Final Flashcards
What 3 things are the professional relationship based on?
- Respect
- Trust
- Professional Intimacy
Why is a professional relationship important?
Essential to ensure patients and clients receive safe, ethical and effective assessment and treatment.
What are the 3 things that can make you a client?
- Has the practitioner charged or received payment for health care services for the individual
- The practitioner has contributed to the health record or file of the individual
- The individual has consented to a health care service recommended by the practitioner.
What is the power dynamic?
- A healthcare worker holds an inherent position of power over patients/clients because of their specialized skills and knowledge, access to personal health information, and the patients’/client’s reliance on the practitioner to improve their condition/provide health services
- Practitioners are responsible for anticipating the boundaries that exist
o Ensure that trust is not betrayed
o Establish clear boundaries - Need to establish these boundaries so that we can make sure personal dignity, privacy, control and professional detachment are really understood
- Boundaries are limits that allow safe and respectful connections between you, your patient and perhaps individuals that are connected within that patients circle of care.
What are the 3 components of a professional relationship?
- Respect & trust
- Professional intimacy
- Power
Explain respect and trust in a professional relationship
- When we speak about respect and trust these are the foundations to a successful professional relationship. All based on what we have evaluated to be a patients physical or emotional needs and we need to make sure the client feels respected and trusts us to be able to deliver the services. Them withholding info from us can be a barrier to treatment.
Explain professional intimacy in a professional relationship
- Intimacy – degree of personal closeness between us and patients and this may not exist in other professional relationships. Due to the volume of time or convos that are had during sessions it’s not the same as dropping taxes off with an accountant and getting them later. Our engagement might actually include touching or physical closeness. They might disclose very personal/private info to us. Really important that we recognize this and respect this.
- Should note that with professional intimacy the intimacy is appropriate in the context of delivering patient centered care or services. Intimacy is not intimacy that would be spoken about in other relationships – e.g., between 2 partners. Never intimacy of a sexual nature.
Explain power in a professional relationship
- The idea of professional intimacy along with our knowledge and expertise all of those things places us in a position of power. Doesn’t matter that this isn’t intended or if treating someone of equal knowledge to you. The second you are in a client/patient relationship a power dynamic automatically exists b/c I am reliant on you to provide care to me in addition to that you have personal info/details and a professional closeness. Provide sensitivity in this area.
- Want to be sensitive to the patient’s subjective impressions even though some boundaries might not be something that we are not uncomfortable with (e.g., being amongst athletes/teams where those boundaries feel a bit more free vs someone you met for the first time – want consent if going to touch them). Each individual in front of you needs to be met with the same level of professional engagement at all times. That power dynamic always exists therefore regardless of that person’s comfort level you want to make sure you are establishing and maintaining those professional boundaries in the way you are presenting yourself and upholding your space within this professional relationship.
What are the performance expectations for professional boundaries?
- Show sensitivity to the power imbalance (real or perceived)
- Establish and manage boundaries
- Refrain from behaviour that could be seen as inappropriate, abusive and/or neglectful
- Refrain from excessive or inappropriate touching of a patient
- Engage in appropriate professional communication
- Respect a patient/client’s rights to reach decisions about treatment and/or services
- Advocate for the patient/client’s best interests
- Demonstrate sensitivity to diversity and adjust boundaries as appropriate
- Refrain from treatment of individuals with whom there is a close personal relationship
- Refrain from engaging in a close personal relationship with a patient/client’s family member
- Refraining from dual relationships
- Educating patient’s/clients and advocates on the professional relationship and protecting them from boundary violations or abuse
What is the definition of a close personal relationship?
Relationship with a person that is characterized by feelings of warmth and familiarity and/or has elements of exclusivity, privacy or intimacy.
What defines a spouse?
A spouse is considered to be a person’s legal spouse under the family law act but a spouse may also be defined as someone a person has lived in a conjugal relationship outside of marriage for not less than 3 years.
What is a duel relationship?
- Refraining from duel relationships means refraining from you seeking services from a patient at the same time as they are seeking services from you for health care purposes. Definition is when a practitioner has a business or personal relationship that is outside of their practice. E.g., your accountant has decided to seek care for low back pain. I should not be treating him b/c I see him for services and therefore this would be an inappropriate professional relationship.
What is abuse?
The misuse of the power imbalance existing in the professional relationship and a manipulation of the core elements of the relationships- trust, respect, and professional intimacy, when the practitioner knew, or ought to have known, that their behaviour would cause harm.
- Abuse can be verbal, financial, sexual, emotional, physical, neglect (is considered abusive).
What are 3 ways to establish and manage boundaries?
- Professional distance
- Refraining from accepting and giving gifts
- Refraining from inappropriate self-disclosure
- In establishing and maintaining your boundaries having professional distance so you can maintain objectivity as it relates to a patient and their care. The closer you get our objectivity becomes blurred.
What are 2 ways we can engage in appropriate professional communication?
- Communication delivery
- Refrain from voicing personal opinions about values, lifestyle, politics, etc.
Need to be aware of nonverbal communication. Doesn’t mean this is what your intentions are but it’s not about your intentions rather what is perceived.
- Some might say no opinions – she says rather voicing strong personal opinions. This does not necessarily mean you can’t express to someone that you’re a firm believer in taking time for your self and promoting time for yourself as it pertains to maintaining health and wellness. But it depends on how it is presented. Context is key. Need to present info in ways that are meaningful to the patient and if the individual isn’t receptive to the convo then it’s not a convo that is going to be successful.
- If a client perceives you are judging them this will create challenges. Avoid these convos as much as possible but at times it does come up b/c it’s related to health/wellbeing
What is the statement on a personal relationship with a client?
- Close personal relationships can diminish a kinesiologist’s objectivity and can increase a patient’s vulnerability.
- A sexual relationship with a patient/client or their substitute decision maker (SDM) is strictly prohibited and is considered sexual abuse unless the patient is the Kinesiologist’s spouse as per the provisions of the spousal exception regulation adopted by the College.
- Their vulnerability is high – we know them from beyond out professional relationship (know their medical history and them personally). Creates a strong inappropriate power dynamic.
- Best case here is refer.
- UNLESS they are your spouse. Everyone else is problematic. Maintain and establish those boundaries so you aren’t developing feelings for your clients and that they aren’t developing feelings for you. Just refer ppl and avoid this territory.
- This close personal relationship doesn’t recognize unique components of the professional relationships and risks really efficiency of the patient’s health improvement.
What are the rules on dating a client?
- In the event that you are in a relationship with someone who is or was a patient of yours – specifically engaging in a sexual relationship this can’t happen for a minimum of 1 year until the end of your professional relationship. Asterisk beside this statement as well. There is always an inherent power dynamic. The power dynamic may never not exist if you are also their practitioner. While the rules have stipulated a period of 1 year or more there may be times where that power dynamic never leaves and therefore it is never going to be appropriate b/c the power imbalance continues to exist.
- Establish and maintain those boundaries so you don’t get in these circumstances at all. Don’t want to have to worry about if there is or isn’t a power dynamic and how long it would last.
What is treatment and what act is the definition in?
Treatment, is defined in the Health Care Consent Act, 1996 as, anything that is done for a therapeutic, preventive, palliative, diagnostic, cosmetic or other health-related purpose, and includes a course of treatment, plan of treatment or community treatment plan”.
It does not include emergency care or minor, episodic care, such as providing manual therapy to alleviate a tense muscle after a period of exercise on a sporadic basis.
What are the general guidelines on treating family or close personal relationships?
- Exceptional circumstances exist when the benefits of providing treatment outweigh the risks
- The best interests of the patient/client, from their perspective, must always be paramount.
- Only in exceptional circumstances if you do. While you or your intentions to deliver the best possible care as well as clinical objectivity, this is likely to be compromised due to the close personal relationships you have.
- However, it is fully recognized that you might be in a position where this does have to happen. There is a clear guideline about how to do this.
They define treatment in a certain way. Highlights that it is very recognized that you and your family member might come to you and say my back is tight and you give them a massage. This is not sexual abuse. If it continues to go on, if it is paired with concurrent care of them (they are under your care) then it could be. I have a sore muscle from being at the gym does not constitute sexual abuse if you rub their shoulder. This standard was created to identify exception circumstances where benefits of providing treatment to family members or close personal relationships actually outweigh the risks. - Need to recognize that there is always going to be real and inherent risks with someone who you know and have a close personal relationship with. Also real power dynamic concerns. Professional boundaries are blurring when you step into this territory. The therapeutic client relationship is our foundation for safe, ethical, care therefore the very existence of having a close personal relationship with someone can be an issue here.
What are the exceptional circumstances when we can treat family or close personal relationships?
- When there is no similar or viable health care provider that is available. I have fallen down the stairs, herniated a disc in my back, can’t go to work, my spouse is a practitioner, they care for me until I can actually see my regular practitioner. This would fall into exceptional circumstances b/c making me sit there in pain or not being able to function. Those risks are greater than you treating me and there being a power imbalance or a professional relationship boundary being blurred. Not ongoing – at the moment there is no other viable option.
- Need to consider if alternative arrangements can lead to demonstrating financial hardship. This is a very real thing that ppl experience especially at this moment in time (post-covid). Health care is very expensive so this could be something that presents as an exceptional circumstance.
- Consider if the individual is unlikely to seek care from anyone that they don’t know. This one is a little bit less realistic in comparison to the other 2 b/c you supporting referral to a spouse could be less likely. Think about you referring your grandparents and they refuse to go. This could be an exceptional circumstance.
- There is really an actual barrier to a patient accessing health care services. Maybe in the area there is a sig communication barrier so can’t seek care elsewhere. Need to identify these sometimes aren’t isolated and might coexist with each other. These might stop at some point as well. That first point- this isn’t going to be the case for years unless in a completely remote area where you have that personal relationship but are the only 2 around. Likely at some point someone else will become available and at that point need to re-evaluate continuously to see when and where you can move them to an appropriate care provider, so you aren’t blurring the line of the professional and personal relationship.
If it is in the best interest of the patient then this is what we need to do.
In which ways do we need to maintain boundaries with family?
- Professional boundaries
- Consent and capacity
- Fees and billing
- Record keeping
- Mandatory reporting
Speak to the idea of disclosure and explaining the conflict of interest with a family member. Need to make sure that any influence from your personal relationship is not being used to influence your clinical relationship.
- Fees – ties into maintaining boundaries with family. You are explicitly transparent and consistent when doing your fees and billing when it relates to family.
- Record keeping – need to be up to date on it. Just like with all other patients if treating a close personal relationship or family member as it pertains to those exceptions we need to make sure you’re documenting appropriately. Documenting the plan – is this patient always going to be yours? – why or why not. If there is a financial hardship has that financial hardship changed? When are you revisiting these concepts? When are you revisiting if another practitioner is a viable option? Be clear these convos are documented in conjunction with all your other reporting duties.
READ FULL LIST BEFORE FINAL!!!
What constitutes sexual abuse and what is the punishment?
- A sexual relationship with a patient/client who is not the practitioners spouse is considered sexual abuse and subject to mandatory revocation of the certificate of registration for 5 years
- Due to the potential for power imbalances, practitioners should refrain, where possible from becoming socially, romantically, or sexually involved with a patient/client’s close personal relations. This may make the patient/client uncomfortable, or may make patient/client feel that the practitioner is placing their interests ahead of the patient.
- The professional relationship extends to the substitute decision maker
Don’t engage in social relationships with clients.
What policy outlines sexual abuse?
The Health Professions Procedural Code (the Code) of the Regulated Health Professions Act, 1991 (RHPA) outlines acts that constitute sexual abuse
What 3 things constitute sexual abuse?
(a) Sexual intercourse or other forms of physical relations between the member
and the patient/client
(b) Touching of a sexual nature of the patient/client by the member
(c) Behavior or remarks of a sexual nature by the member towards the
patient/client
Very important to understand why treating family members, spouses, close personal relationships can be so problematic.
There are a few exceptions to this – as it pertains to a spouse. READ it!!
What are the circumstances the RHPA specifies a mandatory report is required?
o Sexual abuse
o Terminations, restrictions, investigations
o Conduct of others
o Incompetence and incapacity
- Child and Family Services Act, 1990
o Child Abuse - Long-Term Care Homes Act, 2007
o Elder abuse - This mandatory report ensures the college is aware and can investigate any incidents of professional misconduct, incompetence, incapacity. Idea behind it is protection of the public. There are things you can’t turn a blind eye to. If you see it you must report it – can’t pretend you didn’t see it.
- Terminations need to be defined – when they talk about terminations they aren’t saying termination with or without cause. Those are legal terms. What they mean is termination in general for suspicion of professional misconduct. If they are terminating you b/c they’re suspecting that you have incompetence or incapacity. This would fall under second bullet point.
- Conduct of others – you are responsible for promptly reporting anything that is unsafe in terms of practice by other kinesiologists. This is all if you are a COKO member.
- If the person that you suspect is abusing a child or an elder if a member of COKO you report it to them or if a member of any regulated health profession you report it to that regulating body for that person. But also report it to 2 very specific organizations. Be aware that this a separate legislative piece outside of our practice. Ontario legislation.
- Self-reporting – some of this is in relation to the annual reporting that we do in order to maintain our registration/certification. Do need to report if you’ve been found guilty of an offence. Need to report if you’ve been found guilty of professional negligence or malpractice. Negligence meaning you didn’t conduct yourself to a standard of care and therefore something that you did or did not do actually resulted in damages to someone you had a duty of care to. Legal proceedings are separate from ethical proceedings but do need to report those to your college or regulating body. If licenced as a RMT as well as RKIN and the RMT organization is investigating you for something you need to report that to COKO.
What 3 things must we report in self-reporting?
o Guilty of an offence
o Finding of professional negligence or malpractice
o Finding or proceeding by another regulatory body
What is incompetence/incapacity that needs to be reported?
- Incompetence/incapacity – you’re considered to be incompetent if the professional care of the patient displays a lack of knowledge, skill or judgment of a nature or to an extent that demonstrates that the member is unfit to continue to practice or that the members practice should be restricted. Not demonstrated by a mistake rather a repetition or pattern of a deficiency. A mistake once is part of the learning process, reflect and move forwards – use clinical reasoning. This is a demonstration where this is consistently becoming an issue.
What is needed to make a report?
Proof is not necessary, only reasonable suspicion
- Reporters are protected against liability under the RHPA when making a mandatory report, even if the allegations are proven to be false.
What is the fine for not reporting?
It is considered professional misconduct if a kinesiologist fails to report any of the above information. If the College becomes aware of such a failure, the College can investigate. Failure to make a mandatory report is an offence punishable with a fine of up to $50,000.00 for a first offence.
What are some warning signs of a professional relationship crossing a line?
- Spending time with a patient/client that exceeds their health care needs.
- Scheduling irregular appointment times or longer appointment times with a patient/client.
- Dressing differently when seeing a particular patient/client.
- Using suggestive verbal or body language or flirting with a patient/client.
- Physically touching the patient/client in a manner unnecessary for the treatment.
- Asking a patient/client for personal information that is not related to their health care needs, such as asking if the patient/client is dating anyone.
- Answering questions of a similar nature as above from the patient/client.
- Self-disclosure to the patient/client about personal problems or situations.
- Providing a patient/client with personal contact information and/or accepting the personal contact information from the patient/client.
- Contacting and conversing with a patient/client that is not necessary to the treatment of the patient/client.
- Accepting or requesting access to personal social media accounts on platforms such as Facebook, Twitter, LinkedIn or other personal blog sites.
- Reducing or waiving professional fees.
- Receiving or giving gifts, especially those that are expensive or of a personal nature.
- Meeting socially with the patient/client even if there is no physical or sexual contact.
- Frequently thinking about the patient/client in personal terms, and
- Being hesitant to discuss activities with a patient/client to friends, family and colleagues (except for reasons of confidentiality).
- What if running a home business. Need to set clear boundaries between work and personal life is important.
What is professional collaboration?
To work together, especially in a joint intellectual effort, the concurrent treatment of a patient/client by healthcare professionals
-Need to make sure are only collaborating and providing concurrent care when it’s as per our professional judgment a requirement for care.
-The care needs to be compatible.
What is concurrent treatment?
The circumstance where more than one healthcare professional is administering or applying remedies to a patient/client for the same or related disease, injury or for the treatment of unrelated diseases or injury where the treatment of one disease or injury could affect the treatment of the other.
Care is concurrent b/c both engaging with them at the same time but might not be directly for the same disease/disorder.
What are the 4 reasons when we can perform concurrent care?
Provide concurrent treatment in circumstances where the treatment:
- Is appropriate to the needs of the client.
- Is complementary to the treatment provided by the other health care professional
- Is provided following consultation with the other health care professional whenever possible.
- Is coordinated with other health care professional whenever possible.
What are 2 situations where we don’t provide concurrent care?
Not providing concurrent treatment in circumstances where:
- The other healthcare professional has a conflicting treatment approach or client care objective.
- The kinesiology services are unethical or inefficient duplication of healthcare services.
- Why are these services necessary rather than just b/c the person has access to the services/benefits.
Besides when and when not to provide concurrent care what are the other 3 expectations about collaboration and concurrent care?
- In circumstances where, in his or her judgement, the concurrent treatment is unnecessary, clearly communicating this decision to the patient
- Ensuring that the funding mechanism that is paying for the care permits more than one healthcare professional to provide treatment for the patient/client and obtaining informed consent if it does not. However, the patient/client may choose to pay for the treatment themselves should the funding mechanism not permit more than one healthcare professional to provide treatment
- Not commenting on health professionals’ qualifications or services other than to provide professional opinions that are necessary in the circumstances in a respectful manner
- You do have a duty to provide your opinion and say that things are unethical and make sure things are safe for the person you’re caring for but does need to be in a respectful manner.
What are some concerns with collaborating care?
- The treatments provided to the patient/client for the same or related conditions may inadvertently counteract or interfere with each other;
- Conflicting advice and/or information may be provided to the patient/client;
- The member may not be able to determine the impact of his or her treatment intervention on the patient/client;
- Issues of confidentiality and privacy and patient/client control over their personal health information can arise; and
- The concurrent treatment may result in an unethical or inefficient use of healthcare resources.
What is assignment of care?
Assignment is the process of handing over the care of a patient/client (or specific tasks) to another health care worker (either regulated or non)
Who can we assign care to (2)?
o Student: Any student seeking work experience in kinesiology practice or related field
o Support Personnel: An unregulated person who is working under the direct or indirect supervision of a regulated health professional, whose activities are the responsibility of the regulated health professional. Carrying out care for supervisor.
What is indirect supervision?
Where a kinesiologist is not directly assignment care about a specific patient/client, but is in a managerial or oversight role over staff and/or practice environment
What factors of the student/support personnel must you consider?
- the need to encourage a student’s/support personnel’s autonomy and learning;
- a level of supervision appropriate to the assignment;
- the knowledge, skill and clinical reasoning of the student/support personnel;
- the patient’s/client’s level of comfort in working with students/support personnel; and
- the severity or risk level associated with the patient’s/client’s condition.
- Up to your judgement, the complexity of the task and who the patient is, the person you’re assigning care to and the level of risk.
What are the expectations of assigning care (11)?
- Maintaining professional accountability for all aspects of care/service which they assign
- Evaluating the knowledge, skill and judgment of the student(s)/support personnel prior to any assignment.
- Ensuring that the duties assigned are appropriate and take into consideration the complexity of the practice environment and the patient’s/client’s condition along with their: a) Knowledge, skill, and judgement, b) level of education, c) experience, and d) confidence
- Ensuring that the student/support personnel is competent to perform any intervention, service or activity that is assigned to them.
- Conducting ongoing training and evaluation of students/support personnel to ensure that they are competent, and their performance of the assigned intervention meets the standard of practice for the profession.
- Documenting training and evaluation of students/support personnel which is conducted at appropriate intervals related to the placement/position, duration of employment, experience of the student/support personnel and any other relevant factors.
- Minimizing risk of harm to the patient/client by ensuring that they supervise students/support personnel at an appropriate level based on consideration of the activities to be performed and assessment of the level of competency of the student/support person. This does not mean that all students/support personnel must be in the presence of the kinesiologist and under direct observation at all times. It will depend on the student’s/support personnel’s level of knowledge, skills and judgment
- Obtaining informed consent from patients/clients or their substitute decision-makers prior to involving students/support personnel.
- Ensuring that patient/client records and related documentation reflect accurately who has entered what information/notations and who has provided what services or performed which acts described in the notes.
- Ensuring that patient/client records and related documentation written or completed by students/support personnel include a formal acknowledgment that the information has been reviewed by the supervising member.
- Immediately discontinuing student/support personnel involvement in circumstances where their actions or deficient knowledge, skill or clinical reasoning place the patient/client or public at risk, or where the patient/client withdraws consent for their involvement.
- Need to supervise ppl appropriately at an appropriate level based on the activities being performed, the competency of the person, the complexity of the client.
What 2 things can you NOT assign?
- Obtaining informed consent for a course of treatment and/or a change in the course of the treatment
- Discharging a client from treatment and creating a discharge plan
What must you educate your students/personnel on?
MUST educate regarding professional boundaries
- Accountable for making reasonable efforts at ensuring that professional boundaries are maintained.
You are responsible for any and all care that is assigned – and this means responsible for actions of those ppl as well as it pertains to the idea of professional boundaries.
What is delegation?
Delegation is the act of transferring authority from one practitioner to another to perform the controlled act.
Delegation is permitted in order to make the delivery of health care more efficient and effective for patients/clients. In this way, delegation is aimed at protecting the public by advancing the patient’s/client’s interests, which could include more timely access to health care services and the better utilization of available health professionals who have an appropriate level of skills and knowledge.
- When we talk about delegation these are very specific terms and they only are utilized and refer to actions that are in the RHPA for controlled acts.
You do have a responsibility that if you’re going to accept a delegated act or medical directive to be aware of what the responsibilities are and that it’s safe. Don’t just assume that b/c someone has presented it to you and asked you to do this that they’re fully aware of their responsibilities.
What are medical directives?
Medical directives are a form of delegation. Medical directives are standing orders made in advance by the authorizing professional for the performance of a controlled act when certain sets of conditions/circumstances exist (may be client-specific or situation-specific)
There has to be very specific circumstances where this would take place.
- The directive is not a direct order – not telling someone to go communicate a diagnosis with a patient. There is a very clear and clean set of expectations that in the event these conditions are met you CAN perform this. Idea is to make sure we have flexible and efficient care, improving access to health care itself. Useful in facilities where authorizing health personnel are not aways readily available or in settings where the performance of the controlled act is common and frequent.
- These (delegation but especially directives) need to be developed by the authorizing professional in collaboration with the delagatee. The professional doesn’t know what you’re comfortable with or what you know and don’t know, what you can or can’t communicate or what you do and don’t understand.
What controlled acts can NOT be delegated?
- Only particular components - specifically, performing a procedure below the surface of the cornea, or in or below the surfaces of the teeth, including the scaling of teeth.
- Moving the joints of the spine beyond the individual’s usual physiological range of motion using a fast, low amplitude thrust.
- Putting an instrument, hand or finger,
i. beyond the external ear canal,
ii. beyond the point in the nasal passages where they normally narrow,
iii. beyond the larynx,
iv. beyond the opening of the urethra,
v. beyond the labia majora,
vi. beyond the anal verge, or
vii. into an artificial opening into the body - Prescribing, dispensing, selling or compounding a drug as defined in the Drug and Pharmacies Regulation Act, or supervising the part of a pharmacy where such drugs are kept.
- Prescribing or dispensing, for vision or eye problems, subnormal vision devices, contact lenses or eye glasses other than simple magnifiers.
- Prescribing a hearing aid for a hearing impaired person.
- Fitting or dispensing a dental prosthesis, orthodontic or periodontal appliance or a device used inside the mouth to protect teeth from abnormal functioning.
- Managing labour or conducting the delivery of a baby.
- Allergy challenge testing of a kind in which a positive result of the test is a significant allergic response.
What controlled acts can be delegated?
- Communicating a diagnosis or disorder as the cause of symptoms
- Performing a procedure on tissue below the dermis, the surface of a mucous membrane.
- Setting or casting a fracture of a bone or dislocation of a joint
- Administering a substance by injection or inhalation
- Applying or ordering the application of a form of energy prescribed by the regulations under this Act.
- Treating, by means of psychotherapy technique, delivered through a therapeutic relationship, an individual’s serious disorder of thought, cognition, mood, emotional regulation, perception or memory that may seriously impair the individual’s judgement, insight, behaviour, communication or social functioning.
The following conditions must be met before and after accepting delegation:
- Both the authorizer and the delegatee are accountable for the actual performance of the controlled act. The delegator does not need to be present during the presence of the performance of the controlled act;
- The delegatee must be reasonably sure that the authorizer is authorized to perform the act and authorized to delegate the act.
- The member has the knowledge, skills and ability to perform the controlled act, including the competence to manage all reasonably foreseeable outcomes of performing the act.
- The member has confirmed the condition of the patient/client and that the delegator has performed an appropriate assessment of the risk of harm to the patient/client by the performance of the controlled act. The member must also be able to answer the patient’s/client’s questions about the benefits and risks of the procedure;
- The member has confirmed that the patient/client has consented to the delegation of the controlled act. If the member is operating under a directive, they should inform the patient/client of the nature of the directive;
- The member must document the acceptance of delegation, the circumstances of the delegation and also fully document the performance of the procedure and any outcomes. Any discussions with the patient/client about the performance of the controlled act should also be fully documented; and
- The member must not sub-delegate the act.
What is dual health care?
- Dual health care practices occur when a member of the College of Kinesiologists of Ontario (the College) practices as a kinesiologist and practices in another health care discipline (e.g. massage therapist, chiropractor or acupuncturist).
- The other health discipline may be regulated or unregulated.
- While this can benefit patients/clients, it complicates the role and informed consent duties of members, especially when there is overlap in the scope of practice.
What are the 7 dual health care roles?
- Keep the roles of the dual health care practice separate and distinct in the mind of the patient/client
- Ensure that treatments recommended and provided are based solely on patients’/clients’ needs
- Ensure that patients/clients are provided with the information needed to understand the different roles and accountabilities when performing the treatment.
- Ensure that patients/clients are provided with the services that they initially sought unless it is determined to be inappropriate
- Ensure that patients’/clients’ records clearly demonstrate which services have been provided at each encounter
- Claim only the time worked practicing within the scope of practice of kin as practice hours for continued registration within the CKO
- Ensure that any provided care in another discipline is not done in an effort to avoid practicing according to the CKO standards
- You can never take your regulated health professional hat off if member of a regulatory college therefore any and all tasks that you have that come from other certifications, if they fall within the scope of your regulated health profession credential then you are always acting as that credential.
Who are kin’s always accountable to?
Always accountable to the public, through the College, for their practice and conduct.
What is leadership?
- Leadership is a process that occurs whenever an individual intentionally acts to influence another individual or group, regardless of the reason, in an effort to achieve a common goal, which may or may not contribute to the success of the organization.
- Leadership within healthcare requires that skillful individuals meet the health challenges of communities and the populations they serve.
o Idea of process is key. Leadership is typically a transaction between the leader themselves and the ppl who follow them. Not always defined as a trait or characteristic of the leader itself
o Think of it as an interactive process not necessarily a one way process.
o Leaders and followers affect one another.
o When we talk about leadership it’s not necessarily confined to someone who is formally designated as a leader of a group. Can be anyone in any practice or setting that emerges as a leader.
- Leadership is an intentional process.
o Assigned and emergent leadership - Influencing another individual or group is based on the manner in which a leader engages with the other person
- Leaders engage another individual or group, normally with a common purpose
- A common purpose refers to having mutual purpose and achieving something together
