Adult Interdependent Partner is, subject to the Adult Interdependent Relationships Act, “a person is the adult interdependent partner of another person if:
a) the person has lived with the other person in a relationship of interdependence
(a.1) for a continuous period of not less than 3 years, or
(a.2) of some permanence, if there is a child of the relationship by birth or adoption, or
b) the person has entered into an adult interdependent partner agreement with the other person under section 7.”
Adult Interdependent Relationship means the relationship between two persons who are adult interdependent partners of each other.
Adverse events refer to “an event that results in unintended harm to the patient and is related to the care and/or services provided to the patient rather than to the patient’s underlying condition.”1
Client-centered approach refers to “an approach which recognizes the physiotherapist’s expertise and values, respect for and partnership with the people receiving physiotherapy care, including the client’s ability to make key choices in services delivered.”2
Clients (does not apply to Sexual Abuse and Sexual Misconduct Standard) are recipients of physiotherapy services, and may be individuals, families, groups, organizations, communities, or populations. An individual client may also be referred to as a patient. In some circumstances, clients/patients may be represented by their substitute decision-makers.3
Collaborative practice refers to “the process of developing and maintaining effective interprofessional working relationships with learners, practitioners, patients/families, and communities to enable optimal health outcomes. Elements of collaboration include respect, trust, shared decision making, and partnerships.”4
Competence is the degree to which an individual can use the knowledge, skills, and judgments associated with the profession to perform effectively within the domain of professional encounters defining the scope of professional practice.5 Competence is developmental, impermanent, and context-specific.6
Competency is the ability to perform a practice task with a specified level of proficiency.
Complementary refers to “use of two things when each adds something to the other or helps to make the other better, going together well, working well together.”7
Comprehensive refers to “complete; including all or nearly all elements or aspects of something.”8
Concurrent treatment refers to “the circumstance where more than one health professional (provider) is administering or applying remedies, including medical, surgical or other therapies, to a patient for the same or related disease or injury.”9
Confidentiality “is the assurance that certain information that may include a subject’s identity, health, behavior, or lifestyle information, or a sponsor’s proprietary information would not be disclosed without permission from the subject (or sponsor).”10
Conflicts of interest refers to situations that arise when the physiotherapist has a relationship or interest that may be seen as improperly influencing their professional judgment or ability to act in the best interest of the client.”11
Electronic communication, social media refers to “software, applications (including those running on mobile devices), email and websites, which enable users to interact, create and exchange information online.”12 While not strictly speaking electronic communication or social media, the use of videography or the taking and communication of photographs are included in this definition relating to technology.
Episodic care refers to a single encounter with a patient focused on a presenting concern(s), where neither the physiotherapist nor patient have the expectation of an ongoing care relationship. The individual is considered a patient for the duration of the episode of care. A physiotherapist who engages in the type of activity described in the definition of sexual abuse or sexual misconduct while providing episodic care will be considered to have committed sexual abuse or sexual misconduct.
Evidence-informed practice is “derived from evidence-based practice13 and involves clinical problem solving and decision making informed by integrating best available evidence, client context and the personal knowledge and experience of the physiotherapist.”14
Infection prevention and control refers to “measures practiced by health-care personnel intended to prevent spread, transmission and acquisition of infectious agents or pathogens between patients, from health-care workers to patients, and from patients to health-care workers in the health-care setting.”15
Informed consent refers to “receiving client or their legally authorized representative’s permission to proceed with an agreed course of physiotherapy service. Consent may be revoked at any time…Consent can be written or oral, and may be expressed or implied. Having a written consent form does not mean there is informed consent. Informed consent involves ongoing communication between the parties involved.”16
Interventions refer to physiotherapy services that “include but are not limited to education and consultation, therapeutic exercise, soft tissue and manual therapy techniques including manipulation, electro-physical agents and mechanical modalities, functional activity training, cardio-respiratory and neuromotor techniques, and prescribing aids and devices.”17
Near misses refer to “a patient safety incident that did not reach the patient. Replaces ‘close call.’”18
Patient (in regards to Sexual Abuse and Sexual Misconduct Standard): An individual is a patient of a physiotherapist when they are a recipient of physiotherapy services and a therapeutic relationship is formed. This occurs when a physiotherapist has engaged in one or more of the following activities:
- Gathered clinical information to assess an individual
- Contributed to a health record or file for the individual
- Provided a diagnosis
- Provided physiotherapy advice or treatment
- Charged or received payment from the individual or third party on behalf of the individual for physiotherapy services provided
- Received consent from an individual for recommended physiotherapy services
A patient is deemed discharged and no longer a patient if there have been no physiotherapy services provided for one year (365 days).
For the purposes of sexual abuse and sexual misconduct provisions in the Health Professions Act, an individual is not considered a patient if a current sexual, spousal, or adult interdependent partner relationship exists between the individual and the physiotherapist at the time the physiotherapist provides physiotherapy services.
The physiotherapist has provided episodic care to a patient where neither the physiotherapist nor the patient have the expectation of an ongoing care relationship,
48 hours have elapsed between the episode of care and the start of the sexual relationship or communication for the purpose of starting the sexual relationship.
Personal information refers to “information about an identifiable individual that is included in any form including….information relating to the education or the medical, criminal or employment history of the individual or information relating to financial transactions in which the individual has been involved…”19
Personal protective equipment refers to the use of items such as gloves, gowns and goggles to protect the physiotherapist during client treatment.
Physiotherapy practice, as defined in Schedule 20 s. 3 of the Health Professions Act, is when physiotherapists do one or more of the following:
a) assess physical function,
b) diagnose and treat dysfunction caused by a pain, injury, disease or condition in order to develop, maintain and maximize independence and prevent dysfunction,
- 1) engage in research, education and administration with respect to health services delivery and the science, techniques and practice of physiotherapy, and
c) provide restricted activities authorized by the regulations.
Physiotherapy services are “services provided by or under the direction of a physiotherapist. This includes client assessment and intervention, and related communication with and reporting to various parties for the purposes of delivering patient care.”20
Physiotherapy service delivery refers to the period from the initial client assessment to discharge from services provided by the physiotherapist.
Plain language refers to “communication your audience can understand the first time they read or hear it. Language that is plain to one set of readers may not be plain to others. Written material is in plain language if your audience can:
- Find what they need
- Understand what they find
- Use what they find to meet their needs”21
Privacy refers to “a person’s desire to control the access of others to themselves. Privacy protects access to the person, whereas confidentiality protects access to the data.”22
Professional boundaries set the limitations around relationships between clients and health-care providers to ensure the delivery of safe, ethical, client-centered care. Professional boundaries are characterized by respectful, trusting, and ethical interactions with patients that are free of abuse, sexual and/or romantic encounters.23
Proficiency means performance consistent with the established standards in the profession.
Quality of health-care services refers to the “acceptability, accessibility, appropriateness, effectiveness, efficiency, and safety”24 of the services provided.
Quality improvement refers to “a systematic approach to making changes that lead to better patient outcomes (health), stronger system performance (care), and enhanced professional development. It draws on the combined and continuous efforts of all stakeholders — health-care professionals, patients and their families, researchers, planners, and educators — to make better and sustained improvements.”25
Regulated member refers to an individual registered with a regulatory organization governed under the Health Professions Act, of Alberta or another provincial/territorial regulatory organization including physiotherapists.
Risk management refers to the “identification, assessment, and prioritization of risks followed by coordinated and economical application of resources to minimize, monitor, and control the probability and/or impact of unfortunate events.”26
Routine practices are a comprehensive set of infection prevention and control measures that have been developed for use in the routine care of all patients at all times in all health-care settings. Routine practices aim to minimize or prevent health-care acquired infections in all individuals in the health-care setting, including patients, health-care workers, other staff, visitors and contractors. These include hand hygiene, point-of-care risk assessment and indications for and appropriate application of aseptic technique, handling client equipment, cleaning environment waste and sharps handling, etc.27, 28
Sexual abuse is defined in the Health Professions Act, and “means the threatened, attempted or actual conduct of a regulated member towards a patient that is of a sexual nature and includes any of the following conduct:
a) Sexual intercourse between a regulated member and a patient of that regulated member;
b) Genital to genital, genital to anal, oral to genital, or oral to anal contact between a regulated member and a patient of that regulated member;
c) Masturbation of a regulated member by, or in the presence of, a patient or that regulated member;
d) Masturbation of a regulated member’s patient by that regulated member;
e) Encouraging a regulated member’s patient to masturbate in the presence of that regulated member;
f) Touching of a sexual nature of a client’s genitals, anus, breasts or buttocks by a regulated member.”
Sexual misconduct, as defined in the Health Professions Act, “means any incident or repeated incidents of objectionable or unwelcome conduct, behaviour or remarks of a sexual nature by a regulated member towards a patient that the regulated member knows or ought reasonably to know will or would cause offence or humiliation to the patient or adversely affect the patient’s health and well-being but does not include sexual abuse.”
Sexual nature does not include conduct, behaviour, or remarks that are appropriate to the service provided.
Spouse is defined as “a party to a marriage.” (Family Law Act, 46(g)) or “A legal marriage partner. This term includes both opposite and same-sex relationships but does not include common-law partnerships.”
Standardized measures refers to “measurement tools that are designed for a specific purpose in a given population. Information is provided regarding the administration, scoring, interpretation, and psychometric properties for each measure.”29
Supervision is “the action or process of watching and directing what someone does or how something is done.”30
Supervisees refers to students, assistants, and other support personnel.
Therapeutic relationship (in regards to Sexual Abuse and Sexual Misconduct Standard) refers to the relationship that exists between a physiotherapist and a patient during the course of physiotherapy services. The relationship is based on trust, respect, and the expectation that the physiotherapist will establish and maintain the relationship according to applicable legislation and regulatory requirements and will not harm or exploit the patient in any way.
Due to the nature of physiotherapy practice, there is always an inherent power imbalance between the patient and their physiotherapist. Because of the existence of an inherent power imbalance, sexual relationships are prohibited for the duration of the therapeutic relationship even if the patient consents to the sexual relationship.
The therapeutic relationship extends from the time of initial professional contact between the physiotherapist and the patient until one year (365 days) from the date of the last documented physiotherapy service.
Therapeutic relationship refers to the relationship that exists between a physical therapist and a client during the course of physical therapy treatment. The relationship is based on trust, respect, and the expectation that the physical therapist will establish and maintain the relationship according to applicable legislation and regulatory requirements and will not harm or exploit the client in any way.31
Timely refers to “happening at the correct or most useful time: not happening too late.”32