Internal Matters – December 2016

President’s Message

I had the pleasure of going to Ottawa in November to attend the CAMRT National Network meeting. During the round table discussions it appeared to be a common theme that all the provinces were struggling with policy governance in one way or another. The recent change in leadership at the ACMDTT with the hiring of our new CEO, Karen Stone, sparked Council to begin making some much needed changes to the policy governance style that we were using.

Since inception, the ACMDTT operated under the Carver model of Governance. This is a wonderful model of Governance, but it is very rigid. There were many challenges that we faced with this this model, and I will list some of the specific problems we ran into:

  1. Council did not feel sufficiently informed to make decisions. Under the Carver model the Council did not have a role in approving the College budget and the model limited us to the questions we could ask about the budget.
  2. We were not involved in the formation of a strategic plan. This is seen as a staff role within the Carver model.
  3. We spent 80% of our face to face Council meetings monitoring policies, changing wording and adding punctuation. We were not engaged as a board in generative dialogue and forward thinking and planning, and as a result had many talented people leave the board because they were not utilized for their skills.

In a fairly short period of time we have made some wonderful changes within Council and are already seeing the rewards. The changes we have made thus far have been fairly minor, but have allowed for major opportunities within the board. The Carver policies we have in place are good, solid policies. So, we were not starting over from scratch. We are simply modifying the necessary policies to allow for more latitude in respect of Council involvement, while maintaining a policy governance approach. Our CEO is guided by Executive Limitations, and we as Council don’t get into the operational detail, we understand our role as governors and enable the CEO to make our strategic directions happen.

We now label ourselves as a Complimentary Governance board, meaning the Council and the CEO work together collaboratively in a complimentary fashion. We have formed two new workgroups within Council: a finance and audit workgroup – to take a closer look at the finances, to ask the necessary questions and to present back to Council, rather than us all looking at a spreadsheet with glazed over eyes. Council members with special interest or skills in finance sit on this workgroup. The second workgroup is the governance workgroup. This workgroup is responsible for reviewing and monitoring policies and bylaws and presenting suggested changes back to Council for approval.

Since making these changes Council has become much more engaged and empowered. Council members feel like they are actually contributing to make the College better, which in essence is better for the membership and for the protection of the public.

Governance is constantly evolving and changing. We are not experts at it and ensure there is governance education provided at each face to face Council meeting. We have replaced the hours of time in our Council meetings once used to review policies on rich discussions and generative dialogue. I highly recommend all members consider applying for a Council position and becoming involved in the future of the College!

As we head into the holiday season and embrace a new year I would like to thank all of the members for your professionalism, your commitment and dedication to ensuring Albertans are receiving excellent care.

Kelly Sampson, MRT(T) Council President

Registrar In Session

The end of the year is quickly approaching, and for many this is a time for reflection and new beginnings. We all make some form of resolution as the New Year approaches (although if any of you are like me, the more the resolution involves exercise and fitness, the harder it is for me to commit to! Somehow if I commit to less chocolate intake, that is far more palatable).

So in the spirit of new thinking and new ways of doing things, I turn my mind to the one aspect of regulation that is most difficult for all of us – the complaints process (follow this link for more information about the ACMDTT complaints process http://acmdtt.com/about-us/complaints/). Unfortunately, since my arrival at ACMDTT, we have received a number of complaints. Unlike the processes of Registration and Continuing Competence, where the College can walk beside you in the resolution of aspects of your understanding, this is one time that we have to assume a different role, and as regulator, distance ourselves, as we explore the complaint, to determine if there are any issues of public safety that have merit and need to be addressed within the specific details of the complaint. We have to stand apart as we establish our role in the process of determining whether your complaint warrants moving to a Complaints Resolution Process, or is dismissible as it may be frivolous or vexatious, or out of mandate. This process is integral to self-regulation as you are assured that if an issue arises from any person who is delivering services to the public, that there is a fair and equitable mechanism for resolution, or addressing public safety issues. The reason that the College exists is to ensure that the public receives safe, competent and ethical diagnostic and therapeutic care by a properly regulated and constantly advancing profession.

None of us like to have anyone tell us that we have done something wrong. It is ingrained within most of us that we prefer to feel confident and secure in our performance of our work tasks, and we have to work hard to accept constructive criticism positively. But hearing how we can improve on what we do is something that we should encourage broadly. If there are ways that we can become better practitioners, then we should celebrate and embrace those ideas. Furthermore, if there are practitioners that are not meeting standards and are compromising public safety, then these issues must be addressed.

However, when you receive a letter form the College indicating that a complaint has been made, this is presumably one of the most intensively stressful times of your career. There are huge issues at stake-

As a practitioner:

  • Your right to practice
  • Your confidence in yourself
  • Implications for your employment

As a member of the public:

  • Patient safety
  • Respect
  • Your legal and ethical rights

As a practitioner, a complaint can be truly traumatic. Please make sure that you take care of yourself through this process. Speak to someone (a friend/colleague; an Employee Assistance Program counsellor; a union representative; your professional association; or your supervisor). Make sure that you remain calm. The process isn’t designed to seek out people and find fault. If you have done your job well, to the best of your ability, and you have followed the standards of practice, then you should have nothing to worry about. If you have made a mistake, owning that, and making sure that you learn from it is an important part of the process. The College needs to assure that public that we are providing a safe, competent and ethical environment of medical diagnostic and therapeutic care. Your colleagues want to know that their profession is safeguarded from unsafe practices, and poorly trained people who could bring disrepute to the profession. Stay calm, and participate towards resolving the issue that is raised.

Please remember that the College is always fair. We investigate if the complaint has merit, and we always hear both sides. We always provide an opportunity for everyone to be heard, and we try and find a way that will ensure public safety while respecting all parties involved.

The most common issue that arises in complaints is that of communication (or lack thereof) between the patient and the practitioner. Always remember that a small effort goes a long way when you spend a few moments explaining to the patient what is going to happen to them. They may be your twelfth patient of the day, but for them, you are the first practitioner of the day, and how you approach them can mean so much to how they experience the procedure. Communicate clearly and respectfully, and this will go a long way towards enhancing the patient’s satisfaction with your professionalism.

While the complaints process is stressful, it is one of the most important pillars of self-regulation. You are judged by your peers against standards designed and developed by you as members for your profession. It is a wonderful privilege, to be able to operate in an environment where your professionalism will be recognized and celebrated.

Unfortunately, some complaints are serious, and the implications are far reaching. Please understand that this is important too, because as a regulated profession we want to ensure that the public is protected in every possible way.

As the New Year approaches, we will be focusing on developing the professionalism within our membership. The Competence Committee is focused on trying to demonstrate to you the benefits of continuous and diverse learning opportunities that prepare you as diligent professionals for changes within your profession. (See their article in our current December Newsletter). The Registration Committee has been hard at work ensuring that all credentials obtained outside of Canada match yours sufficiently to warrant the issuance of an entry to practice registration with the College. You folks deliver an amazing and important part of the Health Care system. Celebrate your place in it, and protect your right to self-regulation fiercely.

Thank you for all that you do. Have a restful Holiday Season, and may 2017 bring you many happy and memorable moments!

Karen Stone
CEO/Registrar

ACMDTT/AHS 2017 Annual General Conference
April 7-8, 2017 Deerfoot Inn & Casino, Calgary AB  

  • Meet 50% of your College CCP requirement
    Claim one CCP hour per each attended session

 

  • Choose from over 35 talks on trends, technologies and best practices
  • Sonography sessions
    Let your sonography colleagues know that sonographers can attend at a single day conference rate on Saturday, April 8, 2017. Accreditation from Sonography Canada will be requested for all conference presentations.
  • Network with over 250 peers
    Fabulous breakfasts, lunches and snacks and a wine & cheese event

 

Stay tuned – Conference Registration and Website will open in early January!

Awards Nominations Open

Award Nominations are Now Open!

We have all thought about it, but this year, take some time to nominate a co-worker, educator or student for an award. Many people are deserving of professional recognition in an area in which they excel ranging from patient care to continuing education.

Please take a look at the list below of some of the Awards given each year by the College and start thinking about a deserving recipient. If you have any questions regarding these awards, please contact Dacia Richmond, Director of Education at 780.487.6130 ext. 226; 1.800.282.2165 or via email drichmond@acmdtt.com.

Click on the award name for the nomination form.

Some of the Awards are…

Excellence in Professional Collaboration: in recognition of the increasing multidisciplinary nature of our professions, this award was created to honour a healthcare team consisting of at least one full member in good standing with the College.  The honoured team will embody the concept of professional collaboration, either solely within the specialties of the College or with those of other professionals within the healthcare environment. This team will have contributed to a common goal related to professional practice either technically or with humanity which has had a positive impact on the profession.

Professional Excellence in Leadership: for those who demonstrate professional excellence in leadership; provide guidance and mentorship to colleagues; lead by example demonstrating respect, integrity and professionalism; foster a positive working environment and promote effective relationships within the healthcare environment.

Professional Excellence in Patient Care: for those who demonstrate professional excellence in direct patient care; demonstrate outstanding abilities in the delivery of diagnostic and therapeutic services; foster a healthy culture of respect and integrity within healthcare; advocate for quality patient care and facilitates a safe working environment and inspire confidence and trust in patients.

George C. Hall Invitational Address: this honouree is chosen to speak at the College’s annual awards luncheon. This award, now through a nomination process, is bestowed to someone who has influenced the growth of the profession in clinical practice, education, research and/or administration.

Herbert M. Welch Memorial Award: for dedication and service and for those who have made a significant contribution to the outstanding growth of the profession.

Joan Graham Award: for those who impart shared learning in the form of continuing education and encourages continuing competence

Carol Van Velzer Memorial Award: for an electroneurophysiology technologist (ENP) who presents an exhibit or platform presentation of excellence related to the field of electroneurophysiology at an ENP Branch Meeting. Please contact Branch Chair, Angie Sarnelli, ENP (angie.sarnelli@albertahealthservices.ca) to arrange a presentation.

ACMDTT Honorary Life Membership: to honour an individual whose professional activities have promoted the profession provincially and/or nationally and whose leadership serves to motivate others to become involved in professional activities.

Student Leadership Awards: for senior year students, in each specialty, who showcase leadership skills, professionalism and involvement in the profession in the early stages of their careers. Students are required to apply for this award, so encourage them today!

CCP Audit

On October 13-14, 2016, the Competence Committee held the annual Continuing Competence Program (CCP) audit. In June, a random audit sample was computer-generated based on the input criteria that 10% of the membership would be audited in this cycle. ACMDTT can select members for audit to add to the sample, but this year, no members were selected aside from the random audit sample. The number of 10% is not an arbitrary decision, but is based on a number of statistical and logistical factors. These factors include the percentage of members over the previous three years who are non-compliant out of the sample audited and the capacity of the committee to complete the audit within the time they are in session in Edmonton. The 10% audit sample, for the September 1, 2015 – August 31, 2016 CCP cycle, equated to 231 regulated members receiving notification of CCP audit.

 

This year was the first year that members were notified of their selection by email. This is a general practice among regulators in Alberta as members are legally required to provide the College with an active email address that is accessed often. This decreases the costs that have been incurred through the increasing cost of registered mail in Canada.  All audited members contacted the Director of Education to acknowledge their receipt of the email and this constituted a trail that ensured that there was timely notification and confirmation of member receipt of this notification.

On September 1, audited members were able to submit their CCP documentation electronically through the My CCP platform. This is done simply by clicking on the “submit button” that is populated into the left banner of those members who were selected for audit.  Once submitted, the audited CCP cycle was now visible to the administration account.  All submitted documentation was reviewed by the Director of Education for completeness and to provide feedback to the member to give them the best chance of success on the audit. The College is not seeking to find fault, but to assist members in achieving the highest standards of professionalism and professional development. This CCP process is merely an indicator of that professional integrity (and of course, the ACMDTT is mandated to perform the competence assessment of its members). The feedback provided by the Director of Education aligns with:

  • Competence Committee policy
  • CCP requirements within the legislation
  • Decisions of the Competence Committee in previous audits (precedent and consistency)

We interrupt this article to bring you the opportunity to win a gift card. If you are reading this, and interested in winning free stuff, please email info@acmdtt.com with the subject line “self-regulation” and your name by January 13, 2017 to be entered into a draw for a $50 gift card (one entry per member).  Thank you for reading the newsletter and supporting the self-regulation of your profession.

Members are then given the opportunity to amend their records. It is completely the member’s decision to take the advice, or not.  If they choose to, the processes with the Director of Education is iterative and augments the member’s record so that the Competence Committee may review it efficiently. The records of those who do not take the advice are put through to audit unaltered for complete assessment by the Competence Committee.

At the conclusion of the audit, the results were:

Number drawn for audit 231
Number cancelled audits (members retired prior to August 31) 2
Number audited by Competence Committee 229
Members with satisfactory audit result 192
Members with satisfactory with exemptions audit result 21
Members with unsatisfactory audit result requiring remediation 16
Members remediated by registration renewal deadline 16
Members referred to Complaints Director for non-compliance 0

As per s. 13 of the regulations, compliance with the CCP is a requirement for registration renewal. Use of the online My CCP platform is a required component of the CCP; therefore, all members must be recording their CCP through the platform to be compliant. Non-compliance elevates the matter to the Complaints Director and the member will be investigated.

The audit is merely a process that confirms a members’ diligence in self-development and facilitates currency within their profession. We encourage members to develop as a professional in as broad a scope as possible. Attending conferences and educations sessions are valuable activities; but, we also encourage members to read resources and journals that compel professional practice and scientific advancements to new levels of delivery in service to patients. The College wants you to be the best that you can be as a practitioner within a self-regulated environment. Continuous learning, reflection and application of this learning is one way to achieve this.

If any member has any questions about the CCP or the audit process, please contact Dacia Richmond, Director of Education, at drichmond@acmdtt.com or via phone 780.487.6130 ext. 226.

Nominating Committee

BECOME AN ACMDTT COUNCIL MEMBER!

Are you passionate about your profession? Do you want to enhance the professionalism of practitioners within your profession? Do you have enthusiasm and commitment? Are you willing to contribute your thoughts and strategic thinking in the board room? If you said yes to any of these, consider joining the ACMDTT Council.

The Nominating Committee is seeking members to let their name stand for the ACMDTT Council. Benefits to you include: governance education; meeting with members from other specialties; participation in strategic generative discussion on trends affecting the profession; a complimentary registration to the ACMDTT Annual Conference; and an honorarium while being a part of the decisions that will shape our future.

Meetings typically are four times per year, held on weekends to avoid interfering with regular work hours. All expenses are covered.

If interested, please submit an application including a resume and short biography (to be published), to the Nominating Committee c/o ACMDTT office by February 10, 2017.

Wendy Read MRT(T) (Chair), Alefiyah Gulamhusein, MRT(NM), Darren Oczkowski, MRT(MR)

TO CT or not to CT?

When is it appropriate for a nuclear medicine technologist to perform CT and in what capacity?

The landscape of nuclear medicine has changed considerably over the last decade as has the entire field of medical radiation technology. As you are all aware, one of the major catalysts to this change is the introduction of hybrid scanners: SPECT/CT, PET/CT, PET/MR…where does it end?

 

What I would like to explore here is a facet of professional regulation that is often misunderstood; that is authorized practice. We are going to delve into the concepts of restricted activities, authorization and enhanced practice.  I hope that this gives you insight into the regulatory environment and the rationale behind some of the requirements of being a regulated professional in Alberta.

 

The current practice of nuclear medicine technologists in Alberta is governed by the Medical Diagnostic and Therapeutic Technologists Profession Regulation. The document was last amended by government in 2009 – a time when we were starting to hear about SPECT/CT and thinking “we’ll never get one, so why do I have to worry about it?”  Well, fast-forward seven years and you are hard-pressed to buy a gamma camera without a CT, of some sort, attached.  Working with a CT of some sort within a nuclear medicine department has become the norm in 2016 but we must step back, reflect on our practice and ask if we are authorized by the College to do this. Can I perform this restricted activity?

 

In response to these changes in practice the College addressed the question of authorization within the framework of practice by releasing a position statement CT in the Nuclear Medicine Environment.  What it says is that if a nuclear medicine technologist is performing CT with the intention of no more than attenuation correction and/or anatomical mapping, it is considered within the scope of any nuclear medicine technologist’s practice. It is important to focus on the intent of the actions and not the camera which you are operating.  Should the CT images that you are producing be used/interpreted separately from the nuclear medicine images, or if you are preparing and/or administering diagnostic imaging contrast media, it is required that you have the CT and Contrast Media enhanced practice authorization on your practice permit.

For some systems, the intent is obvious as the camera does not have the physical capability to produce diagnostic CT images; but, with some hybrid systems, this question is quite muddy. It is important for you to be aware of what the images that you are producing are being used for. Only attenuation correction (AC) or is the radiologist or resident “reading” the scan and commenting on what they see rather than  the former where the radiological images are purely augmenting the bone scan, MIBI or whatever nuclear medicine procedure you are performing?  The answer to this question will tell you whether you require the CT and Contrast Media enhanced practice authorization to perform these scans or not.

So moving back to the concept of restricted activities, some of you may not have heard the term. In Alberta’s Government Organization Act, government has published a finite list of health acts that may cause possible harm to the public.  This doesn’t suggest that these activities will cause harm, but there is the possibility for it.  Examples include application of ionizing radiation; application of non-ionizing radiation; preparation and administration of contrast media; and venipuncture.  Other examples include such health services as the prescription of contact lenses and surgical procedures.  It is a comprehensive list applicable to all regulated health professionals in Alberta.  When a College’s regulations are created, a subset of these restricted activities is incorporated by the College and government to give different groups of members’ different restricted activities and therefore different authorizations.

This is why CT and contrast media is such a big deal currently for nuclear medicine technologists. Having registration with the College does not authorize you, because the restricted activity isn’t in the nuclear medicine register list, to apply ionizing radiation in medical radiography (read CT) nor to prepare or administer contrast media.  The College wants to evolve practice and keep up with the times and we are very fortunate that some foresight was put into the regulation to allow for enhanced practice authorizations by “borrowing” restricted activities from other registers or other specialties of the College.  As a result, if it is a requirement that a nuclear medicine technologist perform CT over and above what is required for attenuation correction and anatomical mapping AND/OR is preparing and/or administering contrast media, they can complete a program of study and apply for the authorization as they must have the CT and Contrast Media enhanced practice authorization to be legally permitted to perform these additional restricted activities.

The College cannot police, nor does it want to, all registered practitioners to ensure that they are performing only those activities for which they are authorized. It therefore falls back to the regulated professional to ensure that they are performing within their authorizations in a safe and effective manner. As a regulated professional, this is your responsibility. In a worst case scenario, in any situation, something may go awry and a complaint may be brought upon a member of the College by the public.  If you are performing duties that you are authorized to perform, your professional liability insurance (PLI) policy will be valid for the occurrence as it is within your scope.  If you are performing something that you are not authorized for, something goes awry and a complaint results, your PLI will not be valid and you will be left with the personal consequences; both financial and professional.

Hopefully this explains the rationale and process for enhanced practice. Should you have any questions or concerns, please feel free to contact the College.  It’s imperative that we move practice forward together and communication is the best starting point.  We look forward to hearing from you.

Deciding Factor

Mark is a relatively new graduate who is working at the clinic with a temporary practice permit. Mark wrote the CAMRT exam in September but found out in October that he was not successful.

Question to be asked:

What does Mark do now?

Mark is required to contact the College to inform the Registration Assistant that he was unsuccessful. She will work with Mark to ensure that he renews his permit appropriately.

What type of practice permit does he need now and for renewal?

As he has not yet been unsuccessful on the exam, Mark must continue to practice on a Temporary Practice Permit (TPP). This means that he must continue to practice under supervision.  Mark will renew his TPP through the online registration system.

What does he do once he passes the exam (hopefully in January)?

Once Mark passes the CAMRT exam, he must notify the College and apply for a full practice permit. To apply for the full permit, he must provide to the College:

  • A completed Membership Status Change form
  • Proof of successful exam completion. This may be his certificate or a copy of his online CAMRT transcript

What Standards of Practice apply to this scenario?

Here are a few indicators which apply to this situation:

Indicator 2.1a – assume personal responsibility for the quality and effectiveness of the regulated member’s practice

Indicator 2.1c – perform restricted activities only as authorized according to the regulations of the College

Indicator 2.1g – adhere to legal obligations required by the College

Indicator 2.2b – practice within the limits of the regulated member’s competence

Indicator 2.3a – perform only those restricted activities for which he or she has the required competence and current authorization

Indicator 2.4a – adhere to the Code of Ethics of the College

New Scenario

Bill is a magnetic resonance technologist who has the venipuncture additional authorization on his practice permit. In October, Bill went online and completed his registration renewal for 2017. He would like to claim his registration fees and so, in November, he logged into his profile to print his receipt but there is no receipt online.

Questions to be asked:

  • Why is there no receipt?
  • What must Bill do to complete his registration?
  • What Standards of Practice apply to this scenario?

Regulation 101 

Declaration of CCP Compliance – a legal and binding issue

During registration renewal, all regulated members must self-declare compliance or non-compliance with the CCP for the previous cycle. This self-declaration is a legal and binding clause to which members must attest honestly.  Compliance with the CCP includes:

  • completion of a self-assessment
  • development and implementation of a learning plan
  • completion of a certain number of hours of reflective learning

This must all be done online via the mandatory My CCP platform.

The College must ensure due diligence in assessing member professionalism and honesty through this self-declaration. The College is able to access information as to whether you have accessed and updated all components of the CCP through the online platform in each CCP cycle, or not. The contents of your CCP still remain confidential.  As compliance with the CCP mandates use of the online platform, those members who have not accessed or updated their CCP records online will be contacted by the College in follow up.

It is imperative that members declare in accordance with their activities throughout the cycle. If members have any questions, or must declare CCP non-compliance, please contact the College and we will seek to assist you.

Notice of AGM

The 2017 Alberta College of Medical Diagnostic and Therapeutic Technologists’ Annual General Meeting will take place Saturday, April 8, 2017 from 8:00 a.m. – 9:00 a.m. at the Deerfoot Inn & Casino in Calgary AB. The meeting shall include reporting of the Audited Financial Statements, the 2017-2018 budget, the President’s Report and the Chief Executive Officer’s Report. Materials including the agenda and the rules of procedure will available on the College website 21 days in advance of the meeting. Anyone is welcome to attend, but only regulated members will be entitled to vote.

Branch News

Peace Country Branch

Branch Chair:   Tunde Bodi, MRT(R) (PeaceCountryMRTb@outlook.com)

The Branch would like to put out a call for volunteers for those interested in participating with the Branch Executive. Member participation is essential to ensure that educational and networking opportunities are available to those in the Branch.  These volunteers can be from anywhere in the Peace Country Branch area!

Next meeting:           TBA

Edmonton Branch

Branch Chair:  Kathy Dudycz, MRT(R) (kdudycz@hotmail.com)

Our last meeting was the 6th Annual Education Day which was held on October 22, 2016 and was attended by 136 members (not including executive members). The next membership meeting will take place in the spring 2017; details are to be determined.

The executive members met on November 15 to plan for spring meeting as well as to discuss preliminary plans for Education Day 2017 which will take place on October 28, 2017.

On behalf of Edmonton Branch we wish all MRTs a safe, relaxed Christmas and prosperous New 2017 Year!

Next Meeting:  March 21, 2017

Parkland Branch

Branch Chair:  Jeff Christenson, MRT(R) (Jeff.Christenson@albertahealthservices.ca)

Next Meeting:   TBA

Calgary Branch

Branch Chair:  Gina McRae, MRT(R) (gina.mcrae@albertahealthservices.ca

Next Meeting:  March 22, 2017

Southern Alberta Branch

Branch Chair: Carmen Lowry, MRT(R) (carmen.lowry@gmail.com

Next Meeting:   TBA

ENP Branch

Branch Chair:  Angie Sarnelli, ENP (angie.sarnelli@albertahealthservices.ca)

Next Meeting:  April 4, 2017

Did you Know?

-The College office will be closed between December 28-30, 2016 and will re-open on January 3, 2017!