The OMA has developed a series of checklists to help you understand and implement the CPSO’s Continuity of Care policies.
This checklist organizes the expectations set out in the Availability and Coverage policy into common practice contexts. It lists key action items followed by the exact wording from the policy. It also includes optional guidance from the CPSO’s Continuity of Care: Advice to the Profession document.
This checklist is not intended as a substitute for reading the CPSO's Continuity of Care policies in full.
Physicians must have an office telephone that is answered and/or allows voicemails to be left during regular business hours. (Availability and Coverage, 1)
NOTE: In a group practice, institutional, or departmental setting, there may be a common phone and voicemail system shared among a number of physicians.
Physicians must ensure that the outgoing voicemail message is up to date and accurate, indicating, for example, office hours, any closures, and relevant information regarding coverage arrangements or access to appropriate care outside of regular office hours and during temporary absences from practice. (Availability and Coverage, 2)
Physicians must ensure that voicemail messages are reviewed and responded to in a timely manner. What is timely will depend on, for example, when the message was left and the impact to patient safety that may be caused by a delay in responding.
Physicians providing care as part of a sustained physician-patient relationship must structure their practice in a way that allows for timely access to appointments for urgent or time-sensitive issues. (Availability and Coverage, 6)
Physicians must respond in a timely manner when contacted by other physicians or health-care providers who want to communicate or request information about a patient. What is timely will depend on, for example, the impact to patient safety that may be caused by a delay in responding. (Availability and Coverage, 4)
Physicians must include their professional contact information when ordering a test, writing a prescription, or making a referral and must provide relevant coverage contact information directly to other health-care providers (e.g., laboratories, diagnostic facilities) where it is appropriate to do so. (Availability and Coverage, 5)
Physicians providing care as part of a sustained physician-patient relationship must inform patients of when and where to access appropriate care outside of regular office hours (e.g., Telehealth, local walk-in clinics, emergency department, any coverage arrangements that have been made, etc.). (Availability and Coverage, 7)
The legal concept of “duty of care” may require you to take additional steps to help patients access the right kind of care (e.g., post-operative follow-up, obstetrical care, etc.). Your “duty of care” will depend on your practice type. You may wish to seek legal advice for further clarity.
Physicians must ensure that critical test results can be received and reviewed at all times, including outside of regular office hours and during temporary absences from practice, and that appropriate steps can be taken to notify patients if immediate emergency intervention is required. (Availability and Coverage, 11)
Physicians providing care as part of a sustained physician-patient relationship must make reasonable efforts to arrange for another health-care provider(s) to provide care to patients during planned temporary absences from practice. What is reasonable will depend on, for example, the length of the absence, the needs of the physicians’ patients, and the health- care provider and/or health system resources available in the community.
What is considered “reasonable efforts” to find coverage while you are away depends on a variety of factors. Other options, like informing patients about appropriate points of care (such as the emergency department) may be appropriate when you don’t have any other reasonable options.
It is also important to help patients understand the benefit of seeing physicians they have an ongoing relationship with. For example, you can help your patients understand that waiting to see their own physician (if they are able to) may contribute to continuity of care.
You can also support continuity of care by encouraging patients to develop a list of their medications and health conditions that they can share if they need to go to an emergency room, walk-in clinic, or other health-care provider.
Physicians who will be unavailable during temporary absences from practice must make specific coverage arrangements with another health-care provider(s) to:
Physicians must include their professional contact information when ordering a test, writing a prescription, or making a referral and must provide relevant coverage contact information directly to other health-care providers (e.g., laboratories, diagnostic facilities) where it is appropriate to do so. (Availability and Coverage, 5)
Physicians must ensure that critical test results can be received and reviewed at all times, including outside of regular office hours and during temporary absences from practice, and that appropriate steps can be taken to notify patients if immediate emergency intervention is required. (Availability and Coverage, 11)
Physicians must also have a plan or coverage arrangement in place that allows other health-care providers to communicate or request information pertaining to patients under their care during temporary absences from practice. (Availability and Coverage, 9)
The information provided in this resource is for informational purposes only and is not to be construed as legal advice. Physicians are ultimately governed by the CPSO policies which can be found at: https://www.cpso.on.ca/Physicians/Policies-Guidance/Policies This resource is not intended as a substitute for reading the CPSO Continuity of Care policies in full.
Updated September 20, 2019