Working with Physiotherapist Assistants Standard
1. Authority and Responsibility
A physiotherapist who assigns care to a physiotherapist assistant remains responsible for all of the patient's care. The physiotherapist must be listed on the College's roster.
2. Duties that Cannot be Assigned
A physiotherapist must not assign the following activities to a physiotherapist assistant:
care the physiotherapist does not have the knowledge, skills, and judgement to perform
initial assessments and re-assessments
treatment that would require the physiotherapist assistant, on their own, to change the established plan of treatment
any controlled act that has been delegated to the physiotherapist
any part of acupuncture, communicating a diagnosis, spinal manipulation or internal assessment or internal rehabilitation of pelvic musculature.
3. Assigning and Supervising Care
The physiotherapist must carefully balance the risks of assigning and supervising care with the patient’s best interests and quality of care. The supervising physiotherapist must:
Ensure that the physiotherapist assistant has the knowledge, skill, and judgment to deliver the assigned care safely and with the same quality of care as the physiotherapist would provide.
Discuss the roles and responsibilities of the physiotherapist and the physiotherapist assistant with each patient or their substitute decision maker. They should know the physiotherapist assistant by name and job title and give their consent to the care.
Ensure the physiotherapist assistant’s name and job title appear on invoices whenever they have provided all or part of the treatment.
Provide a level of supervision suitable for the patient’s condition, the clinical environment, the abilities of the physiotherapist assistant, and any other relevant factors.
The physiotherapist must have a written communication protocol that states:
how and when they will discuss patient care with the physiotherapist assistant
- how to contact the physiotherapist
how to contact the alternate supervisor if the physiotherapist cannot be reached
5. Responsibilities of the Alternate Supervisor
The physiotherapist must designate another physiotherapist that the physiotherapist assistant can contact if they cannot be reached. If this happens, a transfer of care takes place. The alternate supervisor assumes responsibility for decisions about the patient’s care and the care the physiotherapist assistant delivers.
A physiotherapist who agrees to be the alternate contact for a physiotherapist assistant must:
- be able to assume this responsibility
have the knowledge, skill, and judgement to perform the assigned care
be available to intervene according to the communication protocol
Ontario Regulation 388/08 under the Physiotherapy Act, Professional Misconduct: Section 1, paras 1, 22, 23, and 41.
Previous Standard Dates: June 2005, January 2007, January 2009, March 2010
Approved Date: June 17, 2016
Effective Date: June 29, 2016