Mike Provencher, Policy Analyst, Paramedicine and Medical Transport Division.

Transcription

1 PAGE 1/5 Concurrent Policy Name: Private / Corporate Services Medical Oversight Authorization Issuing Authority Signature/Date Original Signed July 29, 2009 Office of Administrative Responsibility Author Level Four (4) Original Approval Date Effective Date Upon Signature Review Date July 2010 Revision Date(s) N/A Cathy Burke, Director Emergency Ambulatory Care and Scott Wilson, MD, CCFP(EM) Provincial Medical Director Air and Ground Ambulance Paramedicine and Medical Transport Mike Provencher, Policy Analyst, Paramedicine and Medical Transport Division. Overview Medical Oversight is the process by which a dedicated physician guides and oversees the patient care that is provided by pre-hospital practitioners. It is a requirement that any invasive medical procedure preformed by a Medical First Responder (MFR), Emergency Medical Responder (EMR), Primary care Paramedic (PCP), Advanced Care Paramedic (ACP), or Critical care Paramedic (CCP) be authorized under the direct supervision of a licensed physician, through a delegation of authority. Failure to be covered under the delegation of authority from a physician while performing invasive procedures would be considered practicing medicine without a license. Additionally, Medical Oversight is a system of physician directed quality assurance that provides professional and public accountability for medical care in the pre-hospital setting. Medical oversight involves granting authority and accepting responsibility for the care provided by the authorized pre-hospital practitioners and includes participation in all aspects of care to ensure maintenance of accepted standards of medical practice.

2 PAGE 2/5 Quality medical oversight is an essential process to provide optimal care for pre-hospital and transfer patients. The Provincial Medical Oversight Program (PMO) has set the scope of practice for all MFR s, EMR s, PCP s, ACP s and CCP s that practice in Newfoundland and Labrador. During the provision of medical oversight a physician can not authorize any of the aforementioned registration levels to perform procedures that are outside of the scope of practice of the level in which the individual is registered. Additionally, the PMO and Department of Health and Community Services (DHCS) requires all persons that use and work under the titles of EMR, PCP, ACP and CCP be actively registered in the province. POLICY 1. EMR, PCP, ACP and CCP registrants must have medical oversight authorization in order to practice. 2. Registrants are not authorized to performed procedures that are outside the scope of practice in which they are registered. 3. Any physician providing medical oversight authorization shall forward a copy of their treatment protocols to the office of the PMO for review and approval. 4. The PMO shall determine and provide notification to the physician providing medical oversight authorization if their protocols are within the scope of practice for the applicable registration levels. 5. Registrants that perform procedures outside of their scope of practice, regardless of private medical oversight authorization, shall have their registration suspended pending a professional practice review. Scope Registrants working in privately funded services Private Medical Oversight Physicians

3 PAGE 3/5 Purpose To ensure registrants do not perform procedures beyond the scope of practice of their registration level. Ensure safe and proper patient care. Procedure 1. All Registrants that work outside of publicly funded ambulance services must file the contact information of their medical oversight physician with the PMO. 2. All medical oversight physicians must contact the PMO and provide the following prior to delegating any procedures to the aforementioned levels: a. A list of the names of the individuals in which he/she is providing medical oversight. b. A detailed list of written protocols containing a drug formulary (if applicable). c. The minimum contact information of address and telephone number. d. Provide proof of licensure to practice medicine in Newfoundland & Labrador. 3. The office of the PMO will review all submitted protocols to ensure they are do not exceed the scope of practice of each registration level. 4. The PMO will provide a letter to the private medical oversight physician either certifying the protocols are within the provincial scope of practice or a letter requiring the protocols be revised to the provincial scope of practice. 5. If a Private Medical Control Physician receives a letter from the PMO requiring protocol revisions they are to resubmit the revised protocols to the PMO for review and certification prior to allowing delegated medical acts to be performed. 6. All treatment protocols must be certified by the PMO to be within the scope of practice of the levels covered by the protocols. 7. Registrants that practice under non-certified protocols will immediately

4 PAGE 4/5 have their registration suspended pending a professional practice review. 8. Any changes in protocols must be reviewed, in the same manner as described above, by the PMO prior to implementation to ensure adherence to scope of practice. 9. The office of the PMO will notify the physician providing medical oversight of any changes to a registrant s registration status. And the Physician shall notify the PMO of changes to the registrant s medical oversight status. 10. Registrants that have their medical oversight authorization revoked by a private medical oversight physician shall provide all information regarding the circumstances that caused the revocation to the PMO. 11. Based on the information provided PMO will determine through consultation with physicians and interviewing of the registrant if the private medical oversight physician s revocation of medical oversight authority was justified. 12. If justified the registrant s registration status will be restricted, inactivated or deactivated. Supporting Documents (References, Industry Best Practice, Legislation, etc) National Occupational Competency Profile Industry Best Practice Linkages Scope of Practice Policy 3543(PMO) PRO Key Words Medical Oversight Authorization

5 PAGE 5/5 Definitions & Acronyms Industry Best Practice Medical Oversight Authorization Scope of Practice A technique or methodology that has proven to be the most efficient and effective way of accomplishing a task based on repeatable procedures that have proven over time, through experience and/or research, to reliably lead to a desired result within the industry. Direction and authorization to perform delegated medical acts provided by a physician to registered personnel who are providing medical care at the scene of an emergency or en route to a health care facility or in a health care facility via written policies, procedures, and protocols and/or through on line consultation. The procedures and treatments a registration level is allowed to do as defined in the PMO Scope of Practice policy 3543(PMO) PRO 060.