The CPSO Council has approved a new policy on Continuity of Care with specific policy direction in four key areas.
- Availability and Coverage
- Managing Tests
- Transitions in Care
- Walk-in Clinics
Physicians are expected to comply with these documents in 30 days. In order to understand what you need to do before October 20, 2019 please use these OMA checklists so that you are aware of obligations to implement the new Continuity of Care policies in your practice.
What has changed?
In our member consultation last fall, and our December 2018 response to the CPSO based on family physician feedback, the OCFP highlighted several areas of concern for family physicians. We are pleased to see that in some areas, our proposed changes were updated in the new policies. In other areas, there are still expectations that we know will present some challenges to members. Key impacts have been summarized briefly below. A complete list of obligations can be found in the OMA Continuity of Care resources.
| Key Area |
Expectations for Physicians |
Availability and
coverage |
- Must have an office telephone that is answered and/or allows voicemails to be left during regular business hours.
- Physicians providing care as part of a sustained physician-patient relationship must make reasonable efforts to arrange for another health-care provider(s) to provide care to patients during planned temporary absences from practice. What is reasonable will depend on, for example, the length of the absence, the needs of the physicians' patients, and the health- care provider and/or health system resources available in the community.
- a) If specific arrangements are made, physicians must inform patients seeking care during the temporary absence of these arrangements; b) If after reasonable efforts are made it is not possible to make specific arrangements, physicians must inform patients seeking care during the temporary absence about appropriate alternative access points of care (e.g., Telehealth, local walk-in clinics, emergency department, etc.).
- Physicians must also have a plan or coverage arrangement in place that allows other health-care providers to communicate or request information pertaining to patients under their care during temporary absences from practice.
|
Managing tests |
- When ordering a test, physicians must inform patients of the significance of the test, the importance of getting the test done (in a timely manner, as appropriate), and the importance of complying with requisition form instructions.
- For patients who have a high risk of receiving a clinically significant test result, physicians must track their test results when they are not received when expected.
- Must either personally track test results or assign this task to others.
- Must ensure that critical test results can be received and reviewed at all times, including outside of regular office hours and during temporary absences from practice, and that appropriate steps can be taken to notify patients if immediate emergency intervention is required.
- When in receipt of a clinically significant test result, physicians must always communicate the test result to their patient and must do so in a timely manner.
|
Transitions in care |
- Consultant physicians must acknowledge referrals in a timely manner, urgently if necessary, but no later than 14 days from the date of receipt.
- Consultant physicians must communicate the anticipated wait time or the appointment date and time to the patient, unless the referring physician has indicated that they intend to do so, and must allow patients to make changes to the appointment date and time directly with them. When providing an anticipated wait time, consultant physicians must follow-up once an appointment has been set.
|
Walk-in clinics |
- Physicians practising in a walk-in clinic must provide the patient's primary care provider (if there is one) with a record of the encounter when:
- a) The patient makes a request to do so; or b) In their opinion, one is warranted from a patient safety perspective and the patient has provided consent to do so.
- If it is not possible to send the record of the encounter directly to the patient's primary care provider (e.g., where there is uncertainty regarding their identity or incomplete contact information), physicians practising in a walk-in clinic must provide the patient with the record of the encounter and inform them of the importance of sharing it with their primary care provider.
- Physicians practising in a walk-in clinic must use their professional judgement to determine whether it would be appropriate to sensitively remind patients:
- a) That there are differences between episodic care and care that is provided as part of a sustained physician-patient relationship; b) About the benefits of seeing their primary care provider, if they have one, for care within their physician's scope of practice; and/or c) About the benefits of having a primary care provider and encouraging them to seek one out, if they don't already have one.
- Physicians practising in a walk-in clinic who are asked for assistance in finding a primary care provider must be as helpful as possible in supporting the patient.
|
Managing handovers
in hospitals and other
health-care institutions |
- When handing over primary responsibility for patients to another health-care provider, physicians must facilitate a comprehensive and up to date exchange of information and allow for discussion to occur or questions to be asked by the health-care provider assuming responsibility.
- Within hospitals or health-care institutions where care is provided by a team of changing individuals, physicians must coordinate with others on the team to keep patients informed about who has primary responsibility for managing their care (i.e., their most responsible provider).
|
Tracking referrals |
- Both referring and consultant physicians must keep a copy of the referral request and any consultation reports in their respective patient medical records. Where the referring and consultant physician have access to a common medical record, referral requests and consultation report may be contained in that common medical record.
- When acknowledging the referral, consultant physicians must indicate to the referring health-care provider whether or not they are able to accept the referral.
|
Questions?
Please continue to share your feedback with us. We will continue to ensure we are always reflecting your practice realities and needs so that you can thrive in your profession and provide the best care possible for your patients.
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