practice partner
ing to the assessment of risk, taking into
account the specific act being delegated, the
circumstances under which the act will be
performed, and the knowledge, skill, and
judgment of the person performing it.
7 Physicians must ensure there is
ongoing monitoring and evaluation of the
act being performed.
This would include ensuring the currency
of the delegate’s knowledge and skills. It
would also include periodic evaluation of
the delegation process itself to ensure it is
safe and effective.
Once you have determined delegation is
appropriate and that it should take place
through a medical directive, you will need
to create a directive. We will provide more
information about the critical elements in
the development of a directive in the next
issue of Dialogue. In the meantime, please
read our policy on the College’s website at
www.cpso.on.ca.
Here are some of the most frequently
asked questions about delegation:
Q. Do I have to be trained and experienced in the controlled act that I wish
to delegate?
A. Physicians must only delegate acts
that they are competent to perform
personally, and which constitute part of
their regular practice.
Q. Does the person to whom I am delegating the act need to be a regulated
health professional?
A. No. It is the physician’s responsibility to ensure that the individual to
whom the act is being delegated has
the appropriate knowledge, skill and
judgment to perform the delegated act.
In some cases the physician may not
personally know the individual to whom
he or she is delegating. For example, in
a hospital setting, the hospital employs the delegates (nurses, respiratory
therapists, etc.) and the medical staff
is not involved in the hiring process. In
this case, it is reasonable to assume
that the institution has ensured that its
employees have the requisite knowledge, skill and judgment.
Q. Can the controlled act of psychotherapy be delegated?
A. No, psychotherapy cannot be delegated because it could reduce the
quality of care and negate treatment
benefits, and presents an unduly high
level of risk to the patient.
Q. Are there liability issues that arise
from delegation?
A. Physicians remain accountable for
the acts that they delegate to others.
If you have liability concerns, these
should be discussed with the CMPA
prior to delegation.
Issue 1, 2016 Dialogue
31