Transforming and Supporting Patient Care - Health Professions ...

60Chapter 3 - A New Drug Approvals Framework For OntarioSystemic changes are needed to ensure that individuals with the rightprofessional skills are providing appropriate patient care. This will enablemembers of some health professions, such as medicine, to focus on areaswhere their expertise is essential. “Chasing orders” is no longer an optionin a health care system that is pressured and when members of healthprofessions have the qualifications to provide safe and effective patientcare. It will also facilitate chronic care and disease management,particularly where patients move from one setting to another. Patients oftenmove from home care to long-term care to hospital and back, as their needschange, and are often cared for by a number of health professionals.During its consultations, HPRAC heard that a lack of access to such healthprofessionals as physicians and dentists is an issue in a number of settings,including long-term care homes. Broadening authorities for prescribing andadministering drugs and substances, and ensuring collaborative workingrelationships between health professionals, can help to meet the needs ofa growing number of people in Ontario.The Ontario government has indicated that interprofessional collaborationis one approach to addressing the health human resource shortage andensuring appropriate patient care. For interprofessional collaboration tobe successful, each profession must be able to practice to the full extent ofits competencies, including in some cases, prescribing, dispensing, sellingor compounding drugs. These authorities must be within the healthprofession’s scope of practice, and meet the most exacting standards toensure patient safety.In this review, HPRAC found there is a clear understanding and readinessto accept the accountabilities that are attached to the controlled act ofprescribing, dispensing, selling and compounding drugs among a numberof health professions. In some cases, health professions agree that terms,limitations and conditions should be attached to the controlled act orcomponents of the act. In many cases, the education and training has beenestablished, and the health college is ready to make necessary changes toensure that any required upgrades to education and training are in placeto maximize patient safety and ensure health professionals have theneeded skills.HPRAC stresses the importance of keeping patient safety at the forefrontwhen making changes to prescribing rights. In many cases, expandedprescribing rights necessarily must be accompanied by terms, limitationsand conditions for those authorities. Health colleges will be expected todevelop relevant standards of practice for their members. Additionalsafeguards might be needed to further protect the public. Appropriatepharmacotherapeutic education and training, continuing competencyrequirements, and standards for safe prescribing, record-keeping andretention, referral protocols and medication therapy management areessential components of health college programs.The Minister’s question to HPRAC recognizes the inefficiencies of the currentregulation-making and approval process that often takes years for a singledrug to be added to regulations under a health profession Act. During itsHPRAC Critical Links January 2009