Legislative Reform and the Path to Safer Care

Voices Shaping Safer Care is a blog series featuring reflections and experiences from people across health and social care in Canada. Through stories from patients, caregivers, healthcare providers, leaders and community partners, the series explores the everyday moments, relationships and systems that influence safety.

Safer care isn’t just about what happens at the bedside.

Recent reforms made by the Government of New Brunswick are a perfect example. When the province first introduced patient safety legislation in 2018, the focus was on advancing quality of care and patient safety within its healthcare organizations through committees that were responsible for doing so.

Now, nearly a decade later, the lessons learned throughout the province and from other jurisdictions – not to mention insights from the COVID-19 pandemic – have resulted in the legislation’s first reforms, which came into effect in June 2026.

When the law gets in the way of learning

One of the most significant updates helps ensure that patient safety learnings and recommendations can be broadly shared between healthcare organizations, health leaders from those organizations and patient partners to drive system-level improvements.

“While the original legislation was focused on patient safety, it did not allow for insights and recommendations to translate into broader actions that would improve safety for everyone,” explains Joanna Seeley, Healthcare Consultant, Quality of Care and Patient Safety, Government of New Brunswick.

That meant healthcare organizations participating in the province’s Quality Care and Patient Safety Advisory Committee – which had existed before the 2018 legislation – faced significant challenges in sharing information with each other for quality improvement purposes. Even when identifying patient information was removed, concerns around compliance with privacy laws often led to hesitancy or delays in determining whether those disclosures were allowed. For a committee whose role was improving health quality and patient safety for the province, not being able to share quality assurance information was a significant limitation.

“Despite its important work, the advisory committee had never been officially recognized in legislation. That has changed with these reforms – and as a result our health system is stronger,” explains Seeley. “Now, healthcare organizations can better share information with each other to learn more rapidly and effectively – which makes healthcare safer and better for all New Brunswickers.”

Many voices, better policy: Lessons from legislative reform

To inform its legislative reforms, the Government of New Brunswick undertook an extensive consultation over four years. During this time, they reached out to experts and partners within the province and across the country to learn from proven safety and privacy practices. Quality of care, patient safety and healthcare safety perspectives were also considered to ensure the new policy direction matched national standards.

Based on Seeley’s experience in New Brunswick, she offers the following lessons for other provinces to consider in implementing their own policies affecting patient safety:

• Begin with partnership engagement: Rather than a “one and done” activity, partnership engagement should be broken down into smaller, more achievable steps that builds on policy themes as they emerge. “If you give the public engagement process the breadth it needs to be a fulsome activity, the policy will better reflect broader system values and benefit patients as a whole,” she says.

• Don’t wait until the engagement phase is complete before capturing knowledge: The partnership engagement process is lengthy by design, meaning that people will come and go. The voices of people consulted early in the process are just as important as the voices of those engaged later.

• Support new partners in seeing the full journey: As new partners are engaged, provide them with a complete view of work that has taken place before their involvement so they are building on existing information and wisdom and can share perspectives and experience that will add the most value.

• Engage patients and families meaningfully: Patient and family voices are essential in shaping how their information is collected, used, retained and disclosed with others. Seeing a direct line between their experience and the policies that shape care helps to build trust – including confidence in how their personal health information is used in the pursuit of safer, high-quality care.

Seeley also notes that policies and legislation with a patient safety focus help to support everyone with a role to play in enabling better, safer care. “We all have a responsibility to improve patient safety and improve the quality of care," she shares. “Policy should be a lever that helps us collectively do this work.”