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Quality Assurance Update
Regulation of MR technologists
Delegation of Controlled Acts and Medical Directives
Questions About New Proposed Fee Bylaw
SARS
Medical Directives
Suspended Members
Reminder: E-Delivery Registration
Quality Assurance Update
Year 2002 was the sixth year in which the Quality Assurance Committee assessed the Self-Assessment Profiles and Continuous Learning Portfolios of members randomly selected by the College. The Committee was gratified to find the quality of members’ portfolios continues to be excellent. In order to assist MRTs to complete their QA records, we are providing you with questions frequently asked by members about the QA Program.
What constitutes the QA records?
There are three major components:
- Self-Assessment Profile – a record of the member’s self-assessment of his or her knowledge, skills and judgement based on the standards of practice (to be filled in annually)
- Continuous learning activities – a record of the continuous learning activities carried out by the member (annually)
- Certificate – of compliance with the QA Program and competence to practise completed by members and submitted as part of the annual renewal of registration (annually)
What is a continuous learning activity?
“A continuous learning activity” includes any activity through which a member can enhance his or her knowledge, skills or judgement related to the practice of the profession and includes any such activity whether done individually or during the course of practice.
How can I find 25 hours to go to classes?
The requirement is to complete a minimum of 25 hours per year of continuous learning activities. How a member chooses to learn is his or her choice and responsibility, but is not limited to attending classes.
When will I know if I have been randomly selected to submit my records to the College?
QA Program key dates:
- September – notice mailed to members who have been randomly selected to submit their portfolios (1% of members of each specialty)
- January – requested QA records must be received by the College
- January – MRTs’ QA records will be assessed by the QA Committee members
Do I have to use the CMRTO Forms to complete my Quality Assurance Records?
- Yes, our regulation provides that “the Quality Assurance records shall be in the form provided by the College.”
- It is important that all CMRTO members’ QA records be in a consistent format to facilitate a fair evaluation process.
As mentioned previously in Insights, the College has undertaken a major project to revise the Standards of Practice, and as the standards are used as a reference tool in the QA Program, the program will also be revised. The revisions to the QA Program will take place at the same time as the review of the Standards of Practice and will result in a QA workbook appropriate for all four specialties of the College – radiography, nuclear medicine, radiation therapy and magnetic resonance. The review process will also allow the QA Committee to revise the forms provided to members to document their continuous learning activities.
Regulation of MR technologists
As you are aware, the Ministry of Health and Long-Term Care (MOHLTC) has requested the College of Medical Radiation Technologists of Ontario (CMRTO) to regulate magnetic resonance (MR) technologists in conjunction with the CMRTO. The necessary regulations made under the Medical Radiation Technology Act came into force on May 29, 2003.
MR technologists are now regulated with the CMRTO. Under the new regulations, MR technologists must now be registered with the CMRTO in the specialty of magnetic resonance (MR) in order to represent that they are qualified to practise the specialty of magnetic resonance in Ontario. After June 18, 2004, a person must be a member of the CMRTO (or the College of Physicians and Surgeons of Ontario) in order to be legally authorized to apply electromagnetism for magnetic resonance imaging in Ontario.
The CMRTO is now able to issue certificates of registration in the specialty of magnetic resonance to applicants who meet all the registration requirements as set out in the regulations.
If you are an MR technologist and you have not yet received an application package for MR from the CMRTO, please contact Linda Gough, Deputy Registrar at (416) 975-4353 or 1-800-563-5847, or lgough@cmrto.org.
Delegation of Controlled Acts and Medical Directives
The delegation of controlled acts, and understanding the responsibility of MRTs in handling medical directives, are among the most complex aspects of our professional responsibilities. Although this issue has been covered before in Insights, it is useful to be reminded of the key aspects of our obligations as MRTs.
Both the Regulated Health Professions Act (RHPA) and the Healing Arts Radiation Protection Act (HARP Act) govern medical radiation technology procedures. Health care professionals are authorized by their specific health profession Act to perform specific controlled acts on patients. Controlled acts are those that are potentially harmful to a patient if performed by unqualified people. In all, there are 13 of these controlled acts set out in the Regulated Health Professions Act (RHPA).
The controlled acts that are authorized to MRTs are the following:
- Taking blood samples from veins
- Administering substances by injection or inhalation
- Administering contrast media through or into the rectum or an artificial opening into the body
- Tattooing
MRTs are only permitted to perform the specific authorized acts referred to above, if the procedure is ordered by a member of the College of Physicians and Surgeons of Ontario. In order for an MRT to perform any of these procedures, there must be an order from a physician.
At the same time, the HARP Act applies to the ordering and application of ionizing radiation by regulating the use and operation of X-Ray machines and equipment. The application, or ordering of the application, of ionizing radiation is not a controlled act procedure therefore, it can not be delegated. Ionizing radiation can only be ordered and applied by those who are specifically named in the HARP Act.
However, for practical purposes, the rules governing MRTs when applying ionizing radiation are similar to those governing the performance of authorized act procedures in that both require an order from the appropriate authorizing health professional.
Questions About New Proposed Fee Bylaw
At the beginning of May, all College members received a letter outlining proposed changes to the fee structure supporting the College. Some of you have written in to ask questions about the changes. Summarized here are answers to the most commonly asked questions.
Why were fees not raised in smaller increments over the past ten years?
The College has attempted to hold the line on fee increases until it was absolutely necessary to increase the fees. The demands on the College have grown appreciably over the past three years in particular. The current proposal to increase fees is the result of a two-year review of the College’s financial strategy, and a comprehensive look at the resources the College will need to carry out its statutory responsibilities today and in the future.
Why are fees going up when MRT salaries are lower than those of other health care professionals?
An increase in fees is necessary if the College is to continue to ensure the protection of the public through self-regulation of the profession. The annual fee we pay as MRTs has been the same for the past ten years, while the costs of meeting the College’s statutory responsibilities have increased significantly.
Why should part-time technologists pay the same fees as full-time technologists?
The fees paid to the College are for registration and ongoing membership in the College. It is necessary to be a member of the College in order for an MRT to practise his or her profession in Ontario. The cost of regulating a member does not change as a result of the number of hours worked. In addition, the College cannot determine how many hours per week each of the more than 5,000 members works in order to consider pro-rating the fee. Administration of such a system would be extremely costly.
Why do I have to pay fees to so many professional organizations?
To practise as a medical radiation technologist in Ontario you are only required by legislation to remit an annual fee to the College. Other professional associations provide important services for members, and some employers require membership in these associations as a condition of employment. However, the decision to join is in general a matter of individual choice.
Why not use the Internet as a replacement for current printed publications in order to save money?
The Council believes that all College members require equal access to communication material about the issues being managed by the College. At present, not every MRT in Ontario has easy access to the Internet. At the same time, while the quality of the College’s publications do reflect the professional standing of MRTs in Ontario, they are, in fact, based on design templates developed 10 years ago, and are produced and printed in a cost-effective manner.
Are my fees going up to cover the costs of regulating magnetic resonance technologists?
There has been a cost to the College in supporting self-regulation of MR technologists, but is not the cause of the deficit position in which the College has found itself over the past three years.
The Council had considered charging MR technologists a higher fee to cover the costs of regulation, but decided not to do so. The number of MR technologists to be regulated is small – in fact, 154 of the anticipated 200 MR technologists who can register in this specialty are current members of the College, and most of the others have been members of the College.
Can’t you just cut operating expenses of the College?
We have been operating with a deficit budget in the past years, drawing on our reserves to finance the difference. Although we have postponed many projects that required specialized staff, these projects can no longer be delayed if we are to meet our ongoing statutory responsibilities.
SARS
The outbreak of the SARS virus placed – and continues to place – enormous pressure on the technologists, physicians, nurses, administrators and support personnel working in Ontario’s healthcare system. At a Federation of Health Regulatory Colleges meeting in April, George Zegarac, Assistant Deputy Minister of Integrated Policy and Planning Division of the Ministry of Health and Long-Term Care thanked all health care practitioners for their incredible efforts during March and April as they worked to contain the SARS outbreak. The College Council would like to add its thanks to the growing list of organizations and individuals who have recognized that Ontario’s healthcare professionals are among the most dedicated and hard-working in the country.
Medical Directives
In 1995, with the support of the Ministry of Health and Long-Term Care, agreement was reached between the College, CNO, CPSO that an X-Ray performed on the authority of an appropriate medical directive meets HARP’s requirements, and that the implementation of a medical directive is not ordering, the actual medical directive is the order.
The need for requesting diagnostic testing by implementing a medical directive must be developed and determined collaboratively by the medical director of the Diagnostic Imaging Department, the appropriate authorizing physician(s), and all affected regulated health care professionals including nurses and medical radiation technologists.
The following three requirements must be in place for this to be the case:
- The directive itself – the directive itself must include the specific components set out in the policy
- The completed requisition – the requisition must include the specific components set out in the policy
- Supportive organizational policies – the required supportive organizational policies are set out in the policy
All of the health care professionals involved should be aware of these requirements, their specific content, and their location in the facility.
Use of medical directives for the performance of an x-ray involves a physician, a nurse and a medical radiation technologist. Their individual responsibilities are the following:
- The physician is responsible for developing the medical directive – the order that the procedure be implemented.
- The nurse is responsible for implementing the medical directive.
- The medical radiation technologist is responsible for determining whether, from a medical radiation technologist perspective, the X-Ray requested is consistent with his or her assessment of the patient’s/client’s condition.
Please refer to the College’s policy in order to understand the requirements and responsibilities of MRTs related to medical directives. The policy can be obtained from the College or the College’s Web site.
Suspended Members
The following are the people whose certificates of registration have been suspended effective May 2003 for failure to pay their fees in accordance with section 24 of the Health Professions Procedural Code. A person whose certificate of registration has been suspended is not a member of the College unless and until the suspension is removed:
| 07732 |
Handley, Carrie L. |
| 11455 |
Vergis, Ted |
| 10916 |
Daley, Anthony |
| 11049 |
Green, Fiona |
| 11529 |
Ng, Desmond |
| 04808 |
Witt, Jeanne C. |
|
Reminder: E-Delivery Registration
You can sign up for electronic delivery of Insights by clicking on this link.
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