Transforming and Supporting Patient Care - Health Professions ...

15Chapter 1 – An Introductionparadigms for the delivery of efficient and effective patient-centred care inOntario, and explains how organizational structures and processes can beshaped to facilitate collaboration among regulatory bodies and closerworking relationships among professionals who provide clinical care.Finally, it proposes a new framework for oversight of Ontario’s healthregulatory colleges by integrating HPRAC’s current roles into a new agencywith additional responsibilities. Moreover, HPRAC’s advice oninterprofessional collaboration provides a foundation for itsrecommendations on non-physician prescribing and use of drugs inprofessional practice.Non-physician prescribing and use of drugs in professional practiceHPRAC was asked by the Minister to consider the ongoing evaluation ofrequests by Ontario’s health colleges for changes to regulations madeunder health professions legislation to ensure that they reflect efficiency,best practices of the profession and provide maximum public protection.This question was posed in the context of advice on a framework andprocess for approvals of designated drugs in the future.To develop its response, HPRAC reviewed requests for changes to currentauthorities made under regulations for the professions of medicallaboratory technology, medical radiation technology, chiropody andpodiatry, dental hygiene, dentistry, midwifery, naturopathy, nursing,optometry, pharmacy, physiotherapy, and respiratory therapy. Thecontrolled act of administration of a substance by injection and inhalation,a controlled act authorized to some professions, was considered, as was theauthority to use drugs, which is specified in regulations for certainprofessions.HPRAC drew heavily on submissions from health colleges, professionalassociations and experts in pharmacotherapeutics in the informationgatheringprocess. It also incorporated work conducted as part of therecent scope of practice reviews of nurse practitioners, pharmacy,physiotherapy, midwifery, medical laboratory technology and medicalradiation technology. As well, HPRAC has referred to work undertaken aspart of its New Directions report in April 2006.To gain a more complete understanding of issues to be addressed and howthey were being met, HPRAC conducted literature, jurisdictional andjurisprudence reviews. The literature review focused on identifying keydocuments in the scholarly and grey literature as well as publicly availablereports and websites, presenting relevant current information about therationale, history and background of non-physician prescribing and drugadministration.In addition, health colleges that were part of the review were asked torespond to a questionnaire highlighting key issues relating to prescribingand use of drugs in their profession and to the drug approvals frameworkin Ontario. Responses are posted on the HPRAC website.This work was supplemented by extensive intelligence and valuable insightsgathered from interviews with key informants including the colleges, healthHPRAC Critical Links January 2009