Transforming and Supporting Patient Care - Health Professions ...

127Chapter 5 – Scope of Practice of Medical Laboratory TechnologyHPRAC has significant concerns with allowing MLTs to initiate tests and theeffect this would have on the health system as a whole. HPRAC wasimpressed by the rigour of the laboratory accreditation, licensing andquality management program. The legislation clearly delineates the rulesand responsibilities of all those involved in the laboratory investigationprocess. HPRAC is satisfied that the current system of protocols andalgorithms for follow-up testing, as well as the process of developing theseat the facility level, is sufficient to address most situations where additionaltesting is required. HPRAC is not convinced that patient care is at risk fromthe protocols and requirements in place for follow-up testing. Rather,facility policies and the ability to consult with either the medical director ofthe laboratory or the ordering professional can appropriately deal withthose cases where MLTs determine, by their own professional judgment,that follow-up testing is required or that a particular test was orderedimproperly.Finally, no other Canadian jurisdiction allows MLTs to initiate laboratoryinvestigations for clinical purposes, though in practice, MLTs in Manitobaand Nova Scotia do not perform tests they deem unnecessary.HPRAC would encourage the continued involvement of MLTs in thedevelopment of facility protocols for the initiation of tests at the laboratorylevel and the determination of the appropriateness of tests. Healthprofessionals consulted were open to continued communication andcollaboration with MLTs in ensuring that the laboratory investigationprocess is as seamless, effective and efficient as possible so as to maximizethe benefit to patient outcomes.Recommendation:2. That MLTs not be added to the list of professionals authorized toorder laboratory tests under the LSCCLA and the PHA.Scope of Practice StatementThe proponents requested that the scope of practice statement beamended to reflect the authorities discussed above, if those were to begranted to MLTs. Though no specific wording was proposed, it was alsorequested that the competencies of MLTs to correlate tests results todiagnosis, take patient histories and engage in public education berecognized.As HPRAC is not recommending that the scope of practice for MLTs beexpanded as requested, the requisite changes in the scope of practicestatement are unnecessary. HPRAC is convinced that MLTs’ expertise isindeed in the science required to ensure the validity of specimens and testresults to support diagnosis by other health professionals. It isacknowledged that MLTs are relied upon to collaborate with thoseprofessionals who diagnose. HPRAC also acknowledges that MLTs are ableto take patient histories and often engage in public education. However,these activities do not need to appear in the legislative scope of practicestatement.HPRAC Critical Links January 2009