Supervision Standard

    The public can expect that licensed healthcare professionals will take responsibility for the actions of those they supervise, that they will delegate or assign services only when it is safe and appropriate to do so based on an assessment of the patient’s needs and the competence of the supervisee, and that they will act promptly if there are concerns about safety, quality, or ethical conduct.

    This Practice Standard applies to all licensed healthcare professionals when they act as supervisors, regardless of practice setting.

    A licensee must:

    1. Delegate only when authorized to do so under the CHCPBC Bylaws, which means to: 
      1. Meet the delegation requirements in the HPOA, Regulations, and CHCPBC Bylaws.
      2. Meet all supervision and documentation requirements.

    1. Delegate or assign activities appropriately, which means to: 
      1. Ensure that the delegation or assignment of an activity is safe and appropriate, and that the activity is within the supervisee’s competence and will be performed in accordance with the requirements of the Ethics and Practice Standards. 
      2. Ensure that the delegation or assignment of an activity is consistent with the patient’s interests based on all circumstances. 
      3. Only delegate or assign activities the licensee is qualified and competent to perform themselves. 
      4. Provide clear and appropriate instructions, expectations, and necessary support before performance of the delegated or assigned activity begins. 
    1. Supervise appropriately, which means to:
      1. Use appropriate supervision strategies, proportionate to the risk associated with the delegated or assigned activity, as well as to the patient’s needs and the supervisee’s abilities and role. 
      2. Maintain appropriate oversight to ensure that the activity delegated or assigned is provided in a safe, effective, and ethical manner, in compliance with all requirements under the HPOA, CHCPBC Bylaws, and Ethics and Practice Standards.
      3. Intervene and/or re-delegate or reassign the activity if safety or quality of care may be compromised. 
      4. Be available to provide their supervisee with guidance and assistance and to intervene in the patient’s care to ensure their safety as required.

    1. Retain accountability, which means to:
      1. Recognize that they are accountable and responsible for the delivery of any health services delegated or assigned to another healthcare provider, as well as for the overall care of the patient.
      2. Revoke the delegation or assignment if there is reason to believe that the supervisee is incapable or unwilling to perform the activity safely and in accordance with the HPOA, the Regulations, and the CHCPBC Bylaws.

    1. Document appropriately, which means to:
      1. Ensure that delegation or assignment decisions—including to whom the delegation or assignment was made, instructions provided, supervisory actions taken, and any issues or incidents arising from the delegated or assigned activities—are appropriately documented.

    1. When delegating restricted activities to a student as part of a recognized education program:
      1. Delegate in accordance with any limits or conditions established by the education program.
      2. Ensure that supervision complies with any guidelines established by the education program.
      3. Ensure that the student is covered by liability insurance or professional liability protection as required in the bylaw.
      4. Ensure that the delegated activity is carried out on either the premises on which the education program is taking place or other premises that the student is attending for the purposes of the education program.

    Glossary

    Accountable: being responsible and answerable for one’s professional conduct, including off-duty conduct that has a sufficient connection to the profession.

    Assignment: in relation to the provision of health services, means the designation of another person to perform a healthcare-related activity that is not a “restricted activity” as defined by the HPOA or the CHCPBC Bylaws.

    Delegate: to authorize the performance of a restricted activity, where the authorization is given by a licensee in the course of practising a designated health profession to a person who is not authorized to practise the designated health profession in compliance with the requirements of s. 74 of the HPOA and the CHCPBC Bylaws.

    Health service: any service or activity provided by a licensee in relation to healthcare, including collecting information; assessing, diagnosing, preventing, monitoring, treating, or managing a person’s health or health-related condition; or providing health-related information to an individual or the public, whether or not treatment is provided.

    Patient: a person to whom health services are provided. Throughout the Ethics and Practice Standards, “patient” includes substitute decision-makers, parents, and guardians where applicable.

    Recognized Education Program: a program recognized in Schedule 5 of the CHCPBC Bylaws.

    Restricted activity: an activity that is performed in the course of providing a health service and is prescribed by the Minister as a restricted activity.

    Supervise: to oversee the practice of another individual to ensure that health services are delivered safely, ethically, and in accordance with professional standards while retaining responsibility for the actions of the individual being supervised and the delivery of those health services. The supervision may occur in the context of a formal delegation or assignment.

    Supervisee: an individual working under the supervision of a licensed and authorized healthcare professional. This may include support personnel, students, interns, or individuals required to engage in supervised practice.

    Related standards and legislation

    Restricted Activities and Certifications