration staff, Council, and committee members
i. Describe any improvements / changes implemented in the last year.

All staff were given access to privacy training through a new privacy module.

As part of their annual orientation in 2017, members of the Registration Committee received training in two new areas listed below:

  • an overview about risk assessment and the principles of right-touch regulation
  • an information session about decision writing and reasons with Richard Steinecke
ii. Describe the impact of the improvements / changes on applicants.

This training benefits applicants by ensuring registration processes and decisions continue to be transparent, objective, impartial and fair.

iii. Describe the impact of the improvements / changes on your organization.

Members of the staff and Registration Committee:

  • gained an enhanced understanding of their roles and responsibilities in relation to privacy and risk assessment
  • remained informed about ensuring that registration processes and decisions are objective, fair, transparent, impartial and timely
k) Mutual recognition agreements
i. Describe any improvements / changes implemented in the last year.

No changes this year

ii. Describe the impact of the improvements / changes on applicants.

No changes this year

iii. Describe the impact of the improvements / changes on your organization.

No changes this year

l) Other (include as many items as applicable)
i. Describe any improvements / changes implemented in the last year.

Already covered in previous sections

ii. Describe the impact of the improvements / changes on applicants.

Already covered in previous sections

iii. Describe the impact of the improvements / changes on your organization.

Already covered in previous sections

Describe any registration-related improvements/changes to your enabling legislation and/or regulations in the last year

No changes this year

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2. Quantitative Information

a) Languages
Indicate the languages in which application information materials were available in the reporting year.
Language Yes/No
English Yes
French Yes
Other (please specify)
Additional comments:
 
b) Gender of applicants
Indicate the number of applicants in each category as applicable.
Gender Number of Applicants
Male 1780
Female 11748
None of the above 0
Additional comments:
 
c) Gender of members
Indicate the number of members in each category as applicable. Select the option that best corresponds to the terminology used by your organization.
Gender Number of Members
Male 14069
Female 164452
None of the above 0
Additional comments:
 
d) Jurisdiction where applicants obtained their initial education
Indicate the number of applicants by the jurisdiction where they obtained their initial education1 in the profession or trade.
Ontario Other Canadian Provinces USA Other International Unknown Total
8932 692 146
India
1908
Philippines
1441
Nepal
54
Pakistan
39
Iran
37
U.K.
31
Jamaica
30
Israel
24
Nigeria
23
Korea
20
Lebanon
15
Australia
15
France
10
Hong Kong
7
Brazil
6
Singapore
6
Zimbabwe
6
China
5
Egypt
4
Haiti
4
Finland
4
Albania
4
Ireland
4
Jordan
4
S Arabia
3
Kenya
3
Italy
3
Ghana
3
Saint Lucia
2
Burkina Faso
2
Trinidad
2
Belgium
2
Romania
2
Estonia
2
Thailand
2
Malaysia
2
United Arab Emirates
2
New Zealand
2
Japan
2
Netherlands
1
Sri Lanka
1
Bulgaria
1
Cameroon
1
Switzerland
1
Uzbekistan
1
Colombia
1
Macedonia, The Former Yugoslav Republic Of
1
S. Africa
1
Qatar
1
Sweden
1
Cuba
1
Bosnia And Herzegovina
1
Moldova, Republic Of
1
Uganda
1
Saint Vincent And The Grenadines
1
Algeria
1
CÙte D'ivoire
1
Bahamas
1
Zaire
1
Greece
1
Barbados
1
Portugal
1
Total
3758
0
13528

1 Recognizing that applicants may receive their education in multiple jurisdictions, for the purpose of this question, include only the jurisdiction in which an entry-level degree, diploma or other certification required to practice the profession or trade was obtained.

Additional comments:
 
e) Jurisdiction where applicants who became registered members obtained their initial education
Indicate the number of applicants who became registered members in the reporting year by the jurisdiction where they obtained their initial education1 in the profession or trade.
Ontario Other Canadian Provinces USA Other International Unknown Total
8274 460 95
India
647
Philippines
489
Iran
21
Pakistan
17
U.K.
15
Jamaica
14
Nigeria
14
Nepal
14
Israel
10
Australia
8
Jordan
7
China
6
Ghana
6
Lebanon
5
France
4
Haiti
4
Ukraine
4
Romania
3
Kenya
3
Korea
3
Singapore
2
Belgium
2
Ireland
2
Mauritius
2
Russia
2
Brazil
2
United Arab Emirates
2
Italy
2
Colombia
2
Cameroon
2
Uganda
1
S. Africa
1
Ethiopia
1
Bulgaria
1
Sweden
1
Algeria
1
Moldova, Republic Of
1
Zimbabwe
1
Japan
1
Sri Lanka
1
Albania
1
Thailand
1
Poland
1
Bangladesh
1
Greece
1
CÙte D'ivoire
1
Germany
1
Zambia
1
S Arabia
1
Morocco
1
Hong Kong
1
Total
1335
0
10164

1 Recognizing that applicants may receive their education in multiple jurisdictions, for the purpose of this question, include only the jurisdiction in which an entry-level degree, diploma or other certification required to practice the profession or trade was obtained.

Additional comments:
 
f) Jurisdiction where members were initially trained
Indicate the total number of registered members by jurisdiction where they obtained their initial education1 in the profession or trade.
Ontario Other Canadian Provinces USA Other International Unknown Total
149158 8749 1573
Philippines
6234
India
4571
U.K.
1467
Poland
572
Hong Kong
503
China
472
Iran
457
Jamaica
418
Russia
407
Macedonia, The Former Yugoslav Republic Of
326
Israel
293
Romania
291
Pakistan
242
Nigeria
221
Australia
120
Korea
197
Lebanon
118
S. Africa
89
Ghana
88
Germany
86
Guyana
85
Sri Lanka
74
Trinidad
71
Jordan
70
Czech Republic
68
Ukraine
66
Ireland
62
Colombia
51
Kenya
50
Nepal
49
Netherlands
48
Haiti
47
Ethiopia
45
Hungary
42
Japan
39
New Zealand
38
Taiwan, Province Of China
35
France
35
Brazil
33
Peru
33
Zimbabwe
29
Bulgaria
27
United Arab Emirates
26
Singapore
25
Italy
24
Belgium
21
Sweden
20
Albania
18
Cuba
17
Serbia
17
Finland
17
Switzerland
15
Portugal
15
Barbados
14
Uganda
14
Malaysia
13
Thailand
13
Saint Vincent And The Grenadines
12
Rwanda
12
Grenada
12
Cameroon
12
Turkey
11
Norway
11
Zambia
11
Mauritius
11
Chile
11
Uruguay
10
Egypt
9
Bosnia And Herzegovina
8
Croatia
8
Austria
8
Denmark
7
Moldova, Republic Of
7
Tanzania, United Republic Of
7
Greece
7
Saint Lucia
6
Slovakia
6
Belarus
6
Uzbekistan
6
Burundi
6
Sierra Leone
6
Kazakhstan
6
Afghanistan
6
Mexico
6
Congo
5
El Salvador
5
Venezuela
5
Algeria
5
Ecuador
5
Somalia
5
Malta
5
Nicaragua
4
Botswana
4
Morocco
4
Argentina
4
Iraq
4
Azerbaijan
4
Bangladesh
3
Tunisia
3
Dominica
3
Lithuania
3
Fiji
3
Antigua And Barbuda
3
Saint Kitts And Nevis
3
Iceland
3
Congo, The Democratic Republic Of The
3
Latvia
3
Tajikistan
2
Sudan
2
CÙte D'ivoire
2
Kuwait
2
Puerto Rico
2
Bahamas
2
Panama
2
Georgia
2
Spain
2
S Arabia
2
Swaziland
2
Costa Rica
2
Eritrea
2
Djibouti
2
Mongolia
1
Armenia
1
Zaire
1
Myanmar
1
Scotland
1
Guatemala
1
Qatar
1
Lesotho
1
Kyrgyzstan
1
Total
18892
149
178521

1 Recognizing that applicants may receive their education in multiple jurisdictions, for the purpose of this question, include only the jurisdiction in which an entry-level degree, diploma or other certification required to practice the profession or trade was obtained.

Additional comments:
 
g) Applications processed
Indicate the number of applications your organization processed in the reporting year:
Jurisdiction where applicants were initially trained in the profession (before they were granted use of the protected title or professional designation in Ontario)
from January 1st to December 31st of the reporting year Ontario Other Canadian Provinces USA Other International Unknown Total
New applications received 8932 692 146 3758 0
13528
Applicants actively pursuing licensing (applicants who had some contact with your organization in the reporting year) 13319 1013 291 9581 0
24204
Inactive applicants (applicants who had no contact with your organization in the reporting year) 950 305 149 4725 0
6129
Applicants who met all requirements and were authorized to become members but did not become members 533 73 10 166 0
782
Applicants who became FULLY registered members 8274 460 95 1335 0
10164
Applicants who were authorized to receive an alternative class of licence3 but were not issued a licence 0 0 0 0 0
0
Applicants who were issued an alternative class of licence3 1376 9 0 9 0
1394

1 An alternative class of licence enables its holder to practice with limitations, but additional requirements must be met in order for the member to be fully licensed.

Additional comments:
 
h) Classes of certificate/license
Inidcate and provide a description of the classes of certificate/license offered by your organization.

You must specify and describe at least one class of certificate/license (on line a) in order for this step to be complete.

# Certification Description
a) General Class Description (a)

Most nurses registered with the College belong to the General Class. Both Registered Nurses and Registered Practical Nurses belong to the class.

b) Extended Class (Nurse Practitioners) Description (b)

The Extended Class is for RNs who have additional education and clinical experience that allsows them to have an expanded scope of practice, with the authority to diagnose, prescribe medication, perform procedures, and order and interpret diagnostic tests. 

c) Non- Practising Class Description (c)

The Non-Practising Class is for members who want to remain College members at times when they are not practising nursing in Ontario.

d) Temporary Class Description (d)

The Temporary Classs is an option for applicants who have met all the registration requirements for the General Class except completing the registration exam. Members in this class are allowed to practise under defined terms and conditions. They can join the General Class after they pass the exam.

e) Special Assignment Description (e)

The Special Assignment Class is time-limited registration for nurses who have an appointment as an RN or RPN with an approved facility  in Ontario. Members in this class can only practise within the scope of their appointment and only under defined terms and conditions.

f) Emergency Class Description (f)

The Emergency Assignment Class comes into force when the provinical government declares an emergnecy and asks the College to issue Emergency Assignment certificates or registration to qualified nurses.

Additional comments:
 
i) Reviews and appeals processed
State the number of reviews and appeals your organization processed in the reporting year (use only whole numbers; do not enter commas or decimals).
Jurisdiction where applicants were initially trained in the profession (before they were granted use of the protected title or professional designation in Ontario)
from January 1st to December 31st of the reporting year Ontario Other Canadian Provinces USA Other International Unknown Total
Applications that were subject to an internal review or that were referred to a statutory committee of your governing council, such as a Registration Committee 128 6 9 486 0
629
Applicants who initiated an appeal of a registration decision 10 0 1 12 0
23
Appeals heard 12 1 0 18 0
31
Registration decisions changed following an appeal 0 0 0 10 0
10
Additional comments:
 
j) Paid staff
In the table below, enter the number of paid staff employed by your organization in the categories shown, on December 31 of the reporting year.

When providing information for each of the categories in this section, you may want to use decimals if you count your staff using half units. For example, one full-time employee and one part-time employee might be equivalent to 1.5 employees.

You can enter decimals to the tenths position only. For example, you can enter 1.5 or 7.5 but not 1.55 or 7.52.

Category Staff
Total staff employed by the regulatory body 220
Staff involved in appeals process 4
Staff involved in registration process 34
Additional comments:
 

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3. Submission

Submission
I hereby certify that:
Name of individual with authority to sign on behalf of the organization:
Anne Coghlan
Title:
Executive Director and CEO
Date:
2018/02/22

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