Frequently Asked Questions > Clarifying Roles


QUESTION — CLARIFYING ROLES

When more than one team member is authorized to diagnose, prescribe, make orders or treat, who is the right one to do so?  How does the team decide?

RESPONSE

If possible, when more than one team member is authorized to diagnose, prescribe, make orders or treat, the team should determine who will play what role in advance.  Factors to consider in making a decision include:

  • availability
  • continuity and consistency of care
  • cost
  • maintaining required roles and functions
  • presence of mechanisms to support care
  • patient/client safety
  • opportunity to realign team in patient interests (e.g. consider another team member, use medical directives or delegation)
  • patient/client wishes and best interests
The decision always rests on the best interests of the patient/client (or patient/client population). However, role clarity is critical in making a decision. 

Ask yourself:

  • Who can? (consider scopes and controlled acts)
  • Who could? (consider authorizing mechanisms, e.g., medical directives and delegation)
  • Who should? (given resources and determination of the best person to provide the best care in the best interest of the patient/client)
  • Who will? 

Facilitating team involvement in decision-making to the greatest extent possible is recommended.  To assist with planning and decision-making, see the Team Workplan section of this eTool.

LINKS

FHRCO Interprofessional Guide on the Use of Orders, Medical Directives and Delegation

COLLEGE LINKS
Acupuncturists
Audiologists
Chiropodists
Chiropractors
Dental Hygienists
Dental Technologists
Dentists
Denturists
Dietitians

The Jurisprudence Handbook for Dietitians in Ontario 

Homeopaths
Kinesiologists
Massage Therapists
Medical Laboratory Technologists
Medical Radiation Technologists

CMRTO Standards of Practice 

Midwives
Naturopaths
Nurses

RHPA Scope of Practice, Controlled Acts Model

Decisions about Procedures and Authority

Authorizing Mechanisms

Nurse Practitioner

NP Diagnostic and Prescriptive Authority

Occupational Therapists

Ontario Society of Occupational Therapists Website

Opticians
Optometrists
Pharmacists

Model Standards of Practice for Canadian Pharmacists

Medical Directives and the Delegation of Controlled Acts

Pharmacy Technicians
Physicians and Surgeons
Physiotherapists
Podiatrists
Psychologists
Psychotherapists
Respiratory Therapists

CRTO Standards of Practice: Accountability and  Therapeutic and Professional Relationships 

CRTO Professional Practice Guideline: Interpretation of Authorized Acts 

CRTO Professional Practice Guideline: Orders for Medical Care (verbal orders) 

CRTO Professional Practice Guideline- Documentation Documentation

CRTO Positions Statement:   Scope of Practice and Maintenance of Competency 

Speech-Language Pathologists
Traditional Chinese Medicine and Acupuncturists