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Processes

Certification

A Medical Director may certify a Paramedic to perform Controlled Acts and other advanced medical procedures listed in the ALS PCS. A Medical Director may stipulate other requirements relating to Paramedic Certification. The Medical Director shall communicate such requirements to the Paramedic and the Employer in writing. The Medical Director shall notify the Paramedic and Employer within three (3) Business Days of the decision with respect to Certification as to whether the Paramedic was successful or not in attaining his or her Certification.

Consolidation

The Medical Director shall require Consolidation on all new Certifications*. A Medical Director may ;require Consolidation with respect to a Paramedic’s Certification where the Paramedic is returning to practice, a Patient Care Concern has been identified in respect of the Paramedic, or as identified in the Paramedic’s customized plan for Remediation. Consolidation provides for the opportunity to acquire more skills and confidence while ensuring that a support mechanism is in place for the Paramedic. The Medical Director shall determine the requirements for the Consolidation, which include the presence of another Paramedic, the level of qualification of that other Paramedic, and the restrictions of the Paramedic’s practice in relation to the presence of that other Paramedic. The Medical Director, in consultation with the Employer, shall determine the duration for the Consolidation. However, the duration for Consolidation on all new Certifications shall be a minimum of 36 hours for a PCP and a minimum of 168 hours for an ACP or CCP. The Medical Director shall provide notice of Consolidation and the requirements thereof in writing to the Paramedic and Employer within two (2) Business Days. Any changes to the Consolidation by the Medical Director shall be communicated to the Paramedic and Employer immediately and any changes to the requirements there of shall be provided in writing as soon as possible.

* See New Certification process

Responding to a Patient Care Concern

The RBHP shall assess all matters regarding patient care to determine whether or not there is a Patient Care Concern and the Employer shall assist where required. Where a matter regarding patient care is identified by the Employer that may be a Patient Care Concern, the Employer shall notify the RBHP as soon as possible.

Where the Patient Care Concern is a Minor Omission or Commission the RBHP shall notify the Paramedic and Employer by aggregate reports provided semi-annually. Where the Patient Care Concern is a Major Omission or Commission, a Critical Omission or Commission, or a repetition of Minor Omissions or Commissions the RBHP shall immediately notify the Paramedic and Employer of the Patient Care Concern and provide notice in writing as soon as possible. The notice in writing shall indicate that the Patient Care Concern is being considered to determine whether the Paramedic will be subject to Remediation, Deactivation or Decertification.

Remediation

A Medical Director may require the Paramedic to receive Remediation. The customized plan in the Remediation shall identify the concern, the remedial action to be followed, and the objectives to be achieved. The plan shall include a specific timeframe in which the Paramedic must successfully complete the Remediation. The RBHP shall develop the plan, in consultation with the Employer as necessary, as soon as possible. Once developed, the RBHP shall provide the written plan to the Paramedic and Employer. Any changes to the plan by the RBHP shall be communicated to the Paramedic and Employer immediately and the updated written plan shall be provided as soon as possible. The Medical Director shall notify the Paramedic and Employer in writing within three (3) Business Days of the successful completion of the Remediation.

Deactivation

A Medical Director may deactivate a Paramedic’s Certification for which the Paramedic has received Authorization.

Deactivation may occur as a result of:

  1. a Patient Care Concern;
  2. failure to respond to the RBHP’s requests for feedback or interviews regarding a Critical Omission or Commission, Major Omission or Commission or Minor Omission or Commission within a reasonable period of time as specified by the RBHP;
  3. failure to successfully complete Remediation;
  4. misconduct related to Certification (e.g. falsification of documentation, failure to disclose previous Deactivations and Decertifications, including practice in other jurisdictions);
  5. repeated Deactivations in similar clinical areas; or
  6. failure to meet the requirements for maintenance of Certification.

The Medical Director shall immediately notify the Paramedic, Employer, the Senior Field Manager and all other RBHPs of a Deactivation. The Medical Director shall provide a brief written reason for the Deactivation to the Paramedic, Employer, the Senior Field Manager and all other RHBPs as soon as possible.

Following a Deactivation, the Medical Director shall determine whether the requirements for Remediation or the requirements for maintenance of Certification have been met, as the case may be, at which time the Medical Director shall either proceed with Reactivation or Decertification. The Remediation and Reactivation process shall be completed as soon as possible; however it shall not exceed ninety (90) consecutive days in length. Where the Medical Director has proceeded with Reactivation, the Medical Director shall immediately notify the Paramedic, Employer, the Senior Field Manager, and all other RBHPs of the Reactivation.

Decertification

A Medical Director shall revoke a Paramedic’s Certification where that person is no longer employed or retained as a volunteer by an Employer and that person shall be deemed to have undergone Decertification and the PPRC process does not apply. In all other circumstances, a Medical Director shall not proceed with a Decertification unless: (i) a PPRC has been convened and has provided its
written recommendations to the Medical Director and the Paramedic; or (ii) the Paramedic has waived the PPRC process in writing.

The Medical Director shall immediately notify the Paramedic, Employer, the Senior Field Manager and all other RBHPs of his or her decision to either proceed with Reactivation or Decertification of the Paramedic. Where the Medical Director proceeds with Decertification, he or she shall provide a written explanation to the Paramedic, outlining the reasons for Decertification. The Medical Director shall provide a brief written explanation confirming the reason for the Decertification to the Employer, the Senior Field Manager and all other RHBPs as soon as possible.

Contact

Ministry of Health and Long-Term Care
5700 Yonge Street, 6th Floor
Toronto, ON M2M 4K5

416-327-7900

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