Professional Issues 2

• BCCOHP stands for

  British columbia college of oral health professionals
• BCCOHP consists of 12 members, 6 are dental professionals and 6 are government appointed
• Health Professions Act (HPA)

  • serves as umbrella legislation under which health professionals regulate themselves
  • British Columbia HPA Act 1996
• HPOA stands for

  health professions and occupations act
• HPOA Definition

  • designated health profession - a health profession designated for the purpose of this act (task that only relates to you can be done by you)
• colleges mandates are to serve and protect the PUBLIC
• primary function of colleges is to ensure members are qualified, competent and following clearly defined standards of practice and ethics
• colleges establish practice standards and code of ethics

  practice standards:

  • set standard of care expected from all RDH
  • provide guide for self evaluation
  • standard for measuring complaints against and RDH
• HPA

  • under the HPA there are 26 professions, only one is not self regulated
• The HPA umbrella

  • dental hygiene regulation (BCCOHP)
  • scope of practice
  • restricted activities
  • limitations on practice
• in respect of a designated health profession a person who is granted permission as a member of its college

  registrant
• BCCOHP bylaws govern operations of BCCOHP, and registration and licensure of Dental Hygienists

  • bylaws, practice standards and code of ethics
• Structure of the BCCOHP

  • board
  • 12 members, 6 government, 6 appointed by registrants
  • registrar/CEO
  • 10 committees (16 members)
  • staff
• overall responsibility for the college

  BOARD
• responsible for college operations, spokesperson to public and governments, provides support to the board, supports committees

  REGISTRAR/CEO
• deputy registrar, administrator, exec assistant, receptionists, managers

  STAFF
• board of college

  • 12 members
  • 6 elected, 6 appointed by minister of health
  • 1 dental assistant
  • 1 denturist
  • 1 dental therapist
  • 1 dental hygienist
  • 1 dental technician
• COMMITTEES

  • registration committee - responsible for all registration including exams
  • inquiry committee - investigates complaints
  • discipline committee - conducts hearings into matters from inquiry
  • quality assurance committee - responsible for practice standard, code of ethics, have to take 75 credits of edu every 5 years
  • special committees - may be appointed by board for special projects
• liability insurance

  • all registrants except those non-practicing must carry professional liability insurance in amount of at least 1 million per claim. 5 million per policy
  • through CDHA or private insurance
• BCCOHP Dental hygiene regulations (bylaws)

  1. standards of practice
  2. scope of practice
  3. code of ethics
  4. restricted access
  5. limitations on practice
• Practice standards/policies

  • Part of the legal framework for RDH practice in BC
  • Part of the College’s bylaws
  • 10 Practice Standards statements
  • State required criteria for practice
  • Policies provide detailed guidelines for ideal or “best" practice
  • State “must” requirements and “may” recommendations
  • Allows RDH to reflect on areas of practice that require continuing competency
• The minimum, competent, safe levels of care provided by dental hygienists when they apply dental hygiene knowledge, skills and attitudes to their practice. This is the definition of what?

  practice standard
• Purposes of practice standards

  1. Standard of care to protect the public from harm
  2. To inform the public of what to expect
  3. Accountability of the RDH
  4. Self-evaluation
  5. Guidance for educators
  6. Provides a measurable standard to which a complaint against RDH’s can be compared
  7. Comply with HPA
• CDHA code of ethics: 5 principles

  • Principle I: Beneficence
  • Principle II: Autonomy
  • Principle III: Integrity
  • Principle IV: Accountability
  • Principle V: Confidentiality
• BCCOHP Code of ethics

  • Part of the bylaws
  • There are 12 statements in the code of ethics for BC registered dental hygienists
  • General statements of the principles of ethical conduct
• Roles of The Dental Hygienist

  • A RDH integrates the roles of clinician, educator, consumer advocate, manager, change agent, and researcher to help prevent oral disease and promote health
• CLINICIAN

  • ADPIE (Assessment, Diagnosis, Planning, Implementation and Evaluation)
  • Responsible for providing preventive, therapeutic, and educational services
  • Provides dental hygiene care in collaboration with other health care professionals
  • Work in hospitals, extended care facilities, community health, clinical practice, specialty practices
• EDUCATOR / ORAL HEALTH PROMOTER

  • Clients want & need extensive information to promote oral health & prevent oral disease
  • RDH’s must meet the clients learning needs
  • Explain concepts regarding health & disease, demonstrate self-care procedures, determine client understanding, reinforce learning or desired behaviour
  • May be unplanned and informal, or it may be a well planned & formal session
  • May be educators who teach in other settings
  • Public health programs
• Administrator / Manager

  • Coordinate activities of the dental team
  • Develop & modify dental hygiene programs
  • May be employed in a managerial position for healthcare departments
  • Management of client care includes: setting care priorities, eliminating causative factors, deciding on recall intervals, self-care measures, general client management
• Client Advocate

  • Role in protecting the clients rights & well-being
  • Clients have the right to participate in their own health care
  • Facilitates client decision making by providing the information they need –informed choice
  • May interpret findings, identify other variables or alternatives to consider, involve other HP’s, and help clients assess the options
  • Protects the patient by maintaining a safe environment, prevents injury, & ensures that the patient does not endure adverse effects
  • Respects client’s decision
• • Historically DH was regulated under the dental act and was viewed in a more occupational model.  With self-regulation, residential care and independent DH practices, that model is being replaced by the professional model
• History of dental hygiene

  • Dates back to 1819, when oral behaviour first recognized as being important in the preservation of dentition
  • By 1845, articles were published in AJDS, that criticized preventative care neglect
  • Dr. Fones (1934) first introduced women as Oral Health educators for children
  • Throughout time, DH duties expanded to what they are today….and are still expanding
  • First DH license issued in Connecticut, 1917
• History in Canada

  • 1950 - first DH hired by Canadian Department of National Health and Welfare
  • 1950 - Accreditation committee established by CDA
  • 1951 - U of T establishes first DH program
  • 1963 - U of Manitoba
  • 1968 - UBC
  • 1971 - baccalaureate degree in Montreal
  • 1987 - Ontario granted self-governing status
• History of DH in BC

  • Dental hygiene was legally recognized as a health occupation in B.C. in 1951
  • Legislation was drawn up at that time to regulate dental hygiene under the Dentists Act
  • The College of Dental Surgeons of B.C., the regulatory body governing dentists, was delegated as the authority to regulate dental hygienists
  • The first class of dental hygienists educated in BC graduated from the University of British Columbia in 1970
• HEALTH PROFESSIONS ACT

  • In 1990 the Health Professions Act (HPA) was proclaimed
  • This Act was created to serve as "umbrella" legislation for unregulated health professions (rather than developing a specific act for each new health profession) and with a view to bringing existing health professions under the HPA
  • Applies to the all health professions and occupations
  • Provides choice and protection for the public
• HPOA

  • The Minister of Health appointed a three member Council, the Health Professions Council, to review applications for designation under the HPA
  • In 1991 the British Columbia Dental Hygienists’ Association (BCDHA) submitted their application to the Health Professions Council (HPC)
  • In February 1993, the HPC released their report recommending dental hygiene be designated under the HPA
  • Dental hygiene was designated under the Act in 1994
• Dental Hygienists Regulation

  • Identifies the scope of practice, reserved acts and limitations
  • The specific law governing the profession of dental hygiene
  • Dental Hygiene Act: 1991 - an act pertaining exclusively to the practice of dental hygiene
  • On March 1, 1995 dental hygiene became a self-regulating profession in British Columbia
• Self-Regulation

  • When activities pose a possible risk to the public, government regulates those activities to minimize the risks
  • The government delegates the regulatory responsibilities to members of the profession
  • Professionals establish their own licensing structures, rules, & penalties
  • The BCCOHP is the name of the college established under the HPA
• BCCOHP is responsible for establishing, monitoring, and enforcing standards that assure safe, ethical, and competent dental hygiene care
• Bylaws

  • Set out the details of the operation of the college:
  • Election & appointment of governing board
  • Duties and responsibilities of the board, registrar, and deputy registrar
  • Qualifications of registrants
  • Standards of practice
  • Regulation of professional conduct