Sincerely, Dr. Richard Verbeek, MD, FRCPC. Medical Director, Toronto EMS Paramedic Programs. January 30, 2014

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1 January 30, 2014 To: From: Toronto EMS, Chief, Deputy Chiefs, Managers, Educational Personnel and Operational Paramedics cc: Maud Huiskamp, Scott Gorsline, Sue Thomson, Jim Summers Dr. Rick Verbeek, Medical Director SUBJECT: Maintenance of Certification Requirements Sunnybrook Regional Base Hospital and Toronto EMS work in collaboration to validate that each paramedic certified by the Base Hospital has met all the components for the maintenance of certification. During the 2013 CME all of these components were clarified to all staff in attendance. We have fielded numerous questions and as such, we are following up with this letter to recap both the content and the FAQ s that we received during the CME. The Advanced Life Support Patient Care Standards (ALS PCS) Appendix 6 defines what is required from each paramedic certified by an Ontario Base Hospital to meet the maintenance of certification. Here is an overview; A paramedic must: 1. Be employed by an EMS service as a paramedic and the service submit evidence that he/she has completed a minimum of 144 hours of emergency medical experience in the previous 12 months. 2. Provide documentation of practice of skills overseen by the Base Hospital. The Base Hospital requires reviewing a minimum of 5 emergency call charts (epcr s) per paramedic per year where care as per the ALS PCS was ruled in or out. 3. Meet all Base Hospital administrative requirements including completion and submission of administrative forms (example: Feedback request from the quality assurance process). 4. Successfully complete all Base Hospital CME requirements related to their scope of practice. 5. Demonstrate competency and adherence to standards, protocols as per Base Hospital continuous quality improvement initiatives (examples: epcr review, patch review, CME evaluation, skill review). 6. Have no absence from clinical practice greater than 90 days. Early February all paramedics under Sunnybrook will be receiving a letter stating what their certification status is with the Sunnybrook Regional Base Hospital. In cases where the above have not been met paramedics will be administratively deactivated. Once a paramedic has been deactivated an individual plan will be developed to meet the recertification requirements. Please contact Sue Thomson your Manager, Paramedic Practice at Sue.Thomson@sunnybrook.ca if you have any further questions related to the maintenance of certification requirements. Sincerely, Dr. Richard Verbeek, MD, FRCPC. Medical Director, Toronto EMS Paramedic Programs Attachments: Maintenance of certification letter FAQs, ALS PCS Version 3.1 Appendix 6 Regional Base Hospital

2 Maintenance of Certification Requirement s letter FAQ s Why have we never had these Base Hospital certification or deactivation letters before? There are many components of the maintenance of certification which in the past were tracked on an individual basis. We have now established a process where all the requirements are validated on a continuous basis with letters being produced once a year and/or at any change of certification status. Examples: A paramedic who is on leave and reaches the 90 days threshold mark will receive a deactivation letter. A paramedic who returns to practice after a leave upon successful completion of the return to work process will receive a certification letter. A paramedic who does not attend a CME session by the required date will receive a deactivation letter. Does this mean I am no longer a paramedic if I am administratively deactivated by the Base Hospital? This means that you are no longer a certified paramedic. When you once again meet the maintenance of certification requirements, you will then become reactivated and will once again be able to practice as a certified paramedic, within your scope of practice, according to your level of certification. What are the requirements for paramedics who are assigned to special operations? If you are certified by the Base Hospital to perform additional auxiliary medical directives when assigned to PSU, tactical or CBRNE teams, you will also have to meet the annual special operations CME and recertification requirements in order to meet the maintenance of certification requirements. I am on a special team / I usually ask for Operations Superintendent assignments to signature events and/or other events during the summer. Will I still be allowed to do this? If you are administratively deactivated as a paramedic, you will not be able to participate in patient care beyond the level of a first responder until you are reactivated by the Base Hospital. What happens if I move from an administrative or support position to another position within TEMS where clinical paramedic skills are part of the key responsibilities? If your new position within TEMS requires you to reactivate your certification as a paramedic, you will be presented to the Base Hospital for reactivation. Page 1

3 Each reactivation criteria will depend on the length of time you were not active as a paramedic, and your scope of practice. Do I still need to complete the annual compulsory and supplementary CMEs if I am administratively deactivated? If you are currently administratively deactivated, you are not required to attend. Once you are able to return to practice, any missed CME s will need to be covered prior to reactivation. I would like to continue to attend compulsory and supplementary CMEs. Will I be able to do this if I am administratively deactivated? If you are administratively deactivated, you will be able to audit the course if there is space available. This will not count towards any points and any CMEs you have missed while deactivated will have to be taken during the return to practice session as part of the reactivation process. In my current position I have had to function as first responder. I am asked to assess and potentially treat staff in my area (examples: CACC or HQ response) until a transport vehicle arrives. I have access to ALS response bags. Can I still perform these duties? If not, what am I able to do? If you are administratively deactivated, you are able to perform first aid and CPR. If there is an AED, you are able to utilize this device as a first responder. Are there any exceptions? There are no exceptions. The maintenance of certification document is clear on the requirements for each paramedic. Definitions: Certification: means a written approval to perform selected medical Controlled Acts under the license/registration of a Base Hospital medical director Deactivation: means the temporary suspension of selected certified Paramedic privileges to perform Controlled Acts by the Base Hospital medical director for the purpose of performing remediation Reactivation: means the reinstatement of the suspended privileges after a period of deactivation Page 2

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