Dialogue Volume 15, Issue 3 2019 - Page 12

SECTION TK FEATURE It was never a discussion of 'why do we need to do this?' but rather an exploration of how best to do this final policy. A small amendment was made to clarify that patients can also book an appoint- ment to receive the results rather than call in. Follow-up The final policy states that ordering physicians must ensure that appropriate follow-up on test results received occurs. This means com- municating the test result to the patient in an appropriate manner and taking appropriate clinical action in response to the test result. In certain health-care environments, the ordering physician may not be the same physi- cian who receives the test result (e.g., in an emergency department or a walk-in clinic). In these situations, ordering physicians must either delegate, assign or otherwise ensure that there is another person that is responsible for coordinating the follow-up or that there is a system in place to do so. TRANSITIONS IN CARE While the core expectations of the draft have been retained, a number of updates were made in response to practical challenges raised in the feedback. Hospital Discharges Given strong support for the requirement that discharge summaries be completed in a timely manner, and calls to adopt a 48-hour (or shorter) timeline, the policy was amended to include a 48-hour completion requirement. Acknowledging Referrals The final policy retains a requirement that consultant physicians acknowledge a referral 12 DIALOGUE ISSUE 3, 2019 within 14 days. The expectation, in general, received broad support from stakeholders. A minor revision was made to manage vaca- tions, acknowledging that the ‘clock starts’ when physicians return from a temporary absence. WALK-IN CLINICS The core expectation of this policy – that phy- sicians practising in a walk-in clinic must meet the standard of practice of the profession – is unchanged. This expectation applies regardless of whether care is being provided in a sustained or episodic manner. For example, physicians practising in a walk-in clinic must conduct any assessments, tests, or investigations that are required in order for them to appropriately provide treatment and must provide or arrange for appropriate follow-up care. The draft policy included a requirement that physicians practising in a walk-in clinic send a record of each encounter to the patient’s primary care provider (and others, as appropriate). Feedback received identi- fied practical limitations and consequences to operationalizing this requirement (e.g., administrative burden, incomplete informa- tion, increased ‘noise’, privacy concerns). In response, the policy no longer requires that information sharing be done as a matter of course, but rather only where the patient has requested that this be done or where it is a matter of patient safety. The policy acknowl- edges that the record may need to be shared through the patient, rather than directly to the provider. MD