The facility must have methods in place to ensure staff are managed effectively to support the care, treatment and services it provides.

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1 HUMAN RESOURCES The facility must have methods in place to ensure staff are managed effectively to support the care, treatment and services it provides. This standard addresses human resource planning, recruitment of qualified and competent staff, retention of qualified and competent staff, roles and accountabilities, and enhancing staff performance. HUMAN RESOURCE PLANNING Staff qualifications and competencies are established to ensure quality care and services Involvement of key staff who are knowledgeable about advances in service delivery and technology and who are able to determine the required competencies of staff Identifying adequate staffing numbers Anticipating and responding to changes in the environment Anticipating and assessing the impact of technological change Anticipating and responding to potential changes to workforce and capacity needs HR plan ensures adequate staff resources for the scope of services provided HR plan is monitored and revised as necessary HR has a process, in compliance with College Bylaws and requirements, to renew, revise, and deny privileges NHMSFP College of Physicians and Surgeons of British Columbia Page 1 of 10

2 RECRUITMENT OF QUALIFIED AND COMPETENT STAFF The facility defines staff qualifications in written policy The medical director has the responsibility to ensure the facility is staffed appropriately All staff must be appropriately trained, qualified and competent to carry out their specific roles and responsibilities The facility is staffed appropriately to meet individual patient needs, maintain acceptable levels of safety for both patients and staff, as outlined in provincial legislation and College regulation The facility selects and recruits staff based on: active licensure and registration or certification with the appropriate provincial or nationally recognized regulatory and/or certification body verification of credentials with the primary source (e.g. the College, CRNBC, CLPNBC, CDSBC) and document verification upon hire and annually education knowledge, skills and experience reference checks criminal background check applicable health screening /bk129.pdf training and certification as applicable to type of facility and specified staff duties and responsibilities: CPR Level HCP, ACLS, PALS, procedural sedation, medical device reprocessing, laser safety officer training, basic laser safety training, radiation safety training, WHMIS, difficult airway training Physician qualifications All physicians who perform surgery or procedures in a non-hospital facility must: be licensed and in good standing with the College of Physicians and Surgeons of BC hold privileges in a non-hospital facility approved by the College Facility.pdf hold current CPR Level HCP hold current ACLS training if, as the operating physician or endoscopist, administering and/or monitoring a patient under IV sedation and analgesia, when an anesthesiologist is not present to administer/monitor NHMSFP College of Physicians and Surgeons of British Columbia Page 2 of 10

3 All anesthesiologists who provide anesthesia in a non-hospital facility must: be certified by the Royal College of Physicians and Surgeons of Canada be licensed and in good standing with the College of Physicians and Surgeons of BC hold privileges in a facility approved by the College Facility.pdf hold active hospital privileges in the practice of anesthesia, or hold current ACLS training and have completed a difficult airway management course (to be renewed every three years) acceptable to the College if they have not regularly practised anesthesia in a hospital setting within three years All general practitioners who perform surgical assists in a non-hospital facility must: be licensed and in good standing with the College of Physicians and Surgeons of BC hold privileges in a non-hospital facility approved by the College Facility.pdf hold current CPR Level HCP (recommended) Dentist qualifications All dentists who perform dental surgery or procedures in a non-hospital facility must: be licensed and in good standing with the College of Dental Surgeons of BC hold privileges in a facility approved by the College of Physicians and Surgeons of BC hold current CPR Level HCP (recommended) Podiatrist qualifications All podiatrists who perform podiatry surgery or procedures in a non-hospital facility must: be licensed and in good standing with the College of Podiatric Surgeons of BC currently perform podiatry surgical procedures in a BC health authority hospital hold privileges in a facility approved by the College of Physicians and Surgeons of BC hold current CPR Level HCP (recommended) NHMSFP College of Physicians and Surgeons of British Columbia Page 3 of 10

4 Nurse qualifications in the operating or procedure room All registered nurses (RN) must: hold current, practising registration with the CRNBC have completed an approved accredited postgraduate perioperative nursing program, or have submitted documented evidence to the facility supporting the equivalent in education and experience in perioperative nursing acceptable to the College hold current CPR Level HCP if administering and/or monitoring a patient under IV sedation and analgesia, when an anesthesiologist is not present: o hold current ACLS training, and o in addition to ACLS, have completed a procedural sedation course acceptable to the College hold current PALS training or a pediatric critical intervention course acceptable to the College if providing pediatric services o there must be, at minimum, one RN on site per shift with current PALS training or equivalent it is recommended that a facility servicing a pediatric population have a RN both in the OR theatre and the post-anesthesia recovery unit with current PALS training All licensed practical nurses must: hold current, full registration with the CLPNBC have completed a recognized operating room certification program including both theory and practical components o scope of practice in the non-hospital setting is limited to scrub role only o licensed practical nurses may not relieve the circulating registered nurse for coffee, lunch or other duties he/she may only circulate as a second circulator in addition to a first circulator registered nurse present in the room hold current CPR Level HCP Nurse qualifications in post-anesthesia recovery All registered nurses must: hold current, practising registration with the CRNBC have completed an approved postgraduate critical care/post-anesthesia recovery room nursing certification program, or have submitted documented evidence to the facility supporting the equivalent in NHMSFP College of Physicians and Surgeons of British Columbia Page 4 of 10

5 education and experience in critical care/post-anesthesia recovery nursing acceptable to the College hold current CPR Level HCP hold current ACLS training if duties include overnight patient stay at the facility o at least one registered nurse with current training in ACLS and all other members of the nursing staff with current training in cardiopulmonary resuscitation shall be on duty at all times when patients are in the facility the expected level of ACLS intervention must be clearly defined in the facility s policy manual page 3 hold current PALS training or a pediatric critical intervention course acceptable to the College if providing pediatric services o All licensed practical nurses must: there must be, at minimum, one RN on site per shift with current PALS training or equivalent it is recommended that a facility servicing a pediatric population have a RN both in the OR theatre and the postanesthesia recovery unit with current PALS training hold current, full registration with the CLPNBC have acute surgical ward experience and/or relevant experience and qualifications appropriate to the patient population limit scope of practice in non-hospital setting to being the second post-anesthesia nurse in addition to a registered post-anesthesia recovery nurse o licensed practical nurses may not relieve the post-anesthesia registered nurse for coffee, lunch or other duties Hold current CPR level HCP Other staff qualifications All diagnostic imaging technologists must: be certified with the Canadian Association of Medical Radiation Technologists (CAMRT), or be a certified combined laboratory and X-ray technologist (CLXT) have a defined scope of practice for CLXT staff that is in alignment with their education o under their certification, a CLXT technologist has a limited scope of imaging examinations that they may conduct editation%20standards/updated%2011%20july%202012/radiology% %20Revised%2011Jul12.pdf page 3 NHMSFP College of Physicians and Surgeons of British Columbia Page 5 of 10

6 All sonography technologists must: be certified with the Canadian Association of Registered Diagnostic Ultrasound Professionals (CARDUP), or be certified with the American Registry of Diagnostic Medical Sonographers (ARDMS), or have received specific didactic and practical training, including performing vascular imaging (e.g. peripheral vascular) %20Standards/Updated%2011%20July%202012/Radiology%202010%20Revised%20 11Jul12.pdf page 4 Medical device reprocessing (MDR) staff qualifications Facilities are responsible to ensure that any individual involved in the cleaning, disinfection and/or sterilization of medical devices is properly trained and their practice is assessed on a regular basis All staff who is involved in reprocessing must be qualified through education, training and experience: completion of a recognized qualification/certification course in reprocessing (e.g. Sterile Processing Technician Certificate Program course or Medical Device Reprocessing Technician Certificate Program course) or demonstration of the equivalent in training and experience acceptable to the College, or if have not completed an MDR certification course or cannot demonstrate equivalent training experience, must have completed and passed the theory portion of an MDR course acceptable to the College pages 29, 44, 70 RETENTION OF QUALIFIED AND COMPETENT STAFF The facility has strategies to retain its staff and maintain competent, qualified, and engaged workforce Contributions by staff are recognized Professional development is encouraged and supported Workloads are monitored and managed Staff are involved in decision-making within the defined scope of their role Teamwork and knowledge sharing is encouraged NHMSFP College of Physicians and Surgeons of British Columbia Page 6 of 10

7 ROLES AND ACCOUNTABILITIES The facility provides staff with the information necessary to ensure that they are knowledgeable about their role and accountabilities within the organization and the terms and conditions of their employment Ensure staff practises within their scope of practice HR records provide evidence documentation of an employee s suitability for their role Qualifications, credential, competency and performance evaluations are verified and included as part of the employee s confidential record Position and/or job descriptions exist for all staff, and includes: position and/or job summary nature and scope of work qualifications required reporting relationships conditions of employment performance measures Position and/or job descriptions are annually reviewed and revised to reflect: current practice changing performance requirements, duties or qualifications Reporting relationships are clearly written in policy and understood by staff: organizational chart is available to staff reporting relationships are communicated to individual staff staff are aware of the reporting structure and who to take direction from Physician human resource records are kept current for all physicians and contain: evidence of qualifications, including current College registration evidence of credentialing and granting of privileges: o copy of initial Application for Appointment to a Non-Hospital Medical and Surgical Facility o copy of Physician Annual Re-Application for Privileges evidence of annual performance review and compliancy assessments immunization status at time of appointment health reports as may be required by the organization s human resources policies orientation, continuing education and in-service training records evidence of professional liability insurance coverage, if applicable evidence of criminal records check if in contact with children NHMSFP College of Physicians and Surgeons of British Columbia Page 7 of 10

8 All other employee human resource records (e.g. nurses, dentists, podiatrists, MDR technicians, etc.) are kept current for all staff and contain: evidence of qualifications including current licensure and certification or registration, if applicable evidence of credentialing and granting of privileges, if applicable evidence of education and training appropriate for the position position and/or job description immunization status at time employment commences health reports as may be required by the organization s human resources policies orientation, continuing education and in-service training records performance evaluations competency assessments recruitment information including references evidence of professional liability insurance coverage, if applicable evidence of criminal records check if in contact with children Human resource records are maintained in a confidential manner: only authorized individuals have access to records consent is obtained from the employee prior to release of information contained in their human resources record records are disposed of appropriately and in accordance with legislation ENHANCING STAFF PERFORMANCE The facility ensures that it functions within a culture that is supportive of learning and continuous professional development A key function of enhancing performance in a learning environment is performance management, which allows for staff performance and competence to be assessed and evaluated in order to provide constructive feedback, provide training and education and make improvements as necessary to ultimately improve the quality and safety of medical and surgical services provided to patients Orientation is provided to all new staff that includes the following information: mission, vision, values, goals and objectives facility programs and services safety roles and responsibilities of the individual and key staff policies of the facility and the responsibility of staff to comply relevant policies and procedures related to performing the duties of the position protection of patient confidentiality NHMSFP College of Physicians and Surgeons of British Columbia Page 8 of 10

9 protection of patient rights, including ethical aspects of care, procedures and services quality improvement and risk management practices documented assessments at the completion of a probationary and/or orientation period Orientation is provided to existing staff in response to: changing roles new technology new methods changes in competency demands new laws and regulations Staff are supported and provided with ongoing education, training and professional development to: maintain or increase their competency and participation is documented upgrade knowledge and skills as required when responsibilities change to meet the needs of the facility s services provided and participation is documented maintain competency requirements The facility monitors staff education and training to: determine if objectives have been achieved ensure sharing and dispersion of knowledge identify improvement opportunities ensure that opportunities for reinforcement of knowledge and re-training are made available as necessary take appropriate action when a staff member s competence does not meet expectations REFERENCES College of Physicians and Surgeons of Alberta. Non-hospital surgical facility - standards and guidelines [Internet]. Edmonton: College of Physicians and Surgeons of Alberta; [cited 2012 Sep 14]. Available online: Hospital/NHSF_Standards.sflb.ashx College of Physicians and Surgeons of British Columbia. Bylaws [Internet]. Vancouver: College of Physicians and Surgeons of British Columbia; [updated 2012 Jan]. Section A - Non-hospital medical and surgical facilities program (NHMSFP) p [cited 2012 Sep 14]. Available online: College of Physicians and Surgeons of Ontario. Out-of-hospital premises (OHP) standards [Internet]. Toronto: College of Physicians and Surgeons of Ontario; [cited 2012 Sep 14]. Available online: NHMSFP College of Physicians and Surgeons of British Columbia Page 9 of 10

10 Diagnostic Accreditation Program; College of Physicians and Surgeons of British Columbia. Diagnostic imaging radiology: accreditation standard [Internet]. Vancouver: Diagnostic Accreditation Program; Section: Human resources [cited 2012 Sep 14]. Available online: ds/updated%2011%20july%202012/radiology%202010%20revised%2011jul12.pdf Operating Room Nurses Association of Canada (ORNAC). Standards, guidelines and position statements for perioperative registered nursing practice. Halifax: ORNAC; Section 1: ORNAC beliefs, professional standards and competencies - staffing the surgical suite; p NHMSFP College of Physicians and Surgeons of British Columbia Page 10 of 10

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