Lecture 5 - Regulation of Healthcare Professions

RADTH 328 - Healthcare Policy. University of Alberta

What does it mean for a healthcare profession to be self-regulated?

a professional body enters into an agreement with the government to exercise control over and set standards for its members

• as RTs we are regulated by the ACMDTT, which is not the government

What does it mean when professions are regulated by the government?

legislation controls the conduct and practice of the profession and its members

How is regulatory authority granted?

through legislation, such as an act or statute that outlines the framework for behaviour and values for a given profession

common elements of regulated professions (such as the ACMDTT)

• education standards

  • why I suffer in school

• provincial and territorial examinations

  • CAMRT exam

• practitioner's scope of practice

• curbing of individual's practice if standards are not met

• formal complaints process for the public

  • patients are allowed to complain/sue

• Complaint investigation and follow up

• Title protection

  • only we can be called MRT(T)

• competence and quality assurance

  • lifelong learning credits

What it title protection

Title protection ensures that only qualified members of a regulated profession can use specific professional titles, preventing unlicensed individuals from misrepresenting their qualifications.

• only we can be called MRT(T)

Scope of Practice

A range of skills, learned in school or through on the job training, that a practitioner can perform competently and safely.

controlled acts

procedures that only certain health care professionals may perform; considered potentially harmful if performed by an untrained individual

• we need to get extra training to do this

examples of controlled acts

- giving an injection

- setting or casting a fracture

- prescribing a medication

all need education beyond MRT(T) to do

What are some exceptions to controlled acts that the provinces and territories allow indivudals who are competent but unregulated to perform?

- someone with appropriate training providing first aid or assistance in an emergency

- students learning to perform an act under supervision

- a person trained to perform an act

- an appropriate person designated to perform an act in accordance with a religion

What is a delegated act

a controlled act that a physcian authorizes another HCP (regulated or regulated) to do under thier supervision

General guidelines of delegated acts

- act must be clearly defined and supervised accordingly

- the delegated physician, the delegate, and the facility will share responsibility for the act

- if in a hospital, the board of directors is responsible for ensuring the availability of training for persons performing the act

do regulated professions have a system in place where the public can launch a complaint about a HCP?

Yes, regulated professions typically have a formal complaint mechanism to address concerns regarding healthcare practitioners.

What does a regulator of a profession have the authority to do

set educational standards for training of members to prepare professionals and provide assurance to the public that the provider is competent

What percent of Canada’s workforce work in regulated professions

Approximately 20 percent of Canada's workforce is employed in regulated professions.

• the rest are unregulated: these can range to in-depth specilized training or to jobs with minimal education required

do non-regulated occupations have federal or provincial legislations governing their occupations?

no

Health Professions Act

An act developed to regulate health professions using a model that allows for non-exclusive overlapping scopes of practice

• example: we cannot take x-rays of our own arms as RTTs

restricted activities

high risk activities performed as part of providing a health service that require specific competencies and skills to be carried out safely

What act sets out restricted activities?

The health professions act (HPA)

example of restricted activities

to order or apply any form of ionizing radiation in medical radiography, nuclear medicine or radiation therapy

Do you have to declare what restricted activities are being done on your yearly membership?

Yes, you must declare restricted activities to maintain membership compliance.

• we would declare we apply ionizing radiation in the form of radiation therapy

Examples of restricted activities radiation therapists do

- apply ionizing radiation and other forms of energy to produce diagnostic images

- evaluate the technical sufficiency of the images

- use ionizing radiation and other forms of energy for treatment purposes

- teach, manage and conduct research

- provide restricted activities authorized by the regulation

What titles are members registered in the radiation therapist general register authorized to use?

radiation therapist, medical radiation technologist, medical radiation technologist (therapy), MRT, MRT(T)

what are some examples of restricted activities radiation therapists can do only once they have advanced training

1. administer contrast agents

2. insert or remove instruments done in brachytherapy

• beyond pharynx, opening of urethra, labia majora, anal verge

3. cut body tissue below dermis to start IV line

4. use ultrasound machine

liability insurance

A type of insurance that protects healthcare professionals against claims of negligence or malpractice. It covers legal costs and any settlements or judgments arising from lawsuits.

• all RTTs must have this

What must an applicant for registration as a regulated member have?

a diploma or have successfully completed a program of studies approved by the Council, and have successfully completed an entry examination approved by the Council

An applicant for registration under subsection (1) must meet at least one of the following:

- have met the requirements set out within the 2 years immediately preceding the date the Registrar receives a complete application

- have completed at least 800 working hours of practice in the appropriate area of practice within the 5 years immediately preceding the date the Registrar receives a complete application

colleges

delegated powers and authorities for self-governance

How do health profession colleges carry out governance responsibilities in a manner that protects and serves the public interest?

- setting entry requirements

- identifying services provided with regulated members, setting standards for professional practice

- setting continuing competency requirements

- investigating complaints about regulated members and imposing disciplinary actions

role of professional associations

operate to represent the interests of their members and to advance the profession

What act are Medical Radiation Technologists regulated under?

the Health Disciplines Act

What college are Medical Radiation Technologists governed by?

the Alberta College of Diagnostic and Therapeutic Technologists (ACMDTT)

What is the Health Information Act

a act that contains rules about the collection, use, and disclosure of health information that is intended to protect the privacy of individuals and the confidentiality of their health information.

purposes of the Health Information Act

• allow any person a right to access to the records under control of a public body

• allow individuals and access to personal information about themselves held by a public body

• to provide for independent review of decisions made by public bodies under this act

When did Alberta's Health Information Act come into effect?

April 25, 2001

What are the 2 types of health information as defined by the HIA?

1. diagnostic, treatment and care information,

2. registration information

Diagnostic, Treatment, and Care information

physical or mental health of an individual, information about health service providers involved in care, drugs or health care products and any other information that is collected when a health service is provided

registration information

the demographic information of an individual

What are the rights of the individual under the Health Information Act

AHS has a duty to assist individuals with a request for their own information

key characteristics of HIA health information

Information must be recorded

information must be identifiable

information must be related to a health service

How is AHS affiliated with HIA?

AHS is a custodian under HIA

What are the duties of AHS as a custodian?

- put safeguards in place to protect the confidentiality of information and the privacy of individuals

- have an obligation to collect, use and disclose the lease amount of information required to carry out a purpose authorized by the HIA

- health information must only be collected and used on a need-to-know basis to fulfill job related duties

what two new acts replaced the FOIP act?

1. the Access to Information Act

2. Protection of Privacy Act

what is the focus to the protection of privacy act (PPA)

introduces stricter privacy protections, such as mandatory privacy-by-design for public bodies and notification for privacy breaches

What is the PPCA Act

Protection for Persons in Care Act

What is the purpose of the  PPCA

The act aims to protect vulnerable individuals in care settings from abuse and neglect, ensuring their rights and safety.

• requres the reporting the abuse of clients

• provide for an independent review of reports of abuse

• promote the prevention of abuse involving clients

What does the PPCA provide?

The PPCA provides a framework for protecting individuals in care by establishing reporting requirements for abuse, ensuring independent reviews of allegations, and implementing measures to prevent abuse.

what are our duties under the PPACA?

Under the PPCA, our duties include reporting any suspected abuse or neglect, ensuring the safety and rights of individuals in care, and cooperating with independent reviews of abuse allegations.