FEATURE discussion captured in writing in order to support their ability to recall and act on that information once discharged . Physicians must use their professional judgment to determine both whether this discussion should be accompanied by written reference materials and the specific nature of those materials .
The draft policy also requires that physicians complete a discharge summary for all in-patients in a timely manner and direct that the discharge summary be sent to the patient ’ s primary care provider . Physicians will also be required to take reasonable steps to identify other health-care providers who would benefit from knowledge of the hospitalization , and direct that the discharge summary be sent to them as well .
Walk-in Clinics
This draft policy sets out the College ’ s expectations of physicians practising in walk-in clinics , focusing on those elements that most closely relate to continuity of care . This policy does not address the provision of episodic care in other practice environments or settings .
Physicians practising in walk-in clinics contribute to the health-care system by providing an alternative to crowded emergency departments for patients who are better treated in the community but either cannot access their primary care provider or do not have a primary care provider . The nature of walk-in clinic care may , however , lead to breakdowns in continuity of care that can negatively impact patient health outcomes . Physicians practising in walkin clinics have a responsibility to ensure that patients are being provided with quality care that facilitates continuity of care . “ The draft policy is clear that physicians practising in a walk-in clinic must meet the standard of practice of the profession , which applies regardless of whether care is being provided in a sustained or episodic manner ,” said Dr . Barbara Lent , a London family physician , and member of the working group . “ This means , for example , ensuring the presenting problem is appropriate and adequately
addressed by conducting any assessments , tests , or investigations or referring the patient to another health-care professional or facility who can do so ,” said Dr . Lent . Physicians ordering tests within a walk-in clinic environment must comply with the expectations set out in the Managing Tests policy . This includes , but is not limited to , having a system in place to ensure that appropriate follow-up occurs for all tests that they order and ensuring that clinically appropriate actions are taken in response to results . Similarly , physicians practising in a walk-in clinic who make referrals must provide or arrange for the provision of necessary follow-up care , including reviewing consultation reports . “ It is not appropriate to rely on the patient ’ s primary care provider or another health-care provider involved in the patient ’ s care to provide or coordinate appropriate follow-up for tests or referrals unless they have explicitly agreed to assume this responsibility ,” said Dr . Lent . Physicians practising in a walk-in clinic must provide the patient ’ s primary care provider , if there is one , with a record of the encounter , unless the patient requests that the information not be shared . This may include , for example , a record of any tests ordered , diagnoses reached , any treatment and advice provided , any referrals that were made , and any follow-up care that was arranged or advised . Physicians practising in a walk-in clinic must also take reasonable steps to identify other relevant health-care providers whose ongoing care of the patient would benefit from knowledge of the encounter and provide them with a record of the encounter as well .
Consultation
The College is committed to ensuring that the Continuity of Care draft policies reflect current practice issues , embod the values and duties of medical professionalism , and are consistent with the College ’ s mandate to protect the public . We urge you to give consideration to the issues set out in all the drafts and provide your insights to help inform the finished products . MD
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DIALOGUE ISSUE 2 , 2018