Frequently Asked Questions > Performing Pursuant to Orders & Assessments


QUESTION — PERFORMING PURSUANT TO ORDERS & ASSESSMENTS
  1. Can I provide an order based on another regulated health care practitioner’s assessment?  How about on an unregulated care provider’s?
  2. Can I accept an order from someone who does not have the independent authority to undertake the ordered act him or herself?
RESPONSE
  1. Can I provide an order based on another regulated health care practitioner’s assessment?  How about on an unregulated care provider’s?

    Colleges have different expectations with regard to assessments undertaken by another regulated or unregulated health care provider.  In this, as in so many other aspects of health care, you must know the requirements of your own regulator and exercise professional judgement.

    If your College practice standards and the circumstances permit, you may rely on the assessment of another so long as you are certain that the assessment was appropriately and competently undertaken for the purpose of the activity you are being expected to perform or initiate unless there are indiations that prompt further assessment. See FHRCO Interprofessional Guide on Orders, Medical Directives, and Delegation for more information. 

  2. Can I accept an order from someone who does not have the independent authority to undertake the ordered act him or herself?

    The authority to perform a controlled act under delegation always comes from the medical directive or direct order. It is appropriate for someone else, who cannot delegate the controlled act, to advise you that the medical directive or direct order is in place authorizing you to perform the controlled act. The intermediary is simply communicating information, not directing or authorizing you to perform the controlled act.

    This is an area which is often confusing for practitioners, but the bottom line is that, if there is a medical directive in place, any health care provider appropriately carrying out the activities in the directive may trigger the next activity. Authorizing mechanisms can be useful in this regard.

LINKS

FHRCO’s Interprofessional Guide on Orders, Medical Directives and Delegation

Public Hospitals Act, 1990

COLLEGE LINKS
Acupuncturists
Audiologists

Position Statement on the Acceptance of Delegation of a Controlled Act

Position Statement on the Delegation of the Controlled Act of Prescribing a Hearing Aid For a Hearing Impaired Person

Chiropodists
Chiropractors
Dental Hygienists
Dental Technologists
Dentists
Denturists
Dietitians

The Jurisprudence Handbook for Dietitians in Ontario 

Homeopaths
Kinesiologists
Massage Therapists

Communication / Public Health Standard 14 - Client Health Record

Medical Laboratory Technologists
Medical Radiation Technologists

CMRTO Standards of Practice 

Midwives
Naturopaths
Nurses

Decisions About Procedures and Authority

Professional Standards

Professional Standards Learning Module

Authorizing Mechanisms

Nurse Practitioner

Directives

Occupational Therapists

Guideline on Controlled Acts and Delegation

Opticians

Standard of Practice: Refraction

Optometrists
Pharmacists

Medical Directives and the Delegation of Controlled Acts

Pharmacy Technicians
Physicians and Surgeons
Physiotherapists
Podiatrists
Psychologists
Psychotherapists
Respiratory Therapists

CRTO Professional Practice Guideline: Orders for Medical Care

CRTO Position Statement: Medical Directives and the Ordering of Controlled Acts

CRTO Professional Practice Guideline: Delegation

CRTO Standards of Practice

Speech-Language Pathologists

Position Statement on the Acceptance of Delegation of a Controlled Act

Traditional Chinese Medicine and Acupuncturists