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Notice of Election of Members to Council
Professional Practice Issues
Health Human Resource Planning – the CIHI health human resources database project
English Language Proficiency Standards for Internationally Educated MRTs
HPRAC Review: MRT Scope of Practice
HPRAC Review: Drug Regulations for the Profession of Medical Radiation Technology
HPRAC Reports
Council Highlights
Suspended Members
Notice of Election of Members to Council
District #2 (Eastern District, Radiography) is composed of the geographic area within the territorial boundaries of the District Municipality of Muskoka, the Districts of Parry Sound and Nipissing, the United Counties of Prescott and Russell, Stormont, Dundas & Glengarry, and Leeds and Grenville, the Counties of Frontenac, Hastings, Lanark, Lennox & Addington, Prince Edward and Renfrew, and the City of Ottawa.
District #5 (Radiation Therapy) includes all of the Province of Ontario.
| Date: |
Friday, May 1, 2009 |
| Place: |
College of Medical Radiation Technologists of Ontario
170 Bloor Street West, Suite #1001
Toronto, Ontario M5S 1T9
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| Time: |
Ballots must be received at the College no later than 5:30 p.m. on May 1, 2009 |
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Professional Practice Issues
Medical Directives: What are they and how do you know if there is one in place......
There is much talk in health care facilities and patient care teams about the possibilities and opportunities for health care professionals to perform procedures by way of medical directives. With an increased focus on interprofessional collaboration and a health care system under pressure due to human resource shortages, no doubt the use of medical directives will increase as will the need for all MRTs to understand what they are.
As you are aware, MRTs are required to have an order from a regulated health professional (usually a physician) prior to performing a procedure, treatment or intervention.
An order is an authorizing statement, from a regulated health professional with prescribing authority, permitting an MRT to implement a procedure that falls within the profession’s scope of practice. Under the Medical Radiation Technology Act, an order from a physician is necessary to permit MRTs to implement authorized act procedures. Under the Healing Arts Radiation Protection Act (HARP Act), an order from a physician, dentist, chiropractor, designated chiropodist, osteopath or, under some circumstances, a nurse who holds an extended certificate of registration, is necessary to permit MRTs to apply or administer ionizing radiation.
An order may also be known as a:
- Prescription
- Requisition
- Request for consultation
- Doctor’s note
An order may be one of two types:
- Direct order (for one specific patient)
- Medical directive (also known as protocols or standing orders – for a number of patients under specific circumstances).
A direct order is generally written by the physician, for a specific procedure, treatment or intervention, for a specific patient.
A medical directive is an order or prescription for a procedure, treatment or intervention for a range of patients who meet specific conditions.
Medical directives are given in advance by physicians (or other health care professionals authorized to order a procedure) to enable an implementer to decide to perform the ordered procedure(s) under specific conditions without a direct assessment by the physician or authorizer at the time.
Directives or protocols are always written and must contain:
- a standardized reference number;
- identification of the specific procedure or treatment or range of treatments being ordered;
- identification of who specifically may implement the procedure under the authority of and according to the directive;
- specific patient conditions that must be met before the procedure(s) can be implemented;
- any circumstances that must be met before the procedures can be implemented;
- any contraindication for implementing the procedures;
- documentation requirements;
- quality monitoring mechanisms;
- the name and signature of the physician authorizing the directive; and
- the date and signature of the administrative authority approving the directive.
The establishment of directives and protocols is the responsibility of physicians who have the authority to order procedures. However, MRTs should be involved in the decision regarding whether or not the use of a directive or protocol is appropriate. In addition, safeguards and mechanisms should be in place to ensure that effective channels of communication exist between those involved in the care of the patient and that quality monitoring occurs.
For example, a physician may, through a medical directive, authorize MRTs to take a certain type of x-ray on patients who fit certain prescribed criteria under prescribed circumstances. For instance, a facility’s radiologists may have developed a medical directive giving the authority for MRTs to perform orbit x-rays on patients who may have metal fragments in the eye, identified during the screening process, prior to performing an MRI. In this case, the physician would be what is referred to as the ‘authorizer’and the MRT would be what is referred to as the ‘implementer’. The MRT is not ordering the x-ray but rather implementing the physician’s order. The medical directive is the order. Medical directives are used most frequently in health care facilities to authorize standard diagnostic tests and treatments in certain patient populations in limited circumstances to improve efficiencies and patient care outcomes.
Although the above list may seem long, it reflects only the minimum information that must be in the medical directive. Each subject matter identified requires careful consideration of a number of complex issues. The College encourages MRTs who are involved in developing medical directives or who are already implementing medical directives to familiarize themselves with the Federation of Health Regulatory Colleges of Ontario’s (FHRCO’s) Guide to Medical Directives and Delegation. The site contains a wealth of information as well as templates and forms to guide the development of medical directives.
Health Human Resource Planning – the CIHI health human resources database project
The College wishes to report on the excellent response rate of members who have submitted their baseline information form for the Canadian Institute for Health Information (CIHI) MRT database project. To date we have received the information from more than 90% of you. The new database will provide a rich source of high quality, comparable information on geography, demographics, education and employment for MRTs in Ontario and Canada. This database will be critical to governments, LHINs, and research and educational institutes in their planning for health human resource needs and MRT education programs.
English Language Proficiency Standards for Internationally Educated MRTs
This fall, College members were sent a letter and reminder postcard inviting you to participate in an on-line survey for the English Language Proficiency Standards project. The survey, which took 45 minutes to complete, was completed by more than 1300 College members. This is an impressive participation rate and our sincere thanks to those members who took time to help the College with this important project. We will inform you of the findings of this research in a future edition of Insights.
HPRAC Review: MRT Scope of Practice
The MRT Scope of Practice Review is reaching the final stages. The Health Professions Regulatory Advisory Council’s (HPRAC’s) jurisdictional and literature reviews have been completed and are now posted on the HPRAC website.
HPRAC has also completed its member and stakeholder consultations. On October 23, 2008, HPRAC facilitated a consultation session at the College’s office. The College helped to organize this session and invited members and key stakeholders to speak with HPRAC representatives about their practice and the CMRTO/OAMRT joint submission. At the session, MRTs affirmed that they see themselves as essential health practitioners who work collaboratively in delivering treatment and diagnostic services to their patients.
On November 10, 2008, College Registrar, Linda Gough, and CEO of the OAMRT, Robin Hesler, presented at another HPRAC consultation session – this time for other health regulatory colleges and associations. The session recognized how the role of MRTs has evolved over the years, acknowledged how closely MRTs work with patients and underscored the importance of their assessment skills in clinical practice.
The next step of the process is for HPRAC to provide its advice in a report to the Minister of Health and Long-Term Care due on January 31, 2009. It is at the Minister’s discretion if and when this report is made public. The College will keep members posted as new information becomes available. Once again, our thanks go out to everyone who participated at each stage of this important project.
HPRAC Review: Drug Regulations for the Profession of Medical Radiation Technology
This fall HPRAC asked the College to complete a questionnaire on non-physician prescribing and administration of drugs under the Regulated Health Professions Act, 1991. The timeline for completing the questionnaire was extremely short. However, in just over a month the College consulted with MRTs in clinical practice, education and management in all four specialties. The CMRTO’s submission can be found on the HPRAC website as well as on the CMRTO website in the What’s New section.
HPRAC Reports
Interim reports on interprofessional collaboration, and reports on the scope of practice review for extended class nurses (nurse practitioners) and the use of the “doctor title” in traditional Chinese medicine are now available on the HPRAC website.
Council Highlights
In an effort to help keep members informed of key College activities, we are posting Council meeting highlights on the College website. The highlights provide a summary of decisions made by College Council at its meetings. When there are important decisions made at these meetings we usually include an article in Insights.
At the Council meeting on October 3, 2008, Council approved the proposed amendments to the Quality Assurance and Professional Misconduct Regulations that were circulated to members this past summer. Before approving the proposed amendments, Council considered feedback from members and stakeholders.
Council meetings are generally open to the public and if you would like to attend a meeting just let us know in advance. The dates for Council meetings are posted on the CMRTO website.
Suspended Members
The following are the people whose certificates of registration were suspended between September 1, 2008 and December 15, 2008 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.
| 12191 |
Arsenault, Wayne |
| 08583 |
Biso, Jeri |
| 09264 |
McParland, Neil A. |
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