Dialogue Volume 14 Issue 2 2018 - Page 13

FEATURE be context dependent and require, in part, that physicians comply with the specific expecta- tions set out in the companion policies. The draft policy advises physicians in their role as health advocates to use their expertise and influence to help advance the health and well-being of their patients, their communities, and the broader populations they serve. Ms. Joan Powell, a public Council mem- ber from Thunder Bay and a member of the working group, said her group’s exploration of the issues found that patients also have an important and growing role to play in facilitat- ing continuity of care, as actions they take may contribute to or help prevent breakdowns in continuity of care. “Informed and engaged patients who under- stand their role and responsibilities comple- ment physicians’ efforts to support continuity of care.” she said. “We also noted that patient choices regarding when and how to access care, their availability to receive test results, and their compliance with getting tests completed in a timely manner all impact continuity of care,” Ms. Powell added. Physicians are encouraged to help patients understand their role in their health care, as well as how their actions or inaction can facili- tate or disrupt continuity of care. The Col- lege intends to develop a companion patient engagement document at a later date that will aim to assist patients in understanding how they can facilitate continuity of care. More specific expectations regarding patient engage- ment have been articulated, where relevant, in the companion policies. But while patient engagement can supple- ment and support physicians’ efforts to facilitate continuity of care and is an impor- tant element of patient-centred care, patient engagement is not meant t o absolve physicians of their responsibilities in this regard. Physicians are also strongly advised in the umbrella policy to capitalize on advances in technology that can facilitate continuity of care. Although continuity of care can be achieved without relying on technology, tech- nological solutions exist that can assist with, for example, test results management, facilitating access and/or coverage, facilitating informa- tion exchange between health-care providers, and improving transitions in care, especially as it pertains to handovers within health-care institutions, hospital discharges, and the refer- ral and consultation process. Availability and Coverage This draft policy sets out the College’s expectations of physi- cians regarding physician avail- ability, after-hours coverage, and coverage during temporary absences from practice. The draft notes that “continuity of care does not require individual physicians to personally provide on-demand and continuous access to care. Doing so would negatively impact the quality of care being provided and compromise physician health.” Rather, continuity of care, states the draft, means being available and responsive to patients and health-care providers and making plans or coverage arrangements when physicians are unavailable. “We are asking physicians, who are provid- ing care as part of a sustained physician-patient relationship, to use their professional judgment in developing a plan that works best for their own practice in regard to the coordination of care outside regular operating hours,” said Dr. Copps. The nature of the plan will depend on a variety of factors, including the time of day and type of day (i.e., weekday, weekend, and holiday), the needs of their patients, as well as on the health-care provider and/or health- system resources in the community. “In this way,” she said, “we can minimize un- coordinated access to care and the inappropriate usage of emergency rooms or walk-in clinics.” The working group sought to “strike a bal- ance between setting an expectation that would advance the public interest while at the same time recognizing that there are limitations to ISSUE 2, 2018 DIALOGUE 13