practice partner
medical staff sign a copy of each medical directive , it is acceptable for these individuals to receive copies of each directive and sign one statement indicating that they have read and agreed with all the medical directives referred to therein .
For examples of prototype medical directives , physicians are encouraged to consult the Emergency Department Medical Directives Implementation Kit which has been developed jointly by the Ontario Hospital Association ( OHA ), the Ontario Medical Association , and the Ministry of Health and Long-Term Care and is available on the OHA website . The specific requirements for medical directives are set out below .
1 Appropriate documentation A medical directive must include sufficient detail to ensure that it can be implemented . The following information must be included in a medical directive :
a ) The name and a description of the procedure , treatment or intervention being ordered ; b ) An itemized and detailed list of the specific clinical conditions that the patient must meet before the directive can be implemented ; c ) An itemized and detailed list of any situational circumstances that must exist before the directive can be implemented ; d ) A comprehensive list of contraindications to implementation of the directive ; e ) Identification of the individuals authorized to implement the directive ; f ) A description of the procedure itself that provides sufficient detail to ensure that the individual implementing the directive can do so safely and appropriately ; g ) The name and signature of the physician ( s ) authorizing and responsible for the directive and the date it becomes effective ; and h ) A list of the administrative approvals that were provided to the directive . The dates and each Committee ( if any ) should be specifically listed .
This is where the templates will come in particularly handy as there is a strong emphasis on how to describe the indications and contraindications for the delegation . In addition , the patient ’ s record must include documentation of the name and number of the directive , the name and signature of the delegate , and the name ( s ) of the authorizing physician ( s ).
2 Appropriate patient consent The protocol for the directive must include obtaining the appropriate patient consent . If the individual who will be enacting the medical directive is unable to provide the information required in order to obtain consent , the implementation of the medical directive is inappropriate .
3 Proper supervision Physicians must ensure there is a communication path that will enable the individual implementing a directive to identify the physician responsible for the care of the patient in order to contact him or her immediately , if necessary .
4 Ongoing monitoring and evaluation 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 . Physicians should also consider tracking or monitoring methods to identify when medical directives are being implemented inappropriately or are resulting in unanticipated outcomes . MD
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Dialogue Issue 2 , 2016