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QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST80 College Street, Toronto, Ontario M5G 2E2 Tel: (416) 967-2600 Toll Free: (800) 268-7096 Fax: (416) 967-2605
PREMISES INSPECTION COMMITTEE REPORT
 Dr. Wee-Lim Sim Medical Practice
– Level 2Ottawa, Ontario
 Following a review of the inspection-assessment report and submissions from
 Dr. Wee- Lim Sim Medical Practice
, the Premises Inspection Committee affirms the decision of theoutcome of the inspection to be a FAIL.
 
At this time neither you nor any other physician is permitted to perform any OHP procedures at
 Dr. Wee-Lim Sim Medical Practice.
The Fail outcome will remain sounless and until the Premises receives a Pass or Pass with Conditions, and conditionshave been addressed.You may continue patient consultations for OHP procedures at the Premises.This decision does not affect your non-OHP practice.The Committee directed that your premises would be assessed as a level 2 OHP.Therefore, you are not permitted to perform any therapeutic abortions as you do not usethe minimum expected standard of a Paracervical block for these procedures. In addition,your premises does not meet the level 2 requirements as outlined in the inspection-assessment report.Once all outstanding conditions identified in the inspection-assessments report have beencorrected and brought to a level 2 standard, including providing receipts for all purchaseditems, the premises will be reinspected to see whether the premises can receive a Pass or Pass with Conditions rating.The Committee confirms that insertions/removals of IUDs are procedures that do not fallunder the jurisdiction of OHP.The reasons for the fail result are as follows:
 
QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST80 College Street, Toronto, Ontario M5G 2E2 Tel: (416) 967-2600 Toll Free: (800) 268-7096 Fax: (416) 967-2605
1.As per Out-of-Hospital Premises 3.3. OHP Responsibilities,
the OHPmust provide a policy and procedure (P&P) manual. The premises isrecommended to provide policies and procedures for the following areas:6.1.
Administrative
c ) Scope and limitations of practice to include age of patients seen onthe premises.6.2
Job Descriptions
 a) Job Descriptions that define scope and limitations of functions andresponsibilities for patient care including the role of the physicianassistant.6.3
Procedures:
 i) Combustible and Volatile Materialsii) Delegation of Controlled Actsiii) Infection Control - sterilization of instruments including use of internal, external and biological indicators- cleaning of the procedure room between patients and terminal cleaning- cleaning protocols for housekeeping staff iv) Medication handling and inventoryv) Medical Directivesvi) Patient Booking Systemsvii) Response to Latex Allergiesviii) Safety precautions regarding electrical, mechanical, fire andinternal disaster ix) Garbage Disposal
2.As per Out-of-Hospital Premises Standards, 4.1. General PhysicalStandards,
it is recommended that the premisesa) comply with all fire code regulations including having a fireextinguisher and a fire plan in place. It is also recommended to provideevidence that the premises conforms to local fire codes. b) have an emergency power supply that can provide for safelycompleting the procedure and recovering the patient.c) have a stretcher, wheelchair or other adequate method of emergencytransport.
3.As per Out-of-Hospital Premises Standards, 4.2 ProcedureRoom/Operating Room Physical Standards
, it is recommended for the premises to:
 
QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST80 College Street, Toronto, Ontario M5G 2E2 Tel: (416) 967-2600 Toll Free: (800) 268-7096 Fax: (416) 967-2605
a) ensure that floors and walls are uncluttered so that they can becleaned. b) have accessibility for the disabled.c) ensure space to allow the physician to move around theOR/proceduretable with access to both sides of the patient without contamination.d) provide suction equipment and back-up suction equipment.e) provide oxygen saturation equipment.f) ensure that there is no loose wiring in the reception areaceiling.g) provide a second supply of oxygen (normally a spare cylinder)with a pressure gauge, regulator and wrench available (note currently no oxygenis on the premises).h) provided biotechnician reports that the suction aspirator and sterilizer have been maintained and inspected regularly for functionality. Equipmentoperating manuals, maintenance contracts and a log for maintenance of allmedical devices must be provided.
4.As per Out-of-Hospital Premises Standards 4.4.1 General MedicationStandards,
it is recommended to have a general medication inventoryrecord.
5.As per Out-of-Hospital Premises Standards 4.4.2 ControlledSubstances Standards
, it is recommended that:a)controlled substances be counted by two qualified staff (RN, RPN withmedications, Physician) b)controlled substances are locked in a designated cabinet.
6.As per Out-of-Hospital Premises Standards 4.4.3.1. Equipment forMonitoring and Resuscitation
, it is recommended to have the followingequipment:a)Cardiopulmonary resuscitation equipment with currentACLS/PALS-compatible defibrillator  b)ECG monitor c)Intubation tray with a variety of appropriately sized blades,endotracheal tubes, and oral airways (#3 oral) airway is on premisesd)Laryngeal mask airwayse)Means of giving manual positive pressure ventilation (e.g.,manual self-inflating resuscitation device)f)Means to verify end-tidal CO
2
g)Oxygen sourceh)Pulse oximeter i)Suction with rigid suction catheter  j)Torso backboard
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