CVO 27 readings Flashcards
do veterinarians have a responsibility to provide after hours care? how is this balanced?
one of these responsibilities is for licensed veterinarians to provide after-hours care services to animals that they have recently treated or treat regularly. These services may be provided in a variety of ways, and are contingent on finding the right balance between meeting legislative requirements, managing client expectations, assuring patient needs, and supporting the health of the individual veterinarian.
The legislated requirements for licensed veterinarians to provide after- hours care services are outlined in:
Regulation 1093, Section 20 (Veterinarians Act)
Regulation 1093, Section 20 (Veterinarians Act)
- says that:
- A licensed veterinarian is responsible for providing reasonably prompt services outside of regular practice hours if the services are medically necessary for animals that they have recently treated or that they treat regularly;
- The services required under subsection (1) may be provided by the licensed veterinarian, their associate(s), or by referral to another licensed veterinarian who has agreed to cover the referring licensed veterinarian’s practice;
- When a licensed veterinarian provides after-hours care services by referring to an emergency clinic, the referring veterinarian is responsible for promptly continuing to provide medically necessary services to the animal after discharge from the emergency clinic until the services are no longer required or until the client has had a reasonable opportunity to arrange for the services of another licensed veterinarian;
- A licensed veterinarian is required to inform their clients as to how they can access veterinary services outside of the licensed veterinarian’s regular practice hours;
- A licensed veterinarian is required to promptly inform their clients if the licensed member makes changes to how they offer after-hours care services;
- A licensed veterinarian is required to keep records of every time they provide after-hours care services information to their clients; and
- If an animal is to be hospitalized/housed in a veterinary facility after regular practice hours, the licensed veterinarian treating the animal shall inform their client of the supervision arrangements for that animal.
Licensed veterinarians have a variety of options when deciding how best to provide access to after- hours care services for animals that they have treated recently or treat regularly. These options include (singularly or in combination):
- Providing “on-call” services either by themselves or in cooperation with other licensed veterinarians at the same accredited facility or through an in-house teletriage service;
- Arranging coverage agreements with other licensed veterinarians at neighbouring accredited facilities who have agreed to share the provision of “on-call” services;
- Referring clients to another accredited facility that provides 24/7 services and has agreed to accept the referrals;
- Referring clients to an independent, Ontario accredited teletriage service; and
- Referring clients to an Emergency Clinic, as long as said clinic is open, at a minimum, from 7 pm to 8 am on weekdays, on weekends from Friday at 7 pm to Monday at 8 am and from 7 pm the day prior to a statutory holiday until 8 am the morning after.
does a vet need to notify their clients if they make changes to the after-hours services offered?
If a licensed veterinarian chooses to make alterations to their after-hour care services, either permanently or to cover planned absences such as vacations, they are required to take steps to notify their clients of the changes as soon as possible. Such steps may include a telephone message, signage on the door of the facility or electronic notice. In accordance with Section 20 of Regulation 1093, licensed veterinarians are required to keep record of the information that was provided.
what is required of veterinarians to ensure continuity of care in an emergency
Licensed veterinarians are required to see an animal that they have recently treated or treat regularly after said animal is discharged from an emergency clinic if ongoing medical care is necessary, until emergency services are no longer required, or until the client has had a reasonable opportunity to arrange for the services of another licensed veterinarian.
what must a veterinarian do if unforeseen circumstances affect their provision of after hours care?
Licensed veterinarians are expected to attempt to notify their clients of any unforeseen circumstances, such as severe weather or illness, that will affect their provision of after-hour care services. However, the College does recognize that there will arise circumstances in which a licensed veterinarian is unable to reasonably provide after-hours care services or timely notification. In these instances, the College expects a licensed veterinarian to keep records that note the reasoning behind the circumstances and the information that was provided to clients.
Requirement for Informed Consent when an Animal is Hospitalized After-Hours
Licensed veterinarians are expected to obtain informed client consent that ensures that the client understands and accepts the level of care and supervision provided when animals are housed in a veterinarian’s accredited facility overnight and that the level of care may vary based on circumstance.
standard of practice vs standard of care:
Which is:
- applicable to veterinary medicine
- considered in the review of a veterinarian’s practice
- used in the review of a veterinarian’s professional conduct
- outlines essential professional expectations for all veterinarians
- overseen by the college
- overseen by the courts
- awards monetary damages
both - applicable to veterinary medicine
both - considered in the review of a veterinarian’s practice
both - used in the review of a veterinarian’s professional conduct
Std of practice - outlines essential professional expectations for all veterinarians
Std of practice - overseen by the college
Std of care - overseen by the courts
Std of care - awards monetary damages
what professionals have sought certification in animal physical rehabilitation that work with veterinarians to provide this shared care
chiropractors (DC), physiotherapists (PT), and registered veterinary technicians (RVT), etc.
differences in veterian, certified animal rehab professional, and other public provider for animal rehab
VETERINARIAN:
- Full regulatory oversight
- Direct access to all treatment options
- Proof of training and knowledge in veterinary medicine and animal care
- Published standards of practice
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CARP:
- Profession specific regulatory oversight
- Direct access to animal rehabilitation services
- Proof of training and knowledge in animal rehabilitation
- Profession specific standards of practice
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OTHER PUBLIC PROVIDER:
- No regulatory oversight
- Direct access to animal rehabilitation services
- No proof of training or knowledge in animal rehabilitation
- No standards of practice
Benefits of Collaboration in Animal Physical Rehabilitation for the Public
- increased communication
- continuity of care
- sharing of medical records
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Collaboration increases positive animal outcomes!
The complete medical record is:
a compilation of all information that pertains to the care of an animal or a group of animals, and documents the management of a case. It is a legal document that represents the veterinarian’s thought process, decisions, judgment, actions, and interactions with others (clients, colleagues, other caregivers, and service providers such as specialists and laboratories), each of which has an impact on patient outcomes. The medical record is also a communication tool which facilitates the continuity of care for animals both within and between veterinary medical-care teams.
is a quality medical record important? what if we depart from the standard, what should we do?
A quality record is fundamental to quality practice, and this Professional Practice Standard itemizes the essential elements of a quality record. As such, justification for any departure from this Professional Practice Standard should be documented in an appropriate place within the medical record.
A veterinarian meets the Professional Practice Standard: Medical Records when they:
- Create a record for each animal(s) or group of animals where a veterinarian-client-patient
relationship (VCPR) is established. - Ensure records are accessible.
- Ensure the record provides an accurate, complete, and up-to-date profile of the animal(s) or group of animals to enable continuity of care. Ensures that each time a record is updated, the update or change to the record is dated and documented in a clearly identifiable manner and the content of the record before each change or update is preserved.
- Maintain electronic records in accordance with the electronic records requirements outlined in O. Reg. 1093 Section 22. (6).
- Ensure that, in situations where a change to the medical record is required, an audit trail is established where the original content is preserved, and a record of the author and date/time is established. Changes to the original content must be approved by the veterinarian.
- Establish procedures and protocols to protect client confidentiality and safeguard records against loss, damage, unauthorized access or disclosure.
- Respond to or make requests for, and/or provides relevant historical (i.e. medical) information in a timely manner that facilitates the continuity of care of an animal(s) or group of animals between and among veterinarians.
- Respond within two (2) business days to requests from clients or another veterinarian to transfer complete records.
- Maintain records for five (5) years after the last entry is made.
- Destroy records in a manner that protects client confidentiality.
