Responsibility and Accountability
A physiotherapist must collaborate with the patient, and with others involved in the patient’s care when it is relevant to the patient’s physiotherapy plan of care. The collaboration should ensure that the plan of care addresses the needs and goals of the patient.
In a collaborative care situation, the physiotherapist remains responsible for supervising any care he or she assigns to another person.
Collaborating with the Patient
A physiotherapist must work with the patient to create a plan of care that addresses the patient’s needs and goals, and help the patient understand the patient’s role in the plan.
A physiotherapist must help the patient make informed decisions about his or her care.
A physiotherapist must respect the patient’s decisions about his or her own plan of care, including what care the patient will receive, and who will provide that care.
Collaborating with Other Relevant Service Providers
If a physiotherapist believes that a patient requires services from another service provider, the physiotherapist must make the appropriate referral.
The physiotherapist must take reasonable steps to understand what other care the patient is receiving, and ensure that the physiotherapy treatment is compatible with the care provided by other service providers. The physiotherapist does this by:
- understanding what tasks or treatments each service provider will perform
- seeking information from the patient or another service provider about other care the patient is receiving when it is relevant to the physiotherapy treatment
- providing information to the patient or another service provider about the physiotherapy treatment when it is relevant to care provided by others.
Managing the Collaborative Relationship
In a collaborative care situation, problems or conflicts may arise that could interfere with the delivery of safe, quality care. This includes problems that arise from the behaviour of the patient, of other service providers, or the physiotherapist’s own behaviour.
A physiotherapist must recognize those problems or conflicts, and take reasonable steps to resolve them in a collaborative way. The physiotherapist should take these steps:
- document the situation and the steps taken to resolve it.
- discuss the problem directly with the patient or the other service provider, and work together to identify the underlying cause
- agree on how to resolve the problem and the desired outcomes
- identify the consequences if the behaviour, conflict, or situation is not resolved
- take appropriate action if the problem recurs
Definitions
- Others involved in the Patient’s Care
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People who are involved in the patient’s care may include the patient’s substitute decision-maker, family members, caregivers, and other service providers (including other physiotherapists).
- Understand(able)
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For example, by being clearly laid out and written in language that is easy for the average person to understand
- Informed Decisions
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Physiotherapists can help patients make informed decisions about their care by having a discussion about topics such as:
- the range of treatment options
- the scopes of practice and roles of the different health providers
- who is the most responsible person for coordinating their care and sharing information
- the roles of substitute decision-makers, family members and care givers in the patient’s plan of care
- the funding mechanism for the care.
- Relevant Service Providers
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Other relevant service providers may include, for example, health professionals, support workers, caregivers, or providers of equipment.
- Referral
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In this Standard, ‘referral’ means a recommendation or direction that a patient see another service provider for care or services that the physiotherapist believes are necessary but is unable to provide. It does not necessarily mean the formal process of directing a patient to a medical specialist.
When making referrals, physiotherapists should base them on patient need, provide a range of alternatives, and not receive any referral fees. Also see the Conflict of Interest Standard.
- Treatment
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To determine whether the activity performed by the physiotherapist assistant was treatment, ask yourself if the activity was part of the physiotherapist’s treatment plan, for example applying modalities, exercises, gait training, etc. Things such as tidying the treatment area, removing an ice pack or escorting patients to and from the treatment area would likely not be classified as treatment.