Re-deployment FAQs – College of Kinesiologists of Ontario

A health emergency can present unique challenges for kinesiologists that extend beyond disruption to daily practice. In a health emergency such as a pandemic, kinesiologists may be re-deployed to another setting they are not familiar with or have never worked and asked to perform tasks outside their normal practice or personal sphere of competence. Kinesiologists may also be asked to manage a team of health professionals during a health emergency.

The Ontario Government has the authority to make orders directing the activities of regulated health professionals during health emergencies, including re-deployment. These orders can give employers such as hospitals and long-term care homes the authority to re-order staff priorities to address infection control, care of patients/clients and develop, modify, and implement re-deployment plans including:

re-deploying staff within different locations in (or between) facilities;
re-deploying staff to work in pandemic assessment centres;
changing the assignment of work, including assigning non-bargaining unit employees or contractors to perform bargaining unit work;
bringing in emergency service workers who did not previously work for the employer; and
providing appropriate training or education as needed to staff to achieve the purposes of a re-deployment plan.

The following FAQs provide answers to questions received by the College during the COVID-19 pandemic. Many of the questions and responses relate to care/service that did not involve assignment of controlled acts. For information on delegation and controlled acts, read the Practice Guideline- Scope of Practice, Controlled Acts and Delegation.

Health emergencies are fluid situations and information changes quickly. These FAQs will be updated as needed.

FAQs

When a kinesiologist is assigned new tasks or a role(s) within the scope of practice of the profession and they are deemed to be practising kinesiology by their employer in the new role, they are required by law to adhere to the practice standards and guidelines of the profession. You are accountable and responsible to the College for your conduct at all times, and the College would be required to investigate complaints made against you when re-deployed.

A higher standard of conduct is expected of regulated health professionals. It is important to practise safely and ethically in all settings, even those where you are temporarily working.

Before beginning a newly assigned task/activity, you should work with your new supervisor to:

Identify and analyze risks (e.g. risks around task competence, escalation of care, workload, infection prevention and control, etc.), develop and implement a plan to address risks, and monitor and update the plan as required;
Understand your rights and responsibilities as an employee under the Occupational Health and Safety Act to ensure your own safety, the safety of co-workers, and compliance with workplace health and safety legislation;
Ensure the appropriate authorizing mechanisms (e.g. order or medical directive) are in place where required;
Understand and clarify in advance the role, expectations, responsibilities and organizational policies that apply to you; and
Understand how you are expected to interact with your team members, including those making decisions regarding your work.

In some situations, you may feel you are not prepared to perform a task or role competently, even if you have received training. In this case, you should raise your concern with your supervisor and discuss the training you feel you need to perform the task/activity competently. For example, you may require direct supervision initially until you feel competent.

Consider the following:

Work with your supervisor to ensure you receive the required training;
Re-assess your competence in performing the assigned tasks, and identify additional training if necessary;
Establish processes for communications with your supervisor and identify individuals with whom you can consult if questions arise and your supervisor is not available;
Seek feedback on your performance of the assigned tasks from others (e.g. ask colleagues to review records to ensure appropriate documentation); and
Assess your personal limitations and discuss any concerns or gaps with your supervisor.

Similar to your regular practice, you must:

Consider the patient’s/client’s best interests (e.g. integrating patient/client issues, needs and goals); and
Take appropriate actions if patient/client health is unstable and requires assessment and/or supervision by another health professional.

Kinesiologists re-deployed to perform facility cleaning should adhere to the employer’s protocols and advice from the Ontario Ministry of Health and Public Health Ontario, in conjunction with the College’s Practice Standard- Infection Control.

Regardless of where you’ve been re-deployed or the task/activity you’re performing, you are always responsible and accountable to the College for your conduct. When interacting with patients/clients, identify yourself by the title you’ve been assigned by your employer for re-deployment. If you are re-deployed to another setting as a kinesiologist (i.e. asked to work as a kinesiologist), you should inform the patient/client that you are a registered kinesiologist, describe your role and responsibilities, and the services to be provided. If a procedure has been assigned to you by another health professional or supervising practitioner, you should explain to the patient/client that you’ve been assigned a task/activity by another health professional.

When you represent yourself as a kinesiologist, you are indicating to the public, employers, other healthcare providers, etc. that you are a regulated health professional. There is an expectation that your conduct and work are of a higher standard.

You must obtain informed consent from the patient/client before performing any task, whether health care or hygiene-related (e.g. bathing, lifting, transfer, etc.). Consent can be written, oral or implied (e.g. demonstrated by a patient’s actions).

If there are doubts about the patient’s capacity, the supervising practitioner must determine whether the patient is capable of providing informed consent, and identify and consult with the patient’s substitute decision-maker (SDM). The patient may be capable of consenting to certain activities but not others (e.g. health care versus hygiene). The SDM would only provide consent for certain activities. Capacity can vary over time (e.g. the patient has “good days and bad days”).

Where the kinesiologist or supervising practitioner concludes that the patient is not capable of consenting to a proposed intervention, they are expected to inform the patient of this finding, where feasible, and include the patient in the process as much as possible. They must then (absent an emergency) obtain consent from a SDM.

Consent should be considered an on-going conversation with the patient/client or the SDM, rather than a one-time event. If a patient’s condition changes or a different treatment option is proposed, consent should be obtained again. Similarly, you should obtain consent to continue treatment where there has been no change in a patient’s condition.

Minor adjustments to a treatment plan for an incapable patient can be made without having to seek continual consent from the SDM. The patient has the right to withdraw consent at any time.

For more information on consent and capacity, see the Practice Standard- Consent and the Practice Guideline- Consent.

If you are re-deployed to perform tasks/activities as a kinesiologist, you must follow the College’s Practice Standard- Record Keeping. If you are re-deployed to another role where you are not practising kinesiology, you should maintain records in accordance with the organization’s documentation protocol, consulting with your supervisor when unfamiliar with the preferred documentation processes for a particular activity.

Regardless of the nature of your re-deployment, there should be a record of:

the assignment or tasks that have been assigned to you;
any specific instructions related to the assignment;
acceptance of the assignment; and
the name, date and professional designation of the individual assigning the activities/tasks/duties.

This may be provided through a letter or memorandum that provides a general description of your newly assigned duties, position and accountability (who you report to), and training that will be provided to you.

You may be re-deployed to facilities where the supervising health professional is in charge of all documentation and you do not have access to the patient record. In this situation, if there is doubt about whether informed consent has been obtained or a patient is resistant, you should report this information to the supervising practitioner in charge.

The College cannot intervene/interfere with the decisions of employers. Kinesiologists are encouraged to work with their employer to try to find solutions to minimize risk to them and their patients/clients.

Kinesiologists with compromised health conditions may wish to discuss with their employer ways they may be protected through the use of personal protective equipment, re-assignment or work that could be performed from home. Workplace health and safety committees or representatives may also suggest that employers protect employees and prevent the spread of infection such as COVID-19, especially with vulnerable employees and patients/clients.

Regulated health professionals must be insured. This may be obtained by you or you may be insured under clauses of the employer’s insurance. Where you are assigned to work under the direct supervision of another regulated health professional, and you are not working as a kinesiologist, you are covered by the insurance of the supervising health professional.

Professional liability insurance policies typically only cover activities within the scope of practice of kinesiology. Kinesiologists should check with their supervisor/ employer in charge of the assignment to ensure that appropriate professional liability insurance is in place to cover their newly assigned tasks, roles and responsibilities. When in doubt, you should contact your professional liability insurance provider to ensure you have adequate coverage.

Common terms

The term used to describe the process of handing over the care of a patient/client (or specific tasks) to another health professional who can be either regulated or non-regulated (e.g. personal support worker).

The term used to describe the tasks, roles, behaviours and services that an individual kinesiologist can perform safely, competently and ethically. You may be asked to do something outside your normal/regular practice, or you do not have sufficient training or experience to perform the task competently. These tasks would be considered outside your personal sphere of competence. As a regulated health professional, you are responsible for practising within your own personal sphere of competence. When assigned a new task outside your personal sphere, you must get adequate training to ensure you are competent to perform the task before beginning.

The term used to describe what a profession does and covers a range of activities, roles and responsibilities that a kinesiologist could be expected to safely and effectively perform.