Week 5: Practice standards

Question 1

Practice standards

Answer 1

Outline the expectations for kinesiologists that contribute to public protection
Inform kinesiologists of their accountabilities
Inform public of what to expect of kinesiologists

Question 2

Practice guidelines

Answer 2

Help kinesiologists understand their responsibilities and how to make safe and ethical decisions in their practice

Question 3

Code of ethics

Answer 3

Defines the way kinesiologists should uphold the integrity of the profession, serve the interests of patients/clients and act in a manner that justifies public trust

Question 4

Essential competencies of practice for kinesiologists in ontario

Answer 4

Defines the knowledge, skill, judgement and attitudes required to practice in the public interest

Question 5

What are the 12 practice standards?

Answer 5

1. Advertising
2. Conflict of interest
3. Consent
4. Discharging a client
5. Dual health care
6. Fees and billing
7. Infection control
8. Professional boundaries
9. Professional collaboration
10. Record keeping
11. Supervision and education of students and support personnel
12. Code of ethics

Question 6

Practice standard 1: Advertising

Answer 6

Any message communicating info about a member’s practice or professional services they offer

Question 7

Public medium

Answer 7

Any form of communication that is equally available to anyone who chooses to use it and that is directed to the public

Question 8

What must the information in advertisements be?

Answer 8

1. Accurate
2. True
3. Verifiable by kinesiologist
4. Professional and not misleading

Question 9

Who is advertising directed to?

Answer 9

A specific audience and must be comprehensible by audience

Question 10

What must the professional services advertised be within?

Answer 10

The scope of practice of a Rkin

Question 11

What shouldn’t advertisements contain?

Answer 11

• anything that could be interpreted as intending to promote a demand for an unnecessary service
• info that could be interpreted as a testimonial

Question 12

What must advertised fees and prices meet?

Answer 12

The expectations for truth and accuracy

Question 13

What other statements shouldn’t be on advertisements ?

Answer 13

• guarantee of success of the service provided
• comparative or superlative statement about service quality, products or people
• testimonials
• express or implied endorsement or recommendation of a product sold in the practice
• Communication that is undignified and of poor taste

Question 14

What can the Rkin not do according to the advertising standard of practice?

Answer 14

Indirectly solicit clients/patients in a way that is not considered a public medium

Question 15

What must the Rkin’s participation in advertising be consistent with?

Answer 15

The college’s practice standard on conflict of interest

Question 16

Practice standard 2: Conflict of interest

Answer 16

May occur when a kinesiologist engages in a relationship or arrangement as a result of which the kinesiologist’s
personal interests could improperly influence their professional judgment or conflict with their duty
to act in the best interest of patients

Question 17

How does a kinesiologist comply to the standard of conflict of interest?

Answer 17

• being aware of conflicts of interest that may arise
• be aware of conflicts of interest that may never be acceptable or may be permissible under certain circumstances
• Refraining from practice in situations where unacceptable conflicts of interest have arisen or may arise
• Correct application of strategies to mitigate or address conflicts of interest

Question 18

Strategies to address conflicts of interest

Answer 18

• Proactive disclosure
• Timely discharge planning
• Clear separation of personal and professional roles
• Establishing and following an appropriate conflict of interest policy and code of
  conduct
• Ensuring that informed consent is obtained
• Contacting the College or consulting legal counsel regarding the conflict of interest

Question 19

Practice standard 3: Consent

Answer 19

Kinesiologists must respect the autonomy of patients/clients and will only assess or treat them with their informed consent w rare exceptions

Question 20

Elements of consent

Answer 20

1. Fully informed
2. Voluntarily given
3. Related to the patient’s condition and circumstances
4. Not obtained through fraud or misinterpretations
5. Evidenced in a written form signed by the patient or documented in record

Question 21

What does informed consent involve discussing?

Answer 21

1. The nature of the recommended assessment or treatment
2. Why the client should have the assessment or treatment
3. The alternatives
4. The effects, risks and side effects of proposed assessment or treatment
5. What might happen if client chooses to not have the assessment or treatment

Question 22

Things to keep in mind when obtaining consent

Answer 22

• remind patient that they can withdraw consent at any time
• encourage them to ask questions
• use plain language
• pause to allow patient to understand
• complete a medical history

Question 23

What can consent be?

Answer 23

• verbal
• written
• implied through behaviour

Question 24

Minimum age for consent

Answer 24

NONE

Question 25

Hierarchy of substitute decision makers

Answer 25

1. Court-appointed guardian 2. The individual named as power of attorney for personal care 3. Representative appointed by consent and capacity board 4. Family 5. The public guardian and trustee

Question 26

Hierarchy for family members

Answer 26

1. Spouse or partner 2. Parents or child 16 years or older 3. Parent with right of access only 4. Sibling 5. Other relative

Question 27

How old do you have to be to choose a substitute decision maker?

Answer 27

16

Question 28

Practice standard 4: Discharging a client

Answer 28

Occurs when services being provided to patient are terminated

Question 29

Discharging a client standard statement

Answer 29

- plan for discharge of patient as early as possible and involve patient in planning - info regarding discharge is contained in health record - if patient is discharged for a reason other than achievement of goals of treatment plan, members will promote the principles of continuity of care and be sensitive in their communication

Question 30

How does a member demonstrate the standard of discharging a client?

Answer 30

1. Examining reasons for discharge 2. Considering the condition 3. Reviewing availability of alternative services 4. Giving opportunity

Question 31

Practice standard 5: Dual health care

Answer 31

Occur when a member of the College of Kinesiologists of Ontario practises as a kinesiologist and practises in another health care discipline (e.g. massage therapist, chiropractor or acupuncturist). The other health discipline may be regulated or unregulated.

Question 32

How does a member demonstrate the standard of dual health care?

Answer 32

1. Keeping roles of dual health care practice separate 2. Ensuring that recommended treatments are based soley on patient needs 3. Ensuring that patients are provided with the information needed to understand the member’s role and accountability 4. Ensuring that patients are provided with the services that they initially sought unless it is determined to be inappropriate 5. Ensuring that patients’ records clearly demonstrate which services have been provided 6. Claiming only the time worked practising within the scope of practice of kinesiology as practice hours for continued registration with the College 7. Ensuring that any care provided by the member in another discipline is not done in an effort to avoid practising according to the standards of this College

Question 33

How can roles of the dual health care practices be kept separate?

Answer 33

- appt bookings - entries in records - billing and financial records - obtaining written and signed informed consent when performing a diff role than originally sought

Question 34

What would be appropriate to explain when providing a non-kinesiology service under the dual health standard?

Answer 34

- that the service is not within the scope of practice of kinesiology - that the service is unregulated and is not covered by kinesiology liability insurance - that the service cannot be billed to an insurer as kinesiology services

Question 35

Practice standard 6: Fees and Billing

Answer 35

Billing: to invoice/request payment for services provided to a patient/client Fees: the amount charged for services provided

Question 36

What must members ensure under the standard of fees and billing?

Answer 36

* They have a clear fee schedule * Clients/patients receive the relevant fee information to enable them to make an informed choice * The client/patient and any third party payor receive accurate information about the services provided and the fees charged

Question 37

Can an Rkin provide a discount for services?

Answer 37

Yes but must be clear why and to who Can't be selective with who it applies to

Question 38

Who can act as evaluators of capacity and make a determination of incapacity?

Answer 38

Only specified health care professionals, not members