Common use of Professional Responsibility Clause in Contracts

Professional Responsibility. (Article 8.01 applies to employees covered by an Ontario College under the Regulated Health Professions Act only.) 8.01 The parties agree that patient care is enhanced if concerns relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective manner. In the event that the Hospital assigns a number of patients or a workload to an individual nurse or group of nurses such that they have cause to believe that she or they are being asked to perform more work than is consistent with proper patient care, they shall: i) At the time the workload issue occurs, discuss the issue within the unit/program to develop strategies to meet patient care needs using current resources. ii) If necessary, using established lines of communication as identified by the hospital, seek immediate assistance from an individual(s) (who could be within the bargaining unit) who has responsibility for timely resolution of workload issues. iii) Failing resolution of the workload issue at the time of occurrence, or if the issue is ongoing the nurse(s) will discuss the issue with her or his Manager or designate on the next day that the Manager (or designate) and the nurse are both working or within five (5) calendar days whichever is sooner. Complete the ONA/Hospital Professional Responsibility Workload Report Form. The manager (or designate) will provide a written response on the ONA/Hospital Professional Responsibility Workload Report Form to the nurse(s) within 5 days of receipt of the form with a copy to the Bargaining Unit President. When meeting with the manager, the nurse(s) may request the assistance of a Union representative to support/assist her/him at the meeting. iv) Every effort will be made to resolve workload issues at the unit level. A Union representative shall be involved in any resolution discussions at the unit level. The discussions and actions will be documented. v) Failing resolution at the unit level, submit the ONA/Hospital Professional Responsibility Workload Report Form to the Employer-Union Committee within twenty (20) calendar days from the date of the Manager’s response or when she or he ought to have responded under (iii) above. The Chair of the Employer-Union Committee shall convene a meeting of the Employer-Union Committee within fifteen (15) calendar days of the filing of the ONA/Hospital Professional Responsibility Workload Report Form. The Committee shall hear and attempt to resolve the issue(s) to the satisfaction of both parties and report the outcome to the nurse(s). vi) Prior to the issue(s) being forwarded to the Independent Assessment Committee, the Union may forward a written report outlining the issue(s) and recommendations to the Chief Nursing Executive. For professionals regulated by the RHPA, other than nurses, the Union may forward a written report outlining the issue(s) and recommendations to the appropriate senior executive as designated by the Hospital. vii) Any settlement arrived at under Article 8.01 (a) iii), iv), or v) shall be signed by the parties. viii) Failing resolution of the issue(s) within fifteen (15) calendar days of the meeting of the Employer-Union Committee the issue(s) shall be forwarded to an Independent Assessment Committee composed of three (3) registered nurses; one chosen by the Ontario Nurses' Association, one chosen by the Hospital and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chair. If one of the parties fails to appoint its nominee within a period of forty-five (45) calendar days of giving notice to proceed to the Independent Assessment Committee, the process will proceed. This will not preclude either party from appointing their nominee prior to the commencement of the Independent Assessment Committee hearing. ix) The Assessment Committee shall set a date to conduct a hearing into the issue(s) within fourteen (14) calendar days of its appointment and shall be empowered to investigate as is necessary and make what findings as are appropriate in the circumstances. The Assessment Committee shall render its decision, in writing, to the parties within forty-five (45) calendar days following completion of its hearing. x) It is understood and agreed that representatives of the Ontario Nurses' Association, including the Labour Relations Officer(s), may attend meetings held between the Hospital and the Union under this provision. xi) Any issue(s) lodged under this provision shall be on the form set out in Appendix 4. Alternately, the local parties may agree to an electronic version of the form and a process for signing. xii) The Chief Nursing Executive, Bargaining Unit President and the Employer-Union Committee will jointly review the recommendations of the Independent Assessment Committee and develop an implementation plan for mutually agreed changes. (b) i) The list of Assessment Committee Chairs is attached as Appendix

Professional Responsibility. (Article 8.01 applies to employees covered by an Ontario College under the Regulated Health Professions Act only.) 8.01 The parties agree that patient care is enhanced if concerns relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective manner. This provision is intended to appropriately address employee concerns relative to their workload issues in the context of their professional responsibility. In particular, the parties encourage nurses to raise any issues that negatively impact their workload or patient care, including but not limited to: Gaps in continuity of care; Balance of staff mix; Access to contingency staff; Appropriate number of nursing staff. In the event that the Hospital assigns a number of patients or a workload to an individual nurse or group of nurses such that they have cause to believe that she or they are being asked to perform more work than is consistent with proper patient care, they shall: i) At the time the workload issue occurs, discuss the issue within the unit/program to develop strategies to meet patient care needs using current resources. ii) If necessary, using established lines of communication as identified by the hospital, seek immediate assistance from an individual(s) (who could be within the bargaining unit) who has responsibility for timely resolution of workload issues. iii) Failing resolution of the workload issue at the time of occurrence, occurrence or if the issue is ongoing the nurse(s) will discuss the issue with her or his their Manager or designate on the next day that the Manager (or designate) and the nurse are both working or within five ten (510) calendar days whichever is sooner. When meeting with the manager, the nurse(s) may request the assistance of a Union representative to support/assist them at the meeting. iv) Complete the ONA/Hospital Professional professional Responsibility Workload Report Form. The manager (or designate) will provide a written response on the ONA/Hospital Professional Responsibility Workload Report Form to the nurse(s) within 5 ten (10) calendar days of receipt of the form with a copy to the Bargaining Unit President, Chief Nursing Executive, and the Senior Clinical Leader (if applicable). When meeting with the manager, the nurse(s) may request the assistance of a Union representative to support/assist her/him them at the meeting. ivv) Every effort will be made to resolve workload issues at the unit level. A Union representative shall be involved in any resolution discussions at the unit level. The discussions and actions will be documented. vvi) Failing resolution at the unit level, submit the ONA/Hospital Professional Responsibility Workload Report Form to the EmployerHospital-Union Association Committee within twenty (20) calendar days from the date of the Manager’s response or when she or he they ought to have responded under (iiiiv) above. . vii) The Chair of the EmployerHospital-Union Association Committee shall convene a meeting of the EmployerHospital-Union Association Committee within fifteen (15) calendar days of the filing of the ONA/Hospital Professional Responsibility Workload Report Form. The Committee shall hear and attempt to resolve the issue(s) to the satisfaction of both parties and report the outcome to the nurse(s). vi) Prior to the issue(s) being forwarded to the Independent Assessment Committee, the Union may forward a written report outlining the issue(s) and recommendations to the Chief Nursing Executive. For professionals regulated by the RHPA, other than nurses, the Union may forward a written report outlining the issue(s) and recommendations to the appropriate senior executive as designated by the Hospital. vii) Any settlement arrived at under Article 8.01 (a) iii), iv), or v) shall be signed by the parties. viii) Failing resolution of the issue(s) within fifteen (15) calendar days of the meeting of the Employer-Union Committee the issue(s) shall be forwarded to an Independent Assessment Committee composed of three (3) registered nurses; one chosen by the Ontario Nurses' Association, one chosen by the Hospital and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chair. If one of the parties fails to appoint its nominee within a period of forty-five (45) calendar days of giving notice to proceed to the Independent Assessment Committee, the process will proceed. This will not preclude either party from appointing their nominee prior to the commencement of the Independent Assessment Committee hearing. ix) The Assessment Committee shall set a date to conduct a hearing into the issue(s) within fourteen (14) calendar days of its appointment and shall be empowered to investigate as is necessary and make what findings as are appropriate in the circumstances. The Assessment Committee shall render its decision, in writing, to the parties within forty-five (45) calendar days following completion of its hearing. x) It is understood and agreed that representatives of the Ontario Nurses' Association, including the Labour Relations Officer(s), may attend meetings held between the Hospital and the Union under this provision. xi) Any issue(s) lodged under this provision shall be on the form set out in Appendix 4. Alternately, the local parties may agree to an electronic version of the form and a process for signing. xii) The Chief Nursing Executive, Bargaining Unit President and the Employer-Union Committee will jointly review the recommendations of the Independent Assessment Committee and develop an implementation plan for mutually agreed changes. (b) i) The list of Assessment Committee Chairs is attached as AppendixONA/

Professional Responsibility. (Article 8.01 applies to employees covered by an Ontario College under the Regulated Health Professions Act only.) 8.01 21.01 The parties agree that patient care is enhanced if concerns relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective mannermanner within the context of the nurse’s professional responsibility. In particular, the parties encourage nurses to raise any issues that negatively impact their workload or patient care, including but not limited to: - Gaps in continuity of care - Balance of staff mix - Access to contingency staff - Appropriate number of nursing staff In the event that the Hospital Employer assigns a number of patients or a workload to an individual nurse or group of nurses such that they she/he have cause to believe that she or they she/he are being asked to perform more work than is not consistent with proper patient care, they she/he shall: i) At the time the workload issue occurs, discuss the issue within the unit/program unit or department manager to develop strategies to meet patient care needs using current resources. ii) If necessary, using established lines of communication as identified by the hospital, seek immediate assistance from an individual(s) (who could be within the bargaining unit) who has responsibility for timely resolution of workload issues. iii) Failing resolution of the workload issue at the time of occurrence, occurrence or if the issue is ongoing the nurse(s) will discuss the issue with her or his Manager or designate on the next day that the Manager (or designate) and the nurse are both working or within five (5) calendar working days whichever is sooner. Complete . iii) At the ONA/Hospital earliest opportunity (or before fifteen (15) calendar days) the nurse will complete the ONA Professional Responsibility Workload Report Form(including suggested remedial action for the issue) and submit this to the manager and required ONA representatives. The manager (or designate) will provide a written response on the ONA/Hospital Employer Professional Responsibility Workload Report Form (or attach correspondence whether in electronic or letter format) to the nurse(s) within 5 ten (10) calendar days of receipt of the form. A copy of the form with a copy shall be given to the Clinical or Unit manager and the Bargaining Unit PresidentPresident as indicated on the form itself. When The Manager in receipt of the form will notify any member of the Labour Management Consultation Committee of its submission. The Chairman of the Labour Management Consultation Committee shall convene a meeting with of the manager, Labour Manager Consultation Committee within thirty (30) calendar days of the nurse(s) may request filing of the assistance complaint. The Committee shall hear and attempt to resolve the complaint to the satisfaction of a Union representative to support/assist her/him at the meetingboth parties. iv) Every effort will be made to resolve workload issues at the unit or department level. A Union representative shall be involved in any resolution discussions at the unit level. The discussions and actions will be documented. v) Failing resolution at the unit level, submit the ONA/Hospital Professional Responsibility Workload Report Form to the Employer-Union Committee within twenty (20) calendar days from the date of the Manager’s response or when she or he ought to have responded under (iii) above. The Chair of the Employer-Union Committee shall convene a meeting of the Employer-Union Committee within fifteen (15) calendar days of the filing of the ONA/Hospital Professional Responsibility Workload Report Form. The Committee shall hear and attempt reasonable attempts to resolve the issue(s) to the satisfaction of both parties and report the outcome to the nurse(s). vi) Prior to the issue(s) being forwarded to the Independent Assessment Committee, the Union may forward a written report outlining the issue(s) and recommendations to the Chief Nursing Executive. For professionals regulated by the RHPA, other than nurses, the Union may forward a written report outlining the issue(s) and recommendations to the appropriate senior executive as designated by the Hospital. vii) Any settlement arrived at under Article 8.01 (a) iii), iv), or v) shall be signed by the parties. viii) Failing resolution of the issue(s) complaint within fifteen (15) calendar days of the meeting of the Employer-Union Committee the issue(s) shall be forwarded to an Independent Assessment Committee composed of three (3) registered nurses; one chosen by the Ontario Nurses' Association, one chosen by the Hospital and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chair. If one of the parties fails to appoint its nominee within a period of forty-five (45) calendar days of giving notice to proceed to the Independent Assessment Committee, the process will proceed. This will not preclude either party from appointing their nominee prior to the commencement of the Independent Assessment Committee hearing. ix) The Assessment Committee shall set a date to conduct a hearing into the issue(s) within fourteen (14) calendar days of its appointment and shall be empowered to investigate as is necessary and make what findings as are appropriate in the circumstances. The Assessment Committee shall render its decision, in writing, to the parties within forty-five (45) calendar days following completion of its hearing. x) It is understood and agreed that representatives of the Ontario Nurses' Association, including the Labour Relations Officer(s), may attend meetings held between the Hospital and the Union under this provision. xi) Any issue(s) lodged under this provision shall be on the form set out in Appendix 4. Alternately, the local parties may agree to an electronic version of the form and a process for signing. xii) The Chief Nursing Executive, Bargaining Unit President and the Employer-Union Committee will jointly review the recommendations of the Independent Assessment Committee and develop an implementation plan for mutually agreed changes. (b) i) The list of Assessment Committee Chairs is attached as Appendixthirty

Professional Responsibility. (Article 8.01 applies to employees covered by an Ontario College under the Regulated Health Professions Act only.) 8.01 The parties agree that patient care is enhanced if concerns relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective manner. In the event that the Hospital assigns a number of patients or a workload to an individual nurse employee or group of nurses employees such that they have cause to believe that she or they are being asked to perform more work than is consistent with proper patient care, they shall: i(a) At the time the workload issue occurs, discuss the issue within the unit/other employees within their classification and program to develop strategies to meet patient care needs using current resources. ii(b) If necessary, using established lines of communication as identified by the hospitalcommunication, seek immediate assistance from an individual(s) identified by the Hospital (who could be within the bargaining unit) who has responsibility for timely resolution of workload issues. iii(c) Failing resolution of the workload issue at the time of the occurrence, the employee(s) or if group of employees will complete the issue is ongoing ONA Allied Professional Responsibility Workload Report Form (see Appendix A) and provide to their Manager or designate within (5) business days of the nurse(s) occurrence. The Manager or designate will discuss the issue with her the employee or his Manager or designate group of employees on the next day that the Manager (or designate) and the nurse employee(s) are both working or within five (5) calendar days days, whichever is sooner. Complete the ONA/Hospital Professional Responsibility Workload Report Form. . (d) The manager (Manager or designate) designate will provide a written response on the ONA/Hospital ONA Allied Professional Responsibility Workload Report Response Form (see Appendix A) to the nurse(semployee(s) within 5 days of receipt of the form with and a copy will be provided to the Bargaining Unit President. When meeting with President within five (5) business days of the manager, the nurse(s) may request the assistance of a Union representative to support/assist her/him at the meetingdiscussion occurring. iv) Every effort will be made to resolve workload issues at the unit level. A Union representative shall be involved in any resolution discussions at the unit level. The discussions and actions will be documented. v(e) Failing resolution of the workload issue at step (d), the Bargaining Unit President will discuss the alleged improper assignment or workload issue at the unit level, submit the ONA/Hospital Professional Responsibility Workload Report Form to the Employernext Labour-Union Management Committee meeting. Such meeting will occur within twenty thirty (2030) calendar days from the date of the Manager’s response or when she or he ought to have responded under (iii) above. The Chair of the Employer-Union Committee shall convene a meeting of the Employer-Union Committee within fifteen (15) calendar days of the filing of the ONA/Hospital Professional Responsibility Workload Report Formas soon as possible thereafter. The Committee shall hear and attempt to resolve the issue(s) complaint to the satisfaction of both parties and report the outcome to the nurse(s)parties. vi(f) Prior to the issue(s) being forwarded to the Independent Assessment CommitteeFailing resolution, the Union Association may forward a written report outlining the issue(s) complaint and recommendations to the Chief Nursing Executive. For professionals regulated by the RHPA, other than nurses, the Union may forward a written report outlining the issue(s) and recommendations to the appropriate senior executive as designated by the HospitalLRCP Program Director. vii) Any settlement arrived at under Article 8.01 (a) iii), iv), or v) shall be signed by the parties. viii) Failing resolution of the issue(s) within fifteen (15) calendar days of the meeting of the Employer-Union Committee the issue(s) shall be forwarded to an Independent Assessment Committee composed of three (3) registered nurses; one chosen by the Ontario Nurses' Association, one chosen by the Hospital and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chair. If one of the parties fails to appoint its nominee within a period of forty-five (45) calendar days of giving notice to proceed to the Independent Assessment Committee, the process will proceed. This will not preclude either party from appointing their nominee prior to the commencement of the Independent Assessment Committee hearing. ix) The Assessment Committee shall set a date to conduct a hearing into the issue(s) within fourteen (14) calendar days of its appointment and shall be empowered to investigate as is necessary and make what findings as are appropriate in the circumstances. The Assessment Committee shall render its decision, in writing, to the parties within forty-five (45) calendar days following completion of its hearing. x) It is understood and agreed that representatives of the Ontario Nurses' Association, including the Labour Relations Officer(s), may attend meetings held between the Hospital and the Union under this provision. xi) Any issue(s) lodged under this provision shall be on the form set out in Appendix 4. Alternately, the local parties may agree to an electronic version of the form and a process for signing. xii) The Chief Nursing Executive, Bargaining Unit President and the Employer-Union Committee will jointly review the recommendations of the Independent Assessment Committee and develop an implementation plan for mutually agreed changes. (b) i) The list of Assessment Committee Chairs is attached as Appendix

Professional Responsibility. (Article 8.01 applies to employees covered by an Ontario College under the Regulated Health Professions Act only.) 8.01 10.01 The parties agree that patient care is enhanced if concerns relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective manner. This provision is intended to appropriately address employee concerns relative to their workload issues in the context of their professional responsibility. In particular, the parties encourage nurses to raise any issues that negatively impact their workload or patient care, including but not limited to: • Gaps in continuity of care • Balance of staff mix • Access to contingency staff • Appropriate number of nursing staff In the event that the Hospital Employer assigns a number of patients or a workload to an individual nurse or group of nurses such that they have cause to believe that she or they are being asked to perform more work than is consistent with proper patient care, they shall:; i) At the time the workload issue occurs, discuss the issue within the unit/program to develop strategies to meet patient care needs using current resources. ii) If necessary, using established lines of communication as identified by the hospitalcommunication, seek immediate assistance from an individual(s) identified by the Employer (who could be within the bargaining unit) who has responsibility for timely resolution of workload issues. iii) Failing resolution of the workload issue at the time of occurrence, or if the issue is ongoing the nurse(s) will discuss the issue with her or his Manager or designate on the Manager’s or designate’s next day that the Manager (or designate) and the nurse are both working or within five ten (510) calendar days days, whichever is sooner. Complete the ONA/Hospital Professional professional Responsibility Workload Report Form. , The manager (or designatedesignate ) will provide a written response on the ONA/Hospital ONA/ Employer Professional Responsibility Workload Report Form to the nurse(snurses(s) within 5 ten (10) days of receipt of the form with a copy to the Bargaining Unit President. When meeting with the manager, the nurse(s) may request the assistance of a Union representative to support/assist her/him at the meeting. iv) Every effort will be made to resolve workload issues at the unit level. A Union representative shall be involved in any resolution discussions at the unit level. The discussions and actions will be documented. v) Failing resolution at the unit level, submit the ONA/Hospital Professional Responsibility Workload Report Form to the Employer-Union Hospital- Association Committee within twenty (20) calendar days from the date of the Manager’s response or when she or he ought to have responded under (iii) above. The Chair of the Employer-Union Hospital- Association Committee shall convene a meeting of the Employer-Union Hospital- Association Committee within fifteen (15) calendar days of the filing of the ONA/Hospital Professional Responsibility Workload Report Formcomplaint. The Committee shall hear and attempt to resolve the issue(s) complaint to the satisfaction of both parties and report the outcome to the nurse(s). viv) Prior to the issue(s) complaint being forwarded to the Independent Assessment Committeecommittee, the Union may forward a written report outlining the issue(s) complaint and recommendations to the Chief Nursing Executive. For professionals regulated by the RHPA, other than nurses, the Union may forward a written report outlining the issue(s) and recommendations to the appropriate senior executive as designated by the Hospital. vii) Any settlement arrived at under Article 8.01 (a) iii), iv), or v) shall be signed by the parties. viiivi) Failing resolution of the issue(s) complaint within fifteen (15) calendar days of the meeting of the EmployerUnion-Union Employer Committee the issue(s) complaint shall be forwarded to an Independent independent Assessment Committee composed of three (3) registered nurses; one chosen by the Ontario Nurses' Association, one chosen by the Hospital Employer and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chair. If one of the parties fails to appoint its nominee within a period of forty-five (45) calendar days of giving notice to proceed to the Independent Assessment Committee, the process will proceed. This will not preclude either party from appointing their nominee prior to the commencement of the Independent Assessment Committee hearing. ixvii) The Assessment Committee shall set a date to conduct a hearing into the issue(s) complaint within fourteen (14) calendar days of its appointment and shall be empowered to investigate as is necessary and make what findings as are appropriate in the circumstances. The Assessment Committee shall render report its decisionfindings, in writing, to the parties within forty-five (45) calendar days following completion of its hearing. xviii) It is understood and agreed that representatives of the Ontario Nurses' Association, including the Labour Employment Relations Officer(s)Officer and the Nursing Practice Officer, may attend meetings held between the Hospital Employer and the Union under this provision. xiix) Any issue(s) complaint lodged under this provision shall be on the form set out in Appendix 4. Alternately, the local parties may agree to an electronic version of the form and a process for signing. xii) The Chief Nursing Executive, Bargaining Unit President and the Employer-Union Committee will jointly review the recommendations of the Independent Assessment Committee and develop an implementation plan for mutually agreed changes6. (b) i) The list of Assessment Committee Chairs Chairpersons is attached as AppendixAppendix 2. The parties agree that should a Chairperson be required, the Ontario Hospital Association and the Ontario Nurses’ Association will be contacted. They will provide the name of the person to be utilized on the alphabetical listing of Chairpersons. The name to be provided will be the top name on the list of Chairpersons who has not been previously assigned. Should the Chairperson who is scheduled to serve decline when requested, or it becomes obvious that the Chair would not be suitable due to connections with the Employer or community, the next person on the list will be approached to act as Chairperson.

Professional Responsibility. (Article 8.01 applies to employees covered by an Ontario College under the Regulated Health Professions Act only.) 8.01 The parties agree that patient care is enhanced if concerns relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective manner. This provision is intended to appropriately address employee concerns relative to their workload issues in the context of their professional responsibility. In particular, the parties encourage nurses to raise any issues that negatively impact their workload or patient care, including but not limited to: Gaps in continuity of care Balance of staff mix Access to contingency staff Appropriate number of nursing staff In the event that the Hospital assigns a number of patients or a workload to an individual nurse or group of nurses such that they have cause to believe that she or they are being asked to perform more work than is consistent with proper patient care, they shall: i) At the time the workload issue occurs, discuss the issue within the unit/program to develop strategies to meet patient care needs using current resources. ii) If necessary, using established lines of communication as identified by the hospital, seek immediate assistance from an individual(s) (who could be within the bargaining unit) who has responsibility for timely resolution of workload issues. iii) Failing resolution of the workload issue at the time of occurrence, occurrence or if the issue is ongoing the nurse(s) will discuss the issue with her or his Manager or designate on the next day that the Manager (or designate) and the nurse are both working or within five ten (510) calendar days whichever is sooner. When meeting with the manager, the nurse(s) may request the assistance of a Union representative to support/assist her/him at the meeting. iv) Complete the ONA/Hospital Professional professional Responsibility Workload Report Form. The manager (or designate) will provide a written response on the ONA/Hospital Professional Responsibility Workload Report Form to the nurse(s) within 5 ten (10) calendar days of receipt of the form with a copy to the Bargaining Unit President, Chief Nursing Executive, and the Senior Clinical Leader (if applicable). When meeting with the manager, the nurse(s) may request the assistance of a Union representative to support/assist her/him at the meeting. ivv) Every effort will be made to resolve workload issues at the unit level. A Union representative shall be involved in any resolution discussions at the unit level. The discussions and actions will be documented. vvi) Failing resolution at the unit level, submit the ONA/Hospital Professional Responsibility Workload Report Form to the EmployerHospital-Union Association Committee within twenty (20) calendar days from the date of the Manager’s response or when she or he ought to have responded under (iiiiv) above. . vii) The Chair of the EmployerHospital-Union Association Committee shall convene a meeting of the EmployerHospital-Union Association Committee within fifteen (15) calendar days of the filing of the ONA/Hospital Professional Responsibility Workload Report Form. The Committee shall hear and attempt to resolve the issue(s) to the satisfaction of both parties and report the outcome to the nurse(s). vi) Prior to the issue(s) being forwarded to the Independent Assessment Committee, the Union may forward a written report outlining the issue(s) and recommendations to the Chief Nursing Executive. For professionals regulated by the RHPA, other than nurses, the Union may forward a written report outlining the issue(s) and recommendations to the appropriate senior executive as designated by the Hospital. vii) Any settlement arrived at under Article 8.01 (a) iii), iv), or v) shall be signed by the parties. viii) Failing resolution of the issue(s) within fifteen (15) calendar days of the meeting of the Employer-Union Committee the issue(s) shall be forwarded to an Independent Assessment Committee composed of three (3) registered nurses; one chosen by the Ontario Nurses' Association, one chosen by the Hospital and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chair. If one of the parties fails to appoint its nominee within a period of forty-five (45) calendar days of giving notice to proceed to the Independent Assessment Committee, the process will proceed. This will not preclude either party from appointing their nominee prior to the commencement of the Independent Assessment Committee hearing. ix) The Assessment Committee shall set a date to conduct a hearing into the issue(s) within fourteen (14) calendar days of its appointment and shall be empowered to investigate as is necessary and make what findings as are appropriate in the circumstances. The Assessment Committee shall render its decision, in writing, to the parties within forty-five (45) calendar days following completion of its hearing. x) It is understood and agreed that representatives of the Ontario Nurses' Association, including the Labour Relations Officer(s), may attend meetings held between the Hospital and the Union under this provision. xi) Any issue(s) lodged under this provision shall be on the form set out in Appendix 4. Alternately, the local parties may agree to an electronic version of the form and a process for signing. xii) The Chief Nursing Executive, Bargaining Unit President and the Employer-Union Committee will jointly review the recommendations of the Independent Assessment Committee and develop an implementation plan for mutually agreed changes. (b) i) The list of Assessment Committee Chairs is attached as AppendixONA/

Professional Responsibility. ‌ (Article 8.01 applies to employees covered by an Ontario College under the Regulated Health Professions Act only.) 8.01 The parties agree that patient care is enhanced if concerns relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective manner. This provision is intended to appropriately address employee concerns relative to their workload issues in the context of their professional responsibility. In particular, the parties encourage nurses to raise any issues that negatively impact their workload or patient care, including but not limited to: • Gaps in continuity of care; • Balance of staff mix; • Access to contingency staff; • Appropriate number of nursing staff. In the event that the Hospital assigns a number of patients or a workload to an individual nurse or group of nurses such that they have cause to believe that she or they are being asked to perform more work than is consistent with proper patient care, they shall: i) At the time the workload issue occurs, discuss the issue within the unit/program to develop strategies to meet patient care needs using current resources. ii) If necessary, using established lines of communication as identified by the hospital, seek immediate assistance from an individual(s) (who could be within the bargaining unit) who has responsibility for timely resolution of workload issues. iii) Failing resolution of the workload issue at the time of occurrence, occurrence or if the issue is ongoing the nurse(s) will discuss the issue with her or his their Manager or designate on the next day that the Manager (or designate) and the nurse are both working or within five ten (510) calendar days whichever is sooner. When meeting with the manager, the nurse(s) may request the assistance of a Union representative to support/assist her/him them at the meeting. iv) Complete the ONA/Hospital Professional professional Responsibility Workload Report Form. The manager (or designate) will provide a written response on the ONA/Hospital Professional Responsibility Workload Report Form to the nurse(s) within 5 ten (10) calendar days of receipt of the form with a copy to the Bargaining Unit President, Chief Nursing Executive, and the Senior Clinical Leader (if applicable). When meeting with the manager, the nurse(s) may request the assistance of a Union representative to support/assist her/him them at the meeting. ivv) Every effort will be made to resolve workload issues at the unit level. A Union representative shall be involved in any resolution discussions at the unit level. The discussions and actions will be documented. vvi) Failing resolution at the unit level, submit the ONA/Hospital Professional Responsibility Workload Report Form to the EmployerHospital-Union Association Committee within twenty (20) calendar days from the date of the Manager’s response or when she or he they ought to have responded under (iiiiv) above. . vii) The Chair of the EmployerHospital-Union Association Committee shall convene a meeting of the EmployerHospital-Union Association Committee within fifteen (15) calendar days of the filing of the ONA/Hospital Professional Responsibility Workload Report Form. The Committee shall hear and attempt to resolve the issue(s) to the satisfaction of both parties and report the outcome to the nurse(s). vi) Prior to the issue(s) being forwarded to the Independent Assessment Committee, the Union may forward a written report outlining the issue(s) and recommendations to the Chief Nursing Executive. For professionals regulated by the RHPA, other than nurses, the Union may forward a written report outlining the issue(s) and recommendations to the appropriate senior executive as designated by the Hospital. vii) Any settlement arrived at under Article 8.01 (a) iii), iv), or v) shall be signed by the parties. viii) Failing resolution of the issue(s) within fifteen (15) calendar days of the meeting of the Employer-Union Committee the issue(s) shall be forwarded to an Independent Assessment Committee composed of three (3) registered nurses; one chosen by the Ontario Nurses' Association, one chosen by the Hospital and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chair. If one of the parties fails to appoint its nominee within a period of forty-five (45) calendar days of giving notice to proceed to the Independent Assessment Committee, the process will proceed. This will not preclude either party from appointing their nominee prior to the commencement of the Independent Assessment Committee hearing. ix) The Assessment Committee shall set a date to conduct a hearing into the issue(s) within fourteen (14) calendar days of its appointment and shall be empowered to investigate as is necessary and make what findings as are appropriate in the circumstances. The Assessment Committee shall render its decision, in writing, to the parties within forty-five (45) calendar days following completion of its hearing. x) It is understood and agreed that representatives of the Ontario Nurses' Association, including the Labour Relations Officer(s), may attend meetings held between the Hospital and the Union under this provision. xi) Any issue(s) lodged under this provision shall be on the form set out in Appendix 4. Alternately, the local parties may agree to an electronic version of the form and a process for signing. xii) The Chief Nursing Executive, Bargaining Unit President and the Employer-Union Committee will jointly review the recommendations of the Independent Assessment Committee and develop an implementation plan for mutually agreed changes. (b) i) The list of Assessment Committee Chairs is attached as AppendixONA/

Professional Responsibility. (Article 8.01 applies to employees covered by an Ontario College under the Regulated Health Professions Act only.) 8.01 21.01 The parties agree that patient care is enhanced if concerns relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective mannermanner within the context of the nurse’s professional responsibility. In particular, the parties encourage nurses to raise any issues that negatively impact their workload or patient care, including but not limited to: - Gaps in continuity of care - Balance of staff mix - Access to contingency staff - Appropriate number of nursing staff In the event that the Hospital Employer assigns a number of patients or a workload to an individual nurse or group of nurses such that they she/he have cause to believe that she or they she/he are being asked to perform more work than is not consistent with proper patient care, they she/he shall: i) At the time the workload issue occurs, discuss the issue within the unit/program unit or department manager to develop strategies to meet patient care needs using current resources. ii) If necessary, using established lines of communication as identified by the hospital, seek immediate assistance from an individual(s) (who could be within the bargaining unit) who has responsibility for timely resolution of workload issues. iii) Failing resolution of the workload issue at the time of occurrence, occurrence or if the issue is ongoing the nurse(s) will discuss the issue with her or his Manager manager or designate on the next day that the Manager (or designate) and the nurse are both working or within five (5) calendar working days whichever is sooner. Complete . iii) At the ONA/Hospital earliest opportunity (or before fifteen (15) calendar days) the nurse will complete the ONA Professional Responsibility Workload Report Form(including suggested remedial action for the issue) and submit this to the manager and required ONA representatives. The manager (or designate) will provide a written response on the ONA/Hospital Employer Professional Responsibility Workload Report Form (or attach correspondence whether in electronic or letter format) to the nurse(s) within 5 ten (10) calendar days of receipt of the form. A copy of the form with a copy shall be given to the Clinical or Unit manager and the Bargaining Unit PresidentPresident as indicated on the form itself. When The Manager in receipt of the form will notify any member of the Labour Management Consultation Committee of its submission. The Chairman of the Labour Management Consultation Committee shall convene a meeting with of the manager, Labour Manager Consultation Committee within thirty (30) calendar days of the nurse(s) may request filing of the assistance complaint. The Committee shall hear and attempt to resolve the complaint to the satisfaction of a Union representative to support/assist her/him at the meetingboth parties. iv) Every effort will be made to resolve workload issues at the unit or department level. A Union representative shall be involved in any resolution discussions at the unit level. The discussions and actions will be documented. v) Failing resolution at the unit level, submit the ONA/Hospital Professional Responsibility Workload Report Form to the Employer-Union Committee within twenty (20) calendar days from the date of the Manager’s response or when she or he ought to have responded under (iii) above. The Chair of the Employer-Union Committee shall convene a meeting of the Employer-Union Committee within fifteen (15) calendar days of the filing of the ONA/Hospital Professional Responsibility Workload Report Form. The Committee shall hear and attempt reasonable attempts to resolve the issue(s) to the satisfaction of both parties and report the outcome to the nurse(s). vi) Prior to the issue(s) being forwarded to the Independent Assessment Committee, the Union may forward a written report outlining the issue(s) and recommendations to the Chief Nursing Executive. For professionals regulated by the RHPA, other than nurses, the Union may forward a written report outlining the issue(s) and recommendations to the appropriate senior executive as designated by the Hospital. vii) Any settlement arrived at under Article 8.01 complaint within thirty (a) iii), iv), or v) shall be signed by the parties. viii) Failing resolution of the issue(s) within fifteen (1530) calendar days of the meeting of the Employer-Union Committee Labour Management Consultation Committee, the issue(s) complaint shall be forwarded to an Independent Assessment Committee composed of three (3) registered nurses; one chosen by the Ontario Nurses' ’ Association, one chosen by the Hospital Employer, and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chair. If one of the parties fails to appoint its nominee within a period of forty-five (45) calendar days of giving notice to proceed to the Independent Assessment Committee, the process will proceed. This will not preclude either party from appointing their nominee prior to the commencement of the Independent Assessment Committee hearingChairperson. ixvi) The Assessment Committee shall set up a date to conduct a hearing into the issue(s) complaint within fourteen fifteen (1415) calendar days of its appointment and shall be empowered to investigate as is necessary and make what findings as are appropriate in the circumstances. The Assessment Committee shall render report its decisionfindings, in writing, to the parties within forty-five thirty (4530) calendar days following completion of its hearing. x) It is understood and agreed that representatives of the Ontario Nurses' Association, including the Labour Relations Officer(s), may attend meetings held between the Hospital and the Union under this provision. xi) Any issue(s) lodged under this provision shall be on the form set out in Appendix 4. Alternately, the local parties may agree to an electronic version of the form and a process for signing. xii) The Chief Nursing Executive, Bargaining Unit President and the Employer-Union Committee will jointly review the recommendations of the Independent Assessment Committee and develop an implementation plan for mutually agreed changes. (b) i) The list of Assessment Committee Chairs Chairpersons is attached as AppendixAppendix 1 The parties agree that should a chairperson be required, the Employer and the Ontario Nurses’ Association will be contacted. They will provide the name of the person to be utilized on the alphabetical listing of Chairpersons. The name to be provided will be the top name on the list of Chairpersons who has not been previously assigned. Should the Chairperson who is scheduled to serve decline when requested, or it becomes obvious that she/he would not be suitable due to connections with the Employer or community, the next person on the list will be approached to act as Chairperson.

Professional Responsibility. (Article 8.01 applies to employees covered by an Ontario College under the Regulated Health Professions Act only.) 8.01 The parties agree that patient care is enhanced if concerns relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective manner. In the event that the Hospital assigns a number of patients or a workload to an individual nurse or group of nurses such that they have cause to believe that she or they are being asked to perform more work than is consistent with proper patient care, they shall: i) At the time the workload issue occurs, discuss the issue within the unit/program to develop strategies to meet patient care needs using current resources. ii) If necessary, using established lines of communication as identified by the hospital, seek immediate assistance from an individual(s) (who could be within the bargaining unit) who has responsibility for timely resolution of workload issues. iii) Failing resolution of the workload issue at the time of occurrence, or if the issue is ongoing the nurse(s) will discuss the issue with her or his Manager or designate on the next day that the Manager (or designate) and the nurse are both working or within five (5) calendar days whichever is sooner. Complete the ONA/Hospital Professional Responsibility Workload Report Form. The manager (or designate) will provide a written response on the ONA/Hospital Professional Responsibility Workload Report Form to the nurse(s) within 5 days of receipt of the form with a copy to the Bargaining Unit President. When meeting with the manager, the nurse(s) may request the assistance of a Union representative to support/assist her/him at the meeting. iv) Every effort will be made to resolve workload issues at the unit level. A Union representative shall be involved in any resolution discussions at the unit level. The discussions and actions will be documented. v) Failing resolution at the unit level, submit the ONA/Hospital Professional Responsibility Workload Report Form to the Employer-Union Committee within twenty (20) calendar days from the date of the Manager’s response or when she or he ought to have responded under (iii) above. The Chair of the Employer-Employer- Union Committee shall convene a meeting of the Employer-Union Committee within fifteen (15) calendar days of the filing of the ONA/Hospital Professional Responsibility Workload Report Form. The Committee shall hear and attempt to resolve the issue(s) to the satisfaction of both parties and report the outcome to the nurse(s). vi) Prior to the issue(s) being forwarded to the Independent Assessment Committee, the Union may forward a written report outlining the issue(s) and recommendations to the Chief Nursing Executive. For professionals regulated by the RHPA, other than nurses, the Union may forward a written report outlining the issue(s) and recommendations to the appropriate senior executive as designated by the Hospital. vii) Any settlement arrived at under Article 8.01 (a) iii), iv), or v) shall be signed by the parties. viii) Failing resolution of the issue(s) within fifteen (15) calendar days of the meeting of the Employer-Union Committee the issue(s) shall be forwarded to an Independent Assessment Committee composed of three (3) registered nurses; one chosen by the Ontario Nurses' Association, one chosen by the Hospital and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chair. If one of the parties fails to appoint its nominee within a period of forty-five (45) calendar days of giving notice to proceed to the Independent Assessment Committee, the process will proceed. This will not preclude either party from appointing their nominee prior to the commencement of the Independent Assessment Committee hearing. ix) The Assessment Committee shall set a date to conduct a hearing into the issue(s) within fourteen (14) calendar days of its appointment and shall be empowered to investigate as is necessary and make what findings as are appropriate in the circumstances. The Assessment Committee shall render its decision, in writing, to the parties within forty-five (45) calendar days following completion of its hearing. x) It is understood and agreed that representatives of the Ontario Nurses' Association, including the Labour Relations Officer(s), may attend meetings held between the Hospital and the Union under this provision. xi) Any issue(s) lodged under this provision shall be on the form set out in Appendix 4. Alternately, the local parties may agree to an electronic version of the form and a process for signing. xii) The Chief Nursing Executive, Bargaining Unit President and the Employer-Union Committee will jointly review the recommendations of the Independent Assessment Committee and develop an implementation plan for mutually agreed changes. (b) i) The list of Assessment Committee Chairs is attached as AppendixAppendix 2. During the term of this Agreement, the central parties shall meet as necessary to review and amend by agreement the list of chairs of Professional Responsibility Assessment Committees. The parties agree that should a Chair be required, the Extendicare Employer Management Division and the Ontario Nurses' Association will be contacted. They will provide the name of the person to be utilized on the alphabetical listing of Chairs. The name to be provided will be the top name on the list of Chairs who has not been previously assigned. Should the Chair who is scheduled to serve decline when requested, or it becomes obvious that she or he would not be suitable due to connections with the Hospital or community, the next person on the list will be approached to act as Chair.

Professional Responsibility. (Article 8.01 applies to employees covered by an Ontario College under the Regulated Health Professions Act only.) 8.01 The parties agree that patient care is enhanced if concerns issues relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective manner. This provision is intended to appropriately address employee concerns relative to their workload issues in the context of their professional responsibility. In particular, the parties encourage nurses to raise any issues that negatively impact their workload or patient care, including but not limited to: • Gaps in continuity of care • Balance of staff mix • Access to contingency staff • Appropriate number of nursing staff In the event that the Hospital assigns a number of patients or a workload to an individual nurse or group of nurses such that they have cause to believe that she or they are being asked to perform more work than is consistent with proper quality patient care, they shall: i) At the time the workload issue occurs, discuss the issue within the unit/program to develop strategies to meet patient care needs using current resources. ii) If necessary, using established lines of communication as identified by the hospital, seek immediate assistance from an individual(s) (who could be within the bargaining unit) who has responsibility for timely resolution of workload issues. iii) Failing resolution of the workload issue issue(s) at the time of occurrence, occurrence or if the issue issue(s) is ongoing the nurse(s) will discuss the issue with her or his their Manager or designate on the next day that the Manager (or designate) and the nurse are both working or within five ten (510) calendar days whichever is sooner. When meeting with the manager, the nurse(s) if requested by the nurse(s) a Union representative to support/assist them at the meeting. iv) Complete the ONA/Hospital Professional Responsibility Workload Report Form. The manager (or designate) will provide a written response on the ONA/Hospital Professional Responsibility Workload Report Form to the nurse(s) within 5 ten (10) calendar days of receipt of the form with a copy to the Bargaining Unit President, Chief Nursing Executive, and the Senior Clinical Leader (if applicable). When meeting with the manager, if requested by the nurse(s) may request the assistance of ), a Union representative to support/assist her/him them at the meeting. ivv) Every effort will be made to resolve workload issues at the unit level. A Union representative shall be involved in any resolution discussions at the unit level. The discussions and actions will be documented. vvi) Failing resolution at the unit level, submit the ONA/Hospital Professional Responsibility Workload Report Form to the EmployerHospital-Union Association Committee within twenty (20) calendar days from the date of the Manager’s response or when she or he they ought to have responded under (iiiiv) above. . vii) The Chair of the EmployerHospital-Union Association Committee shall convene a meeting of the EmployerHospital-Union Association Committee within fifteen (15) calendar days of the filing of the ONA/Hospital Professional Responsibility Workload Report Form. The Committee shall hear and attempt to resolve the issue(s) to the satisfaction of both parties and report the outcome to the nurse(s). viii) Any settlement arrived at under Article 8.01 (a) iii) v), or vi) Prior shall be signed by the parties. ix) Failing resolution of the issues through the development of joint recommendations within fifteen (15) calendar days of the meeting of the Hospital Association Committee the issue shall be forwarded to an Independent Assessment Committee. x) Failing development of joint recommendation(s) and prior to the issue(s) being forwarded to the Independent Assessment Committee, the Union may will forward a written report outlining the issue(s) and recommendations to the Chief Nursing Executive. . xi) For professionals regulated by the RHPA, other than nurses, the Union may forward a written report outlining the issue(s) and recommendations to the appropriate senior executive as designated by the Hospital. vii) Any settlement arrived at under . (Article 8.01 (a) iii8.01(a), iv(x), or v(xiii) shall be signed by the parties.and (xiv) and 8.01(b) applies to nurses only) viiixii) Failing resolution of the issue(s) within fifteen (15) calendar days of the meeting of the Employer-Union Committee the issue(s) shall be forwarded to an The Independent Assessment Committee is composed of three (3) registered nurses; one chosen by the Ontario Nurses' Association, one chosen by the Hospital and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chair. If one of the parties fails to appoint its nominee within a period of forty-five thirty (4530) calendar days of giving notice to proceed to the Independent Assessment Committee, the process will proceed. This will not preclude either party from appointing their nominee prior to the commencement of the Independent Assessment Committee hearing. A copy of the Procedural Guidelines contained in Appendix 4 shall be provided to all Chairpersons named in Appendix 2. ixxiii) The Assessment Committee shall set a date to conduct a hearing into the issue(s) within fourteen (14) calendar days of its appointment and shall be empowered to investigate as is necessary and make what findings as are appropriate in the circumstances. The Assessment Committee shall render its decision, in writing, to the parties within forty-five (45) calendar days following completion of its hearing. xxiv) It is understood and agreed that representatives of the Ontario Nurses' Association, including the Labour Relations Officer(s), may attend meetings held between the Hospital and the Union under this provision. xixv) Any issue(s) lodged under this provision shall be on the form set out in Appendix 46. Alternately, the local parties may agree to an electronic version of the form and a process for signing. xiixvi) The Chief Nursing Executive, relevant Clinical Leaders, Bargaining Unit President President, and the EmployerHospital-Union Committee Association Committee, will jointly review the recommendations of the Independent Assessment Committee within thirty (30) calendar days of the release of the IAC recommendations, and develop an implementation plan for mutually agreed changes. (b) i) The list of Assessment Committee Chairs is attached as AppendixAppendix 2. During the term of this Agreement, the central parties shall meet as necessary to review and amend by agreement the list of chairs of Professional Responsibility Assessment Committees. The parties agree that should a Chair be required, the Ontario Hospital Association and the Ontario Nurses' Association will be contacted. They will provide the name of the person to be utilized on the alphabetical listing of Chairs. The name to be provided will be the top name on the list of Chairs who has not been previously assigned. Should the Chair who is scheduled to serve decline when requested, or it becomes obvious that they would not be suitable, the next person on the list will be approached to act as Chair.

Professional Responsibility. (Article 8.01 applies to employees covered by an Ontario College under the Regulated Health Professions Act only.) 8.01 The parties Parties agree that patient resident care is enhanced if concerns issues relating to professional practice, patient resident acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective manner. In the event that the Hospital Health Centre assigns a number of patients residents or a workload to an individual nurse or group of nurses such that they have cause to believe that she or they are being asked to perform more work than is consistent with proper patient resident care, they shall: i) At the time the workload issue occurs, discuss the issue within the unit/program to develop strategies to meet patient resident care needs using current resources. ii) If necessary, using established lines of communication as identified by the hospitalcommunication, seek immediate assistance from an individual(s) identified by the Health Centre (who could be within the bargaining unit) who has responsibility for timely resolution of workload issues. iii) Failing resolution of the workload issue issue(s) at the time of occurrence, or if the issue is ongoing the nurse(s) will discuss the issue with her their Manager (or his Manager or designate designate) on the next day that the Manager (or designate) and the nurse are both working or within five ten (510) calendar days days, whichever is sooner. Complete the ONA/Hospital Professional Responsibility Workload Report Form. The program manager (or designate) will provide a written response respond in writing on the ONA/Hospital ONA Professional Responsibility Workload Report Form to the nurse(s) within 5 days of receipt of the form issue(s), with a written copy to the Bargaining Unit President. When meeting with the managerManager (or designate), nurse(s) is/are entitled to be represented by a Union representative if requested by the nurse(s) may request the assistance of a Union representative to support/assist her/him them at the meeting. iv) Every effort will be made to resolve workload issues Any settlement arrived at the unit level. A Union representative under (a) v) shall be involved in any resolution discussions at signed by the unit level. The discussions and actions will be documentedParties. v) Failing resolution at the unit levelresolution, submit the ONA/Hospital Professional Responsibility Workload Report Form complain in writing to the Employer-Union Committee within twenty (20) calendar days from the date of the Manager’s response or when she or he ought to have responded under (iii) above. The Chair of the Employer-Union Committee shall convene a meeting of the Employer-Union Labour- Management Committee within fifteen (15) calendar days of the alleged improper assignment. The Chair of the Labour- Management Committee shall convene a meeting of the Labour-Management Committee within ten (10) calendar days of the filing of the ONA/Hospital Professional Responsibility Workload Report Formcomplaint. The Committee shall hear and attempt to resolve the issue(s) complaint to the satisfaction of both parties and report the outcome to the nurse(s)Parties. vi) Prior to the issue(s) being forwarded to the Independent Assessment Committee, the Union may forward a written report outlining the issue(s) and recommendations to the Chief Nursing Executive. For professionals regulated by the RHPA, other than nurses, the Union may forward a written report outlining the issue(s) and recommendations to the appropriate senior executive as designated by the Hospital. vii) Any settlement arrived at under Article 8.01 (a) iii), iv), or v) shall be signed by the parties. viii) Failing resolution of the issue(s) complaint within fifteen (15) calendar days of the meeting of the EmployerLabour-Union Management Committee the issue(s) complaint shall be forwarded to an Independent independent Assessment Committee composed of three (3) registered nurses; one chosen by the Ontario Nurses' Association, one chosen by the Hospital Health Centre and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chair. If one of the parties fails to appoint its nominee within a period of forty-five (45) calendar days of giving notice to proceed to the Independent Assessment Committee, the process will proceed. This will not preclude either party from appointing their nominee prior to the commencement of the Independent Assessment Committee hearing. ixvii) The Assessment Committee shall set a date to conduct a hearing into the issue(s) complaint within fourteen (14) calendar days of its appointment and shall be empowered to investigate as is necessary and make what findings as are appropriate in the circumstances. The Assessment Committee shall render report its decisionfindings, in writing, to the parties Parties within forty-five thirty (4530) calendar days following completion of its hearing. xviii) It is understood and agreed that representatives of the Ontario Nurses' Association, including the Labour Relations Officer(s)Officer and the Nursing Practice Officer, may attend meetings held between the Hospital Health Centre and the Union under this provision. xiix) Any issue(s) complaint lodged under this provision shall be on the form set out in Appendix 4. Alternately, the local parties may agree to an electronic version of the form and a process for signing. xii) The Chief Nursing Executive, Bargaining Unit President and the Employer-Union Committee will jointly review the recommendations of the Independent Assessment Committee and develop an implementation plan for mutually agreed changesONA Professional Responsibility Workload Report Form. (b) i) The list of Assessment Committee Chairs is attached as AppendixAppendix 2. During the term of this Agreement, the Parties shall meet as necessary to review and amend by agreement the list of chairs of Professional Responsibility Assessment Committees. The Parties agree that should a Chair be required, the Health Centre and the Ontario Nurses' Association will be contacted. They will provide the name of the person to be utilized on the alphabetical listing of Chairs. The name to be provided will be the top name on the list of Chairs who has not been previously assigned. Should the Chair who is scheduled to serve decline when requested, or it becomes obvious that they would not be suitable due to connections with the Health Centre or community, the next person on the list will be approached to act as Chair.

Professional Responsibility. (Article 8.01 applies to employees covered by an Ontario College under the Regulated Health Professions Act only.) 8.01 The parties agree that patient care is enhanced if concerns relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective manner. In the event that the Hospital assigns a number of patients or a workload to an individual nurse or group of nurses such that they have cause to believe that she or they are being asked to perform more work than is consistent with proper patient care, they shall: i) At the time the workload issue occurs, discuss the issue within the unit/program to develop strategies to meet patient care needs using current resources. ii) If necessary, using established lines of communication as identified by the hospital, seek immediate assistance from an individual(s) (who could be within the bargaining unit) who has responsibility for timely resolution of workload issues. iii) Failing resolution of the workload issue at the time of occurrence, or if the issue is ongoing the nurse(s) will discuss the issue with her or his Manager or designate on the next day that the Manager (or designate) and the nurse are both working or within five (5) calendar days whichever is sooner. Complete the ONA/Hospital Professional Responsibility Workload Report Form. The manager (or designate) will provide a written response on the ONA/Hospital Professional Responsibility Workload Report Form to the nurse(s) within 5 days of receipt of the form with a copy to the Bargaining Unit President. When meeting with the manager, the nurse(s) may request the assistance of a Union representative to support/assist her/him at the meeting. iv) Every effort will be made to resolve workload issues at the unit level. A Union representative shall be involved in any resolution discussions at the unit level. The discussions and actions will be documented. v) Failing resolution at the unit level, submit the ONA/Hospital Professional Responsibility Workload Report Form to the Employer-Union Committee within twenty (20) calendar days from the date of the Manager’s response or when she or he ought to have responded under (iii) above. The Chair of the Employer-Union Committee shall convene a meeting of the Employer-Union Committee within fifteen (15) calendar days of the filing of the ONA/Hospital Professional Responsibility Workload Report Form. The Committee shall hear and attempt to resolve the issue(s) to the satisfaction of both parties and report the outcome to the nurse(s). vi) Prior to the issue(s) being forwarded to the Independent Assessment Committee, the Union may forward a written report outlining the issue(s) and recommendations to the Chief Nursing Executive. For professionals regulated by the RHPA, other than nurses, the Union may forward a written report outlining the issue(s) and recommendations to the appropriate senior executive as designated by the Hospital. vii) Any settlement arrived at under Article 8.01 (a) iii), iv), or v) shall be signed by the parties.. (Article 8.01(a), (viii), (ix) and (x) and 8.01(b) applies to nurses only) viii) Failing resolution of the issue(s) within fifteen (15) calendar days of the meeting of the Employer-Union Committee the issue(s) shall be forwarded to an Independent Assessment Committee composed of three (3) registered nurses; one chosen by the Ontario Nurses' Association, one chosen by the Hospital and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chair. If one of the parties fails to appoint its nominee within a period of forty-five (45) calendar days of giving notice to proceed to the Independent Assessment Committee, the process will proceed. This will not preclude either party from appointing their nominee prior to the commencement of the Independent Assessment Committee hearing. ix) The Assessment Committee shall set a date to conduct a hearing into the issue(s) within fourteen (14) calendar days of its appointment and shall be empowered to investigate as is necessary and make what findings as are appropriate in the circumstances. The Assessment Committee shall render its decision, in writing, to the parties within forty-five (45) calendar days following completion of its hearing. x) It is understood and agreed that representatives of the Ontario Nurses' Association, including the Labour Relations Officer(s), may attend meetings held between the Hospital and the Union under this provision. xi) Any issue(s) lodged under this provision shall be on the form set out in Appendix 4. Alternately, the local parties may agree to an electronic version of the form and a process for signing. xii) The Chief Nursing Executive, Bargaining Unit President and the Employer-Union Committee will jointly review the recommendations of the Independent Assessment Committee and develop an implementation plan for mutually agreed changes. (b) i) The list of Assessment Committee Chairs is attached as AppendixAppendix 2. During the term of this Agreement, the central parties shall meet as necessary to review and amend by agreement the list of chairs of Professional Responsibility Assessment Committees. The parties agree that should a Chair be required, the Extendicare Employer Management Division and the Ontario Nurses' Association will be contacted. They will provide the name of the person to be utilized on the alphabetical listing of Chairs. The name to be provided will be the top name on the list of Chairs who has not been previously assigned. Should the Chair who is scheduled to serve decline when requested, or it becomes obvious that she or he would not be suitable due to connections with the Hospital or community, the next person on the list will be approached to act as Chair.

Professional Responsibility. (Article 8.01 applies to employees covered by an Ontario College under the Regulated Health Professions Act only.) 8.01 10.01 The parties agree that patient care is enhanced if concerns relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective manner. This provision is intended to appropriately address employee concerns relative to their workload issues in the context of their professional responsibility. In particular, the parties encourage nurses to raise any issues that negatively impact their workload or patient care, including but not limited to: • Gaps in continuity of care • Balance of staff mix • Access to contingency staff • Appropriate number of nursing staff In the event that the Hospital Employer assigns a number of patients or a workload to an individual nurse or group of nurses such that they have cause to believe that she or they are being asked to perform more work than is consistent with proper patient care, they shall:; i) At the time the workload issue occurs, discuss the issue within the unit/program to develop strategies to meet patient care needs using current resources. ii) If necessary, using established lines of communication as identified by the hospitalcommunication, seek immediate assistance from an individual(s) identified by the Employer (who could be within the bargaining unit) who has responsibility for timely resolution of workload issues. iii) Failing resolution of the workload issue at the time of occurrence, or if the issue is ongoing the nurse(s) will discuss the issue with her or his Manager or designate on the Manager’s or designate’s next day that the Manager (or designate) and the nurse are both working or within five ten (510) calendar days days, whichever is sooner. Complete the ONA/Hospital Professional professional Responsibility Workload Report Form. , The manager (or designate) will provide a written response on the ONA/Hospital ONA/ Employer Professional Responsibility Workload Report Form to the nurse(snurses(s) within 5 ten (10) days of receipt of the form with a copy to the Bargaining Unit President. When meeting with the manager, the nurse(s) may request the assistance of a Union representative to support/assist her/him at the meeting. iv) Every effort will be made to resolve workload issues at the unit level. A Union representative shall be involved in any resolution discussions at the unit level. The discussions and actions will be documented. v) Failing resolution at the unit level, submit the ONA/Hospital Professional Responsibility Workload Report Form to the Employer-Union Hospital- Association Committee within twenty (20) calendar days from the date of the Manager’s response or when she or he ought to have responded under (iii) above. The Chair of the Employer-Union Hospital- Association Committee shall convene a meeting of the Employer-Union Hospital- Association Committee within fifteen (15) calendar days of the filing of the ONA/Hospital Professional Responsibility Workload Report Formcomplaint. The Committee shall hear and attempt to resolve the issue(s) complaint to the satisfaction of both parties and report the outcome to the nurse(s). viv) Prior to the issue(s) complaint being forwarded to the Independent Assessment Committeecommittee, the Union may forward a written report outlining the issue(s) complaint and recommendations to the Chief Nursing Executive. For professionals regulated by the RHPA, other than nurses, the Union may forward a written report outlining the issue(s) and recommendations to the appropriate senior executive as designated by the Hospital. vii) Any settlement arrived at under Article 8.01 (a) iii), iv), or v) shall be signed by the parties. viiivi) Failing resolution of the issue(s) complaint within fifteen (15) calendar days of the meeting of the EmployerUnion-Union Employer Committee the issue(s) complaint shall be forwarded to an Independent independent Assessment Committee composed of three (3) registered nurses; one chosen by the Ontario Nurses' Association, one chosen by the Hospital Employer and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chair. If one of the parties fails to appoint its nominee within a period of forty-five (45) calendar days of giving notice to proceed to the Independent Assessment Committee, the process will proceed. This will not preclude either party from appointing their nominee prior to the commencement of the Independent Assessment Committee hearing. ixvii) The Assessment Committee shall set a date to conduct a hearing into the issue(s) complaint within fourteen (14) calendar days of its appointment and shall be empowered to investigate as is necessary and make what findings as are appropriate in the circumstances. The Assessment Committee shall render report its decisionfindings, in writing, to the parties within forty-five (45) calendar days following completion of its hearing. xviii) It is understood and agreed that representatives of the Ontario Nurses' Association, including the Labour Employment Relations Officer(s)Officer and the Nursing Practice Officer, may attend meetings held between the Hospital Employer and the Union under this provision. xiix) Any issue(s) complaint lodged under this provision shall be on the form set out in Appendix 4. Alternately, the local parties may agree to an electronic version of the form and a process for signing. xii) The Chief Nursing Executive, Bargaining Unit President and the Employer-Union Committee will jointly review the recommendations of the Independent Assessment Committee and develop an implementation plan for mutually agreed changes6. (b) i) The list of Assessment Committee Chairs Chairpersons is attached as AppendixAppendix 2. The parties agree that should a Chairperson be required, the Ontario Hospital Association and the Ontario Nurses’ Association will be contacted. They will provide the name of the person to be utilized on the alphabetical listing of Chairpersons. The name to be provided will be the top name on the list of Chairpersons who has not been previously assigned. Should the Chairperson who is scheduled to serve decline when requested, or it becomes obvious that the Chair would not be suitable due to connections with the Employer or community, the next person on the list will be approached to act as Chairperson.

Professional Responsibility. (Article 8.01 applies to employees covered by an Ontario College under a) The parties have a mutual interest in the Regulated Health Professions Act only.) 8.01 provision of quality patient care. The parties agree that patient care is enhanced if concerns issues relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective manner. This provision is intended to appropriately address employee concerns relative to their workload issues in the context of their professional responsibility. In particular, the parties encourage employees to raise any issues that negatively impact their workload or patient care, including but not limited to: • Gaps in continuity of care. • Balance of staff mix. • Access to contingency staff. • Appropriate number of RRT staff. In the event that the Hospital assigns a number of patients or a workload to an individual nurse employee or group of nurses employees such that they have cause to believe that she or they are being asked to perform more work than is consistent with proper patient care, they shall: (i) At the time the workload issue occurs, discuss the issue within the unit/program to develop strategies to meet patient care needs using current resources. (ii) If necessary, using established lines of communication as identified by the hospital, seek immediate assistance from an individual(s) (who could be within the bargaining unit) who has responsibility for timely resolution of workload issues. (iii) Failing resolution of the workload issue issue(s) at the time of occurrence, occurrence or if the issue issue(s) is ongoing the nurse(semployee(s) will discuss the issue Z with her their manager (or his Manager or designate designate) on the next day that the Manager manager (or designate) and the nurse employee are both working or within five ten (510) calendar days whichever is sooner. When meeting with the manager, the employee(s) is/are entitled to be represented by a union representative if requested by the employee(s) to support/assist them at the meeting. (iv) Complete the ONA/Hospital Professional Responsibility RRT Workload Report Alert Form. The manager (or designate) will provide a written response on the ONA/Hospital Professional Responsibility RRT Workload Report Alert Form to the nurse(semployee(s) within 5 ten (10) calendar days of receipt of the form with a copy to the Bargaining Unit President, Program Manager, and the Clinical Director for Critical Care. When meeting with the manager, the nurse(semployee(s) may request the assistance of is/are entitled to be represented by a Union union representative to support/assist her/him at the meeting.if requested by the iv(v) Every effort will be made to resolve workload issues at the unit level. A Union union representative shall be involved in any resolution discussions at the unit level. The discussions and actions will be documented. v(vi) Failing resolution at the unit level, submit the ONA/Hospital Professional Responsibility RRT Workload Report Alert Form to the EmployerHospital-Union Association Committee within twenty (20) calendar days from the date of the Managermanager’s response or when she or he they ought to have responded under (iiiiv) above. . (vii) The Chair of the EmployerHospital-Union Association Committee shall convene a meeting of the EmployerHospital-Union Association Committee within fifteen (15) calendar days of the filing of the ONA/Hospital Professional Responsibility RRT Workload Report Alert Form. The Committee shall hear and attempt to resolve the issue(s) to the satisfaction of both parties and report the outcome to the nurse(semployees(s) using the Workload/Professional Responsibility Review Tool to develop joint recommendations (Appendix 9). vi) Prior to the issue(s) being forwarded to the Independent Assessment Committee, the Union may forward a written report outlining the issue(s) and recommendations to the Chief Nursing Executive. For professionals regulated by the RHPA, other than nurses, the Union may forward a written report outlining the issue(s) and recommendations to the appropriate senior executive as designated by the Hospital. vii(viii) Any settlement arrived at under Article 8.01 (a) iii), iv) v), or vvi) shall be signed by the parties. viii) Failing resolution of the issue(s) within fifteen (15) calendar days of the meeting of the Employer-Union Committee the issue(s) shall be forwarded to an Independent Assessment Committee composed of three (3) registered nurses; one chosen by the Ontario Nurses' Association, one chosen by the Hospital and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chair. If one of the parties fails to appoint its nominee within a period of forty-five (45) calendar days of giving notice to proceed to the Independent Assessment Committee, the process will proceed. This will not preclude either party from appointing their nominee prior to the commencement of the Independent Assessment Committee hearing. ix) The Assessment Committee shall set a date to conduct a hearing into the issue(s) within fourteen (14) calendar days of its appointment and shall be empowered to investigate as is necessary and make what findings as are appropriate in the circumstances. The Assessment Committee shall render its decision, in writing, to the parties within forty-five (45) calendar days following completion of its hearing. x) It is understood and agreed that representatives of the Ontario Nurses' Association, including the Labour Relations Officer(s), may attend meetings held between the Hospital and the Union under this provision. xi) Any issue(s) lodged under this provision shall be on the form set out in Appendix 4. Alternately, the local parties may agree to an electronic version of the form and a process for signing. xii) The Chief Nursing Executive, Bargaining Unit President and the Employer-Union Committee will jointly review the recommendations of the Independent Assessment Committee and develop an implementation plan for mutually agreed changes. (b) i) The list of Assessment Committee Chairs is attached as Appendix

Professional Responsibility. (Article 8.01 applies to employees covered by an Ontario College under the Regulated Health Professions Act only.) 8.01 10.01 The parties agree that patient care is enhanced if concerns issues relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective manner. This provision is intended to appropriately address employee concerns relative to their workload issues in the context of their professional responsibility. In particular, the parties encourage nurses to raise any issues that negatively impact their workload or patient care, including but not limited to: • Gaps in continuity of care • Balance of staff mix • Access to contingency staff • Appropriate number of nursing staff In the event that the Hospital Employer assigns a number of patients or a workload to an individual nurse or group of nurses such that they have cause to believe that she or they are being asked to perform more work than is consistent with proper patient care, they shall:; i) At the time the workload issue occurs, discuss the issue within the unit/program to develop strategies to meet patient care needs using current resources. ii) If necessary, using established lines of communication as identified by the hospitalcommunication, seek immediate assistance from an individual(s) identified by the Employer (who could be within the bargaining unit) who has responsibility for timely resolution of workload issues. iii) Failing resolution of the workload issue issue(s) at the time of occurrence, or if the issue is ongoing the nurse(s) will discuss the issue issue(s) with her or his their Manager or designate on the Manager’s or designate’ s next day that the Manager (or designate) and the nurse are both working or within five ten (510) calendar days days, whichever is sooner. When meeting with the manager, the nurse(s) is/are entitled to be represented by a Union representative if requested by the nurse(s) to support/assist them at the meeting. iv) Complete the ONA/Hospital Professional Responsibility Workload Report Form. The , the manager (or designate) will provide a written response on the ONA/Hospital ONA/ Employer Professional Responsibility Workload Report Form to the nurse(snurses(s) within 5 ten (10) days of receipt of the form with a copy to the Bargaining Unit President. When meeting with the manager, the nurse(s) may request the assistance of a Union representative to support/assist her/him at the meeting. iv) Every effort will be made to resolve workload issues at the unit level. A Union representative shall be involved in any resolution discussions at the unit level. The discussions and actions will be documented. v) Failing resolution at the unit level, submit the ONA/Hospital Professional Responsibility Workload Report Form to the EmployerHospital-Union Association Committee within twenty (20) calendar days from the date of the Manager’s response or when she or he they ought to have responded under (iii) above. The Chair of the EmployerHospital-Union Association Committee shall convene a meeting of the EmployerHospital-Union Association Committee within fifteen (15) calendar days of the filing of the ONA/Hospital Professional Responsibility Workload Report Formcomplaint. The Committee shall hear and attempt to resolve the issue(s) complaint to the satisfaction of both parties and report the outcome to the nurse(s). vi) Prior ▇▇▇▇▇ to the issue(s) complaint being forwarded to the Independent Assessment Committeecommittee, the Union may forward a written report outlining the issue(s) complaint and recommendations to the Chief Nursing Executive. For professionals regulated by the RHPA, other than nurses, the Union may forward a written report outlining the issue(s) and recommendations to the appropriate senior executive as designated by the Hospital. vii) Any settlement arrived at under Article 8.01 (a) iii), iv), or v) shall be signed by the parties. viii) Failing resolution of the issue(s) complaint within fifteen (15) calendar days of the meeting of the EmployerUnion-Union Employer Committee the issue(s) complaint shall be forwarded to an Independent independent Assessment Committee composed of three (3) registered nurses; one chosen by the Ontario Nurses' Association, one chosen by the Hospital Employer and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chair. If one of the parties fails to appoint its nominee within a period of forty-five (45) calendar days of giving notice to proceed to the Independent Assessment Committee, the process will proceed. This will not preclude either party from appointing their nominee prior to the commencement of the Independent Assessment Committee hearing. ixviii) The Assessment Committee shall set a date to conduct a hearing into the issue(s) complaint within fourteen (14) calendar days of its appointment and shall be empowered to investigate as is necessary and make what findings as are appropriate in the circumstances. The Assessment Committee shall render report its decisionfindings, in writing, to the parties within forty-five (45) calendar days following completion of its hearing. xix) It is understood and agreed that representatives of the Ontario Nurses' Association, including the Labour Employment Relations Officer(s)Officer and the Nursing Practice Officer, may attend meetings held between the Hospital Employer and the Union under this provision. xix) Any issue(s) complaint lodged under this provision shall be on the form set out in Appendix 4. Alternately, the local parties may agree to an electronic version of the form and a process for signing. xii) The Chief Nursing Executive, Bargaining Unit President and the Employer-Union Committee will jointly review the recommendations of the Independent Assessment Committee and develop an implementation plan for mutually agreed changes6. (b) i) The list of Assessment Committee Chairs Chairpersons is attached as AppendixAppendix 2. The parties agree that should a Chairperson be required, the Ontario Hospital Association and the Ontario Nurses’ Association will be contacted. They will provide the name of the person to be utilized on the alphabetical listing of Chairpersons. The name to be provided will be the top name on the list of Chairpersons who has not been previously assigned. Should the Chairperson who is scheduled to serve decline when requested, or it becomes obvious that the Chair would not be suitable due to connections with the Employer or community, the next person on the list will be approached to act as Chairperson.

Professional Responsibility. (Article 8.01 applies to employees covered by an Ontario College under the Regulated Health Professions Act only.) 8.01 The parties agree that patient care is enhanced if concerns relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective manner. In the event that the Hospital assigns a number of patients or a workload to an individual nurse or group of nurses employee such that they have cause to believe that she or they are being asked to perform more work than is consistent with proper patient care, they shall: i(a) At the time that the workload issue occurs, discuss the issue within the unit/program to develop strategies to meet patient care needs using current resources. ii) If necessary, using established lines of communication as identified by the hospital, seek immediate assistance from an individual(s) (who could be within the bargaining unit) who has responsibility for timely resolution of workload issues. iiib) Failing resolution of the workload issue at the time of occurrence, the employee(s) or if the issue is ongoing the nurse(s) group of employees will discuss the issue with her or his Manager or designate on the next day that the Manager (or designate) designate and the nurse Employee are both working or within five seven (57) calendar days whichever is sooner. Complete the ONA/Hospital Professional Responsibility Workload Report Form. The manager (or designate) will provide a written response on the ONA/Hospital Professional Responsibility Workload Report Form to the nurse(s) within 5 days of receipt of the form with a copy to the Bargaining Unit President. When meeting with the manager, the nurse(s) may request the assistance of a Union representative to support/assist her/him at the meeting. iv(c) Every effort will be made to resolve workload issues at the unit level. A Union representative shall be involved in any resolution discussions at the unit level. The discussions and actions will be documented. v(d) Failing resolution of the workload issue at the unit level, submit the ONA/Hospital Professional Responsibility Workload Report Form to workload issue will be discussed at the Employernext Labour-Union Management Committee meeting. Such meeting will occur within twenty thirty (2030) calendar days from the date of the Manager’s response or when she or he ought to have responded under (iii) aboveas soon as possible thereafter. The Chair of the Employer-Union Committee shall convene a meeting of the Employer-Union Committee within fifteen (15) calendar days of the filing of the ONA/Hospital Professional Responsibility Workload Report Form. The Committee committee shall hear and attempt to resolve the issue(s) complaint to the satisfaction of both parties and report the outcome to the nurse(semployee(s). vi(e) Prior to If the issue(s) being forwarded to matter is unresolved by the Independent Assessment Labour-Management Committee, the Union Association may forward a written report outlining the issue(s) complaint and recommendations to the Chief Nursing Executive. For professionals regulated by VP of Clinical Services or designate for resolution of the RHPA, other than nurses, the Union may forward a written report outlining the issue(s) and recommendations to the appropriate senior executive as designated by the Hospitalissues. vii(f) Any settlement arrived at under Article 8.01 (a) iii)Time limits in this process may be extended only by written, iv), or v) shall be signed by mutual consent of the parties. viii(g) Failing resolution When meeting with the manager in any step of the issue(s) within fifteen (15) calendar days of the meeting of the Employer-Union Committee the issue(s) shall be forwarded to an Independent Assessment Committee composed of three (3) registered nurses; one chosen by the Ontario Nurses' Association, one chosen by the Hospital and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chair. If one of the parties fails to appoint its nominee within a period of forty-five (45) calendar days of giving notice to proceed to the Independent Assessment Committeethis process, the process will proceed. This will not preclude either party from appointing their nominee prior to employee(s) may request the commencement assistance of the Independent Assessment Committee hearing. ix) The Assessment Committee shall set a date to conduct a hearing into the issue(s) within fourteen (14) calendar days of its appointment and shall be empowered to investigate as is necessary and make what findings as are appropriate in the circumstances. The Assessment Committee shall render its decision, in writing, to the parties within forty-five (45) calendar days following completion of its hearing. x) It is understood and agreed that representatives of the Ontario Nurses' AssociationUnion Representative, including the Labour Relations Officer(s), may attend meetings held between ) to support/assist her/him at the Hospital and the Union under this provisionmeeting. xi) Any issue(s) lodged under this provision shall be on the form set out in Appendix 4. Alternately, the local parties may agree to an electronic version of the form and a process for signing. xii) The Chief Nursing Executive, Bargaining Unit President and the Employer-Union Committee will jointly review the recommendations of the Independent Assessment Committee and develop an implementation plan for mutually agreed changes. (b) i) The list of Assessment Committee Chairs is attached as Appendix

Professional Responsibility. ‌ (Article 8.01 applies to employees covered by an Ontario College under the Regulated Health Professions Act only.) 8.01 The parties agree that patient care is enhanced if concerns relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective manner. This provision is intended to appropriately address employee concerns relative to their workload issues in the context of their professional responsibility. In particular, the parties encourage nurses to raise any issues that negatively impact their workload or patient care, including but not limited to: • Gaps in continuity of care; • Balance of staff mix; • Access to contingency staff; • Appropriate number of nursing staff. In the event that the Hospital assigns a number of patients or a workload to an individual nurse or group of nurses such that they have cause to believe that she or they are being asked to perform more work than is consistent with proper patient care, they shall: i) At the time the workload issue occurs, discuss the issue within the unit/program to develop strategies to meet patient care needs using current resources. ii) If necessary, using established lines of communication as identified by the hospital, seek immediate assistance from an individual(s) (who could be within the bargaining unit) who has responsibility for timely resolution of workload issues. iii) Failing resolution of the workload issue at the time of occurrence, occurrence or if the issue is ongoing the nurse(s) will discuss the issue with her or his Manager or designate on the next day that the Manager (or designate) and the nurse are both working or within five ten (510) calendar days whichever is sooner. When meeting with the manager, the nurse(s) may request the assistance of a Union representative to support/assist her/him at the meeting. iv) Complete the ONA/Hospital Professional professional Responsibility Workload Report Form. The manager (or designate) will provide a written response on the ONA/Hospital Professional Responsibility Workload Report Form to the nurse(s) within 5 ten (10) calendar days of receipt of the form with a copy to the Bargaining Unit President, Chief Nursing Executive, and the Senior Clinical Leader (if applicable). When meeting with the manager, the nurse(s) may request the assistance of a Union representative to support/assist her/him at the meeting. ivv) Every effort will be made to resolve workload issues at the unit level. A Union representative shall be involved in any resolution discussions at the unit level. The discussions and actions will be documented. vvi) Failing resolution at the unit level, submit the ONA/Hospital Professional Responsibility Workload Report Form to the Employer-Union Hospital- Association Committee within twenty (20) calendar days from the date of the Manager’s response or when she or he ought to have responded under (iiiiv) above. . vii) The Chair of the EmployerHospital-Union Association Committee shall convene a meeting of the EmployerHospital-Union Association Committee within fifteen (15) calendar days of the filing of the ONA/Hospital Professional Responsibility Workload Report Form. The Committee shall hear and attempt to resolve the issue(s) to the satisfaction of both parties and report the outcome to the nurse(s). vi) Prior to the issue(s) being forwarded to the Independent Assessment Committee, the Union may forward a written report outlining the issue(s) and recommendations to the Chief Nursing Executive. For professionals regulated by the RHPA, other than nurses, the Union may forward a written report outlining the issue(s) and recommendations to the appropriate senior executive as designated by the Hospital. vii) Any settlement arrived at under Article 8.01 (a) iii), iv), or v) shall be signed by the parties. viii) Failing resolution of the issue(s) within fifteen (15) calendar days of the meeting of the Employer-Union Committee the issue(s) shall be forwarded to an Independent Assessment Committee composed of three (3) registered nurses; one chosen by the Ontario Nurses' Association, one chosen by the Hospital and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chair. If one of the parties fails to appoint its nominee within a period of forty-five (45) calendar days of giving notice to proceed to the Independent Assessment Committee, the process will proceed. This will not preclude either party from appointing their nominee prior to the commencement of the Independent Assessment Committee hearing. ix) The Assessment Committee shall set a date to conduct a hearing into the issue(s) within fourteen (14) calendar days of its appointment and shall be empowered to investigate as is necessary and make what findings as are appropriate in the circumstances. The Assessment Committee shall render its decision, in writing, to the parties within forty-five (45) calendar days following completion of its hearing. x) It is understood and agreed that representatives of the Ontario Nurses' Association, including the Labour Relations Officer(s), may attend meetings held between the Hospital and the Union under this provision. xi) Any issue(s) lodged under this provision shall be on the form set out in Appendix 4. Alternately, the local parties may agree to an electronic version of the form and a process for signing. xii) The Chief Nursing Executive, Bargaining Unit President and the Employer-Union Committee will jointly review the recommendations of the Independent Assessment Committee and develop an implementation plan for mutually agreed changes. (b) i) The list of Assessment Committee Chairs is attached as AppendixONA/

Professional Responsibility. (Article 8.01 applies to employees covered by an Ontario College under the Regulated Health Professions Act only.) 8.01 The parties agree that patient care is enhanced if concerns issues relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective manner. This provision is intended to appropriately address employee concerns relative to their workload issues in the context of their professional responsibility. In particular, the parties encourage nurses to raise any issues that negatively impact their workload or patient care, including but not limited to: Gaps in continuity of care. Balance of staff mix. Access to contingency staff. Appropriate number of nursing staff. In the event that the Hospital assigns a number of patients or a workload to an individual nurse or group of nurses such that they have cause to believe that she or they are being asked to perform more work than is consistent with proper patient care, they shall: i) At the time the workload issue occurs, discuss the issue within the unit/program to develop strategies to meet patient care needs using current resources. ii) If necessary, using established lines of communication as identified by the hospital, seek immediate assistance from an individual(s) (who could be within the bargaining unit) who has responsibility for timely resolution of workload issues. iii) Failing resolution of the workload issue issue(s) at the time of occurrence, occurrence or if the issue issue(s) is ongoing the nurse(s) will discuss the issue with her their Manager (or his Manager or designate designate) on the next day that the Manager (or designate) and the nurse are both working or within five ten (510) calendar days whichever is sooner. When meeting with the manager, the nurse(s) may request the assistance of is/are entitled to be represented by a Union representative if requested by the nurse(s) to support/assist them at the meeting. iv) Complete the ONA/Hospital Professional pProfessional Responsibility Workload Report Form. The manager (or designate) will provide a written response on the ONA/Hospital Professional Responsibility Workload Report Form to the nurse(s) within 5 ten (10) calendar days of receipt of the form with a copy to the Bargaining Unit President, Chief Nursing Executive, and the Senior Clinical Leader (if applicable). When meeting with the manager, the nurse(s) may request the assistance of is/are entitled to be represented by a Union representative if requested by the nurse(s) to support/assist her/him them at the meeting. ivv) Every effort will be made to resolve workload issues at the unit level. A Union representative shall be involved in any resolution discussions at the unit level. The discussions and actions will be documented. vvi) Failing resolution at the unit level, submit the ONA/Hospital Professional Responsibility Workload Report Form to the EmployerHospital-Union Association Committee within twenty (20) calendar days from the date of the Manager’s response or when she or he they ought to have responded under (iiiiv) above. . vii) The Chair of the EmployerHospital-Union Association Committee shall convene a meeting of the EmployerHospital-Union Association Committee within fifteen (15) calendar days of the filing of the ONA/Hospital Professional Responsibility Workload Report Form. The Committee shall hear and attempt to resolve the issue(s) to the satisfaction of both parties and report the outcome to the nurse(s). vi) Prior to the issue(s) being forwarded to the Independent Assessment Committee, the Union may forward a written report outlining the issue(s) and recommendations to the Chief Nursing Executive. For professionals regulated by the RHPA, other than nurses, the Union may forward a written report outlining the issue(s) and recommendations to the appropriate senior executive as designated by the Hospital. vii) Any settlement arrived at under Article 8.01 (a) iii), iv), or v) shall be signed by the parties. viii) Failing resolution of the issue(s) within fifteen (15) calendar days of the meeting of the Employer-Union Committee the issue(s) shall be forwarded to an Independent Assessment Committee composed of three (3) registered nurses; one chosen by the Ontario Nurses' Association, one chosen by the Hospital and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chair. If one of the parties fails to appoint its nominee within a period of forty-five (45) calendar days of giving notice to proceed to the Independent Assessment Committee, the process will proceed. This will not preclude either party from appointing their nominee prior to the commencement of the Independent Assessment Committee hearing. ix) The Assessment Committee shall set a date to conduct a hearing into the issue(s) within fourteen (14) calendar days of its appointment and shall be empowered to investigate as is necessary and make what findings as are appropriate in the circumstances. The Assessment Committee shall render its decision, in writing, to the parties within forty-five (45) calendar days following completion of its hearing. x) It is understood and agreed that representatives of the Ontario Nurses' Association, including the Labour Relations Officer(s), may attend meetings held between the Hospital and the Union under this provision. xi) Any issue(s) lodged under this provision shall be on the form set out in Appendix 4. Alternately, the local parties may agree to an electronic version of the form and a process for signing. xii) The Chief Nursing Executive, Bargaining Unit President and the Employer-Union Committee will jointly review the recommendations of the Independent Assessment Committee and develop an implementation plan for mutually agreed changes. (b) i) The list of Assessment Committee Chairs is attached as AppendixONA/

Professional Responsibility. (Article 8.01 applies to employees covered by an Ontario College under the Regulated Health Professions Act only.) 8.01 9.01 The parties agree that patient care is enhanced if concerns relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective manner. In the event that the Hospital Home assigns a number of patients or a workload to an individual nurse or group of nurses nurses, such that they have cause to believe that she or they are being asked to perform more work than is consistent with proper patient care, they shall: i) At the time the workload issue occurs, discuss the issue within the unit/program to develop strategies to meet patient care needs using current resources. ii) If necessary, using established lines of communication as identified by the hospitalhome, seek immediate assistance from an individual(s) (who could be within the bargaining unit) who has responsibility for timely resolution of workload issues. iii) Failing resolution of the workload issue at the time of occurrence, occurrence or if the issue is ongoing the nurse(s) will discuss the issue with her their Manager (or his Manager or designate designate) on the next day that the Manager (or designate) and the nurse are both working or within five (5) calendar days whichever is sooner. Complete The nurse(s) will submit her issue to the ONA/Hospital Professional Responsibility Workload Report Formemployer, in writing. The manager (or designate) will provide a written response on the ONA/Hospital Professional Responsibility Workload Report Form to the nurse(s) within 5 five (5) days of receipt of the form workload issue, with a copy being forwarded to the Bargaining Unit President. . iv) When meeting with the manager, the nurse(s) may request the assistance of a Union representative to support/assist her/him them at the meeting. ivv) Every effort will be made to resolve workload issues at the unit level. A Union representative shall be involved in any resolution discussions at the unit level. The discussions and actions will be documented. vvi) Failing resolution at the unit level, submit the ONA/Hospital Professional Responsibility Workload Report Form written complaint to the EmployerHome-Union Association Committee within twenty (20) calendar days from the date of the Manager’s response or when she or he they ought to have responded under (iii) above. The Chair of the EmployerHome-Union Association Committee shall convene a meeting of the EmployerHome-Union Association Committee within fifteen (15) calendar days of the filing of the ONA/Hospital Professional Responsibility Workload Report Form. The Committee shall hear and attempt to resolve the issue(s) to the satisfaction of both parties and report the outcome to the nurse(s). vi) Prior to the issue(s) being forwarded to the Independent Assessment Committee, the Union may forward a written report outlining the issue(s) and recommendations to the Chief Nursing Executive. For professionals regulated by the RHPA, other than nurses, the Union may forward a written report outlining the issue(s) and recommendations to the appropriate senior executive as designated by the Hospital. vii) Any settlement arrived at under Article 8.01 (a) iii), iv), or v) shall be signed by the parties. viii) Failing resolution of the issue(s) within fifteen (15) calendar days of the meeting of the Employer-Union Committee the issue(s) shall be forwarded to an Independent Assessment Committee composed of three (3) registered nurses; one chosen by the Ontario Nurses' Association, one chosen by the Hospital and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chair. If one of the parties fails to appoint its nominee within a period of forty-five (45) calendar days of giving notice to proceed to the Independent Assessment Committee, the process will proceed. This will not preclude either party from appointing their nominee prior to the commencement of the Independent Assessment Committee hearing. ix) The Assessment Committee shall set a date to conduct a hearing into the issue(s) within fourteen (14) calendar days of its appointment and shall be empowered to investigate as is necessary and make what findings as are appropriate in the circumstances. The Assessment Committee shall render its decision, in writing, to the parties within forty-five (45) calendar days following completion of its hearing. x) It is understood and agreed that representatives of the Ontario Nurses' Association, including the Labour Relations Officer(s), may attend meetings held between the Hospital and the Union under this provision. xi) Any issue(s) lodged under this provision shall be on the form set out in Appendix 4. Alternately, the local parties may agree to an electronic version of the form and a process for signing. xii) The Chief Nursing Executive, Bargaining Unit President and the Employer-Union Committee will jointly review the recommendations of the Independent Assessment Committee and develop an implementation plan for mutually agreed changes. (b) i) The list of Assessment Committee Chairs is attached as Appendixfifteen

Professional Responsibility. (Article 8.01 applies to employees covered by an Ontario College under the Regulated Health Professions Act only.) 8.01 The parties agree that patient care is enhanced if concerns relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective manner. In the event that the Hospital assigns a number of patients or a workload to an individual nurse or group of nurses such that they have cause to believe that she or they are being asked to perform more work than is consistent with proper patient care, they shall: ia) At the time the workload issue occurs, discuss the issue within the unit/program to develop strategies to meet patient care needs using current resources. iib) If necessary, using established lines of communication as identified by the hospital, seek immediate assistance from an individual(s) (who could be within the bargaining unit) who has responsibility for timely resolution of workload issues. iiic) Failing resolution of the workload issue at the time of occurrence, occurrence or if the issue is ongoing the nurse(s) will discuss the issue with her or his Manager or designate on the next day that the Manager (or designate) and the nurse are both working or within five seven (57) calendar days whichever is sooner. Complete the ONA/Hospital Professional professional Responsibility Workload Report Form. The manager (or designate) will provide a written response on the ONA/Hospital Professional Responsibility Workload Report Form to the nurse(s) within 5 seven (7) days of receipt of the form with a copy to the Bargaining Unit President. When meeting with the manager, the nurse(s) may request the assistance of a Union representative to support/assist her/him at the meeting. ivd) Every effort will be made to resolve workload issues at the unit level. A Union representative shall be involved in any resolution discussions at the unit level. The discussions and actions will be documented. ve) Failing resolution at the unit level, submit the ONA/Hospital Professional Responsibility Workload Report Form to the EmployerHospital-Union Association Committee within twenty (20) calendar days from the date of the Manager’s response or when she or he ought to have responded under (iii) above. The Chair of the Employer-Union Committee shall convene a meeting of the Employer-Union Committee within fifteen (15) calendar days of the filing of the ONA/Hospital Professional Responsibility Workload Report Form. The Committee shall hear and attempt to resolve the issue(s) to the satisfaction of both parties and report the outcome to the nurse(s). vi) Prior to the issue(s) being forwarded to the Independent Assessment Committee, the Union may forward a written report outlining the issue(s) and recommendations to the Chief Nursing Executive. For professionals regulated by the RHPA, other than nurses, the Union may forward a written report outlining the issue(s) and recommendations to the appropriate senior executive as designated by the Hospital. vii) Any settlement arrived at under Article 8.01 (a) iii), iv), or v) shall be signed by the parties. viii) Failing resolution of the issue(s) within fifteen (15) calendar days of the meeting of the Employer-Union Committee the issue(s) shall be forwarded to an Independent Assessment Committee composed of three (3) registered nurses; one chosen by the Ontario Nurses' Association, one chosen by the Hospital and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chair. If one of the parties fails to appoint its nominee within a period of forty-five (45) calendar days of giving notice to proceed to the Independent Assessment Committee, the process will proceed. This will not preclude either party from appointing their nominee prior to the commencement of the Independent Assessment Committee hearing. ix) The Assessment Committee shall set a date to conduct a hearing into the issue(s) within fourteen (14) calendar days of its appointment and shall be empowered to investigate as is necessary and make what findings as are appropriate in the circumstances. The Assessment Committee shall render its decision, in writing, to the parties within forty-five (45) calendar days following completion of its hearing. x) It is understood and agreed that representatives of the Ontario Nurses' Association, including the Labour Relations Officer(s), may attend meetings held between the Hospital and the Union under this provision. xi) Any issue(s) lodged under this provision shall be on the form set out in Appendix 4. Alternately, the local parties may agree to an electronic version of the form and a process for signing. xii) The Chief Nursing Executive, Bargaining Unit President and the Employer-Union Committee will jointly review the recommendations of the Independent Assessment Committee and develop an implementation plan for mutually agreed changes. (b) i) The list of Assessment Committee Chairs is attached as Appendixunder

Professional Responsibility. (Article 8.01 applies to employees covered by an Ontario College under the Regulated Health Professions Act only.) 8.01 The parties agree that patient care is enhanced if concerns relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective manner. In the event that the Hospital assigns a number of patients or a workload to an individual nurse or group of nurses such that they have cause to believe that she or they are being asked to perform more work than is consistent with proper patient care, they shall: i) At the time the workload issue occurs, discuss the issue within the unit/program to develop strategies to meet patient care needs using current resources. ii) If necessary, using established lines of communication as identified by the hospital, seek immediate assistance from an individual(s) identified by the Hospital (who could be within the bargaining unit) who has responsibility for timely resolution of workload issues. iii) Failing resolution of the workload issue at the time of occurrence, occurrence or if the issue is ongoing the nurse(s) will discuss the issue with her or his Manager or designate on the next day that the Manager (or designate) and the nurse are both working or within five (5) calendar days whichever is sooner. Complete the ONA/Hospital Professional professional Responsibility Workload Report Form. The manager (or designate) will provide a written response on the ONA/Hospital Professional Responsibility Workload Report Form to the complainant(s), nurse(s) within 5 days of receipt of the form with a copy to the Bargaining Unit President. When meeting with the manager, the nurse(s) may request the assistance of a Union representative to support/assist her/him at the meeting. iv) Every effort will be made to resolve workload issues at the unit level. A Union representative shall be involved in any resolution discussions at the unit level. The discussions and actions will be documented. v) Complain in writing Failing resolution at the unit level, submit the ONA/Hospital Professional Responsibility Workload Report Form to the EmployerHospital-Union Association Committee within twenty (20) calendar days from the date of the Manager’s response or when she or he ought to have responded under (iii) aboveabove of the alleged improper assignment. The Chair of the EmployerHospital-Union Association Committee shall convene a meeting of the EmployerHospital-Union Association Committee within fifteen (15) calendar days of the filing of the ONA/Hospital Professional Responsibility Workload Report Form. The Committee shall hear and attempt to resolve the issue(s) to the satisfaction of both parties and report the outcome to the nurse(s). vi) Prior to the issue(s) being forwarded to the Independent Assessment Committee, the Union may forward a written report outlining the issue(s) and recommendations to the Chief Nursing Executive. For professionals regulated by the RHPA, other than nurses, the Union may forward a written report outlining the issue(s) and recommendations to the appropriate senior executive as designated by the Hospital. vii) Any settlement arrived at under Article 8.01 (a) iii), iv), or v) shall be signed by the parties. viii) Failing resolution of the issue(s) within fifteen (15) calendar days of the meeting of the Employer-Union Committee the issue(s) shall be forwarded to an Independent Assessment Committee composed of three (3) registered nurses; one chosen by the Ontario Nurses' Association, one chosen by the Hospital and one chosen from a panel of independent registered nurses who are well respected within the profession. The member of the Committee chosen from the panel of independent registered nurses shall act as Chair. If one of the parties fails to appoint its nominee within a period of forty-five (45) calendar days of giving notice to proceed to the Independent Assessment Committee, the process will proceed. This will not preclude either party from appointing their nominee prior to the commencement of the Independent Assessment Committee hearing. ix) The Assessment Committee shall set a date to conduct a hearing into the issue(s) within fourteen (14) calendar days of its appointment and shall be empowered to investigate as is necessary and make what findings as are appropriate in the circumstances. The Assessment Committee shall render its decision, in writing, to the parties within forty-five (45) calendar days following completion of its hearing. x) It is understood and agreed that representatives of the Ontario Nurses' Association, including the Labour Relations Officer(s), may attend meetings held between the Hospital and the Union under this provision. xi) Any issue(s) lodged under this provision shall be on the form set out in Appendix 4. Alternately, the local parties may agree to an electronic version of the form and a process for signing. xii) The Chief Nursing Executive, Bargaining Unit President and the Employer-Union Committee will jointly review the recommendations of the Independent Assessment Committee and develop an implementation plan for mutually agreed changes. (b) i) The list of Assessment Committee Chairs is attached as Appendixthe