for Physical Therapists in British ColumbiaStandards of Practice for Physical Therapists in British Columbia | Pg 3 Introduction BACKGROUND Standards of Practice are one component

Standards of Practice for Physical Therapists in British Columbia | Pg 1

Standards of Practicefor Physical Therapists in British Columbia

August 2018

Table of Contents

I. INTRODUCTION 3 Background 3 Purpose of Standards of Practice 3 Assumptions 4 How the Standards of Practice are Organized 4

II. STANDARDS OF PRACTICE 5 Standard 1. Client Assessment, Diagnosis, Interventions 5 Standard 2. Client-Centred Care 6 Standard 3. Collaborative Practice 7 Standard 4. Communication 8 Standard 5. Competence 9 Standard6. ConflictofInterest 10 Standard 7. Consent 11 Standard 8. Documentation and Record-Keeping 12 Standard 9. Evidence-Informed Practice 15 Standard 10. Fees and Billing 16 Standard 11. Infection Control 17 Standard 12. Legislative Responsibilities 18 Standard13.Privacy/Confidentiality 19 Standard 14. Professional Boundaries and Sexual Misconduct 20 Standard 15. Quality Improvement 21 Standard 16. Risk Management 22 Standard 17. Safety 23 Standard 18. Supervision 24 Standard 19. Use of Title 26

III. GLOSSARY 27



IntroductionBACKGROUNDStandards of Practice are one component of a continuum of documents, including codes of ethics, position statements, practice guidelines, Essential Competencies, and Entry-to-Practice Milestones, which direct the practice of professionals to provide quality1 care. Historically in the physical therapy2 profession, each regulatory organization in Canada had its own set of Standards of Practice and Code of Ethics, even though physical therapy practice is more similar than dissimilar across the country. The Core Standards of Practice have been developed toreflectcurrentandfuturepracticetrendsandtobe generally applicable to all physical therapists in Canada.

Core Standards of Practice, developed by a pan-Canadian committee, served as a resource for the development of Standards of Practice that reflectthecontext,jurisdictionalneeds,andlegislation relevant to physical therapy regulatory organizations across Canada. The Core Standards of Practice serve as the foundation for this version of the College of Physical Therapists of British Columbia Standards of Practice. The Standards of Practice apply to all physical therapists in British Columbia registered to practise physical therapy, in all contexts or settings. Compliance with the Standards of Practice is a mandatory component of being regulated members of the profession.

PURPOSE OF STANDARDS OF PRACTICEStandards of Practice serve several purposes, including:

• Definingtheminimumperformanceexpectations that regulated members of the profession must meet. Standards of Practice set out the obligations and requirements of physical therapists in their professional role.

• Fulfillingtherequirementsforself-regulationand providing a frame of reference for regulatory organizations against which actual performance can be compared for quality practice.

• Providing a reference to the public related to expectations for quality care delivered by professionals.


Introduction cont’dASSUMPTIONSThe Core Standards of Practice are based on assumptions which frame the context for the Standard of Practice. The assumptions underpinning the Standards of Practice are listed with reference to the physical therapist, the regulatory organization, and the Standards of Practice themselves as follows:

PHYSICAL THERAPISTS • are autonomous, self-regulated health-

care professionals bound by a code of ethics;

• act in the best interests of clients and are committed to providing quality client- centred services; and

• are required to be knowledgeable of and comply with all Standards of Practice at all times.

THE REGULATORY ORGANIZATION• develops/adopts Standards of Practice as

a basis for monitoring registrants’ performance; and

• is committed to serving and protecting the interests of the public.

THE STANDARDS OF PRACTICE

• outline minimum, mandatory performance requirements;• are one component of a continuum of professional documents outlining professionals’ practice; and• are to be applied as a comprehensive unit that physical therapists must comply with to direct their practice at all times.

HOW THE STANDARDS OF PRACTICE ARE ORGANIZEDThe Standards of Practice are organized alphabetically for ease of access.

Each Standard of Practice includes the following:

• A Standard statement that outlines the expected performance of the regulated member.

• An Expected Outcome that describes what clients can expect from services when the standard is met by the physical therapist.

• Performance Requirements that outline the actions that must be demonstrated by the physical therapist to indicate how the standard is met in practice. The expectations are not all-inclusive, nor are they listed in order of importance.

• Related Standards of Practice that provide complementary and/or additional information relatedtothespecificstandard.

• Legislative References that are relevant to British Columbia.

1 A glossary of terms is included at the end of this document. Terms included in the Glossary are highlighted in blue the first time they appear in the Standards of Practice for Physical Therapists in British Columbia. This only applies to the full set of standards.

2 The terms physical therapy/physiotherapy and physical therapist/physiotherapist are considered synonymous and may be used interchangeably in this document.


Standard 1. Client Assessment, Diagnosis, Interventions

STANDARDThe physical therapist demonstrates proficiency in client assessment, diagnosis, and interventions to deliver quality client-centred services

EXPECTED OUTCOMEClients can expect the physical therapist to select appropriate assessment tools, make an informed physical therapy diagnosis, and apply intervention proceduresthatarecarriedoutproficientlyforthedelivery of quality physical therapy services.

PERFORMANCE REQUIREMENTSThe physical therapist:

a. Obtains clients’ informed consent to proposed services.

b. Applies appropriate assessment procedures to evaluate clients’ health status using standardized measures, as available. Appropriate assessment includes taking a relevant history and completing a physical examination relevant to presenting symptoms.

c. Uses critical thinking and professional judgementtointerprettheassessment findingsanddetermineaphysicaltherapy diagnosis.

d. In collaboration with clients, develops realistic intervention plans to address clients’ needs and goals.

e. Applies intervention procedures safely and effectively.

f. Assigns appropriate tasks to supervisees with clients’ consent.

RELATED STANDARDS OF PRACTICEStandard 2. Client-Centred Care

Standard 3. Collaborative Practice

Standard 5. Competence

Standard 7. Consent

Standard 8. Documentation and Record-Keeping

Standard 9. Evidence-Informed Practice

Standard 18. Supervision

g. Re-evaluates and monitors clients’ responses throughout the course of interventions,makingadjustmentsand discontinuing services that are no longer requiredoreffective.

h. Makes appropriate referrals when clients’ needs are best addressed in collaboration with/or by another provider.

i. Collaborates with clients and other providers, as appropriate, to plan and implement discharge plans.

j. Provides client education to enable and optimize clients’ transition to self- management.

k. Promotes continuity in service by collaborating and facilitating clients’ transition from one health-care sector or provider to another.

l. Delivers only services that are clinically indicated for clients and that they are competently able to provide.


Standard 2. Client-Centred Care

STANDARDThe physical therapist integrates a client-centred approach in all aspects of physical therapy service delivery.

EXPECTED OUTCOMEClients can expect that they will be treated respectfully and their input will be valued, acknowledged, and integrated into all aspects of physical therapy service delivery.


a. Treats clients in a manner that recognizes their autonomy, uniqueness, goals, and self- worth at all times.

b. Involves clients in decision-making regarding their care, respecting their independence and right to refuse or withdraw from treatment at any time.

c. Communicates with clients to facilitate their understanding of the care plan and how it addresses their goals; outlines the risksandbenefitsofservices;andobtains informed consent.

d. Monitors clients’ responses throughout servicedelivery,adjustingandmodifying interventions/approaches, as required, and obtaining ongoing informed consent.

e. Treats all clients with compassion, respect, and dignity throughout the course of their care, especially when conducting sensitive assessment and/or treatments.

RELATED STANDARDS OF PRACTICEStandard 1. Client Assessment, Diagnosis, Interventions

Standard 4. Communication

Standard 7. Consent


Standard 14. Professional Boundaries and Sexual Misconduct




Standard 7. Consent




STANDARDThe physical therapist promotes collaborative practice with clients, health-care team members, and other stakeholders to support the delivery of integrated, quality client-centred care.

EXPECTED OUTCOMEClients can expect that the physical therapist will collaborateeffectivelywithotherstopromoteintegrated client-centred care.


a. Works collaboratively with clients, health- care team members, and other stakeholders to promote shared decision-making and integrated care.

b. Usessharedleadershipandconflict resolution strategies to resolve or acceptdifferencesandoptimizeeffective team collaboration.

c. Communicateseffectively,obtaining informed consent and maintaining confidentialitywithclients,teammembers, and other stakeholders at all times.

d. Shares information with clients, team members, and other stakeholders about the roles and responsibilities of physical therapists in client-centred care.

e. Consults with/refers to the appropriate team member when aspects of clients’ goals are best addressed by another provider.

f. Communicateseffectivelywithclients, team members, and other stakeholders to facilitate collaboration and co-ordinate care.




Standard 7. Consent


Standard 13. Privacy/Confidentiality


g. Participates in concurrent treatment of the same condition when approaches are complementary,ofbenefittoclients, andanappropriateuseofhuman/financial resources.

h. Discontinues concurrent services and documents when the physical therapistapproachesconflict,thereis inefficientuseofresources,and/ortherisks outweighthebenefitstoclients.

i. Treats clients, health-care team members, and other stakeholders with dignity and respect at all times.



STANDARDThe physical therapist communicates clearly, effectively,professionally,andinatimely manner to support and promote quality services.

EXPECTED OUTCOMEClients can expect that communication with the physical therapist will be respectful and professional, and will contribute to their understanding and participation in their health management.


a. Uses respectful, open, clear, and honest communication in all professional interactions (e.g., spoken, written, social media).

b. Communicateseffectivelywithclientsto promote their understanding of proposed services (e.g., active listening, use of plain language, encouraging questions).

c. Identifiespotentialbarrierstoeffective communication and engages appropriate resources to address these barriers (e.g., interpreters, technology, diagrams, printed education materials).

d. Documents all communications accurately, clearly, professionally, and in a timely manner.













STANDARDThe physical therapist practises within their level of competence and pursues learning throughout the career continuum to maintain competence in existing and emerging areas of their practice.

EXPECTED OUTCOMEClients can expect that the services they receive are delivered by a physical therapist who actively maintains their competence in existing and emerging areas of practice.


a. Practises within their level of competence, incorporating the required knowledge and skills to deliver quality client-centred care.

b. Takes appropriate actions (e.g., referral to another physical therapist or health-care provider, courses, mentorship) in situations where they do not have the required competence to deliver quality client-centred care.

c. Complies with the appropriate provincial territorial regulatory requirements of continuing competence programs.

d. Demonstratesengagementinself-reflection toidentifylearningneedsandobjectivesto maintain competence.

e. Demonstrates evidence of actively participating in self-directed lifelong learning to maintain competence in existing practice areas and to acquire competence in new and emerging areas of practice.



Standard 12. Legislative Responsibilities


Standard 6. Conflict of Interest

STANDARDThe physical therapist must identify, and avoid or manage, any real, potential, or perceived conflictsofinterest.

EXPECTED OUTCOMEClients can expect the physical therapist to deliver services in clients’ best interests and that real, potential,orperceivedconflictsofinterestaredisclosed and managed.


a. Identifiesandmanagesanysituationsof real,potential,orperceivedconflictsof interest. This includes but is not limited to:

i. receivingfinancialorotherbenefits from other providers related to accepting referrals, providing services, or selling products;

ii. providing and/or accepting incentives to/from others to generate referrals, provide services, or sell products;

iii. receivingfinancialincentivesbasedon client numbers, service volumes, profits,etc.;

iv. self-referring clients acquired in the public sector for treatment in the private sector for their own personal gain; and

v. providing services or any product for financialgain,ratherthanthebenefitof the client.

b. Avoids participating in any real, potential, ofperceivedconflictsofinterest.Insituations whereconflictofinterestcannotbeavoided, manage and provide full disclosure of


Standard 7. Consent


theconflictofinteresttoclientsandothers as appropriate and document in a complete, open,andtimelymannerhowtheconflict was managed.

c. Makesareasonableefforttoavoid providing services to an individual with whom they have a close personal relationship. In situations where this conflictofinterestcannotbeavoided (e.g., where no other professional with thespecificskillsisavailable),fullydisclose anddocumenttheconflictofinterest, indicating how the relationship is to th client’sbenefitandincompliancewith regulatory requirements.



Standard 7. Consent


Standard 7. Consent

STANDARDThe physical therapist obtains clients’ ongoing informed consent for the delivery of physical therapy services in accordance with the Health Care (Consent) and Care Facility (Admission) Act and the Infants Act.

EXPECTED OUTCOMEClients can expect that they will be informed of the options,risks,andbenefitsofproposedservices;askedto provide their consent; and that the physical therapist will respect their right to question, refuse options, and/or withdraw from services at any time.


a. Communicates with clients to explain and facilitate their understanding of physical therapy service options.

b. Explainstoclientstherisksandbenefits of physical therapy service options and the consequences of participating or not in proposed interventions.

c. Obtains and documents clients’ ongoing informed consent to proposed services.

d. Respects the autonomy of clients to question, decline options, refuse, and/or withdraw from services at any time.

e. Obtains informed consent from the appropriate individual, according to applicable legislation and regulatory requirements, in cases when clients are incompetent, incapacitated, and/or unable to provide consent.

f. Obtains informed consent from a minor’s legal guardian where the client is under 19 years of age in accordance with Section 17 of the Infants Act.






LEGISLATIVE REFERENCEHealth Care (Consent) and Care Facility (Admission) Act, RSBC 1996, c. 181. Available here.

Infants Act, RSBC 1996, c. 223.Available here.

g. In situations of physical therapy research, obtains approval from the appropriate research ethics authority and informed consent from clients prior to their participation in studies.

http://www.bclaws.ca/civix/document/id/complete/statreg/96181_01

http://www.bclaws.ca/EPLibraries/bclaws_new/document/ID/freeside/00_96223_01



STANDARDThe physical therapist maintains paper or electronic documents/records that are accurate, legible, and complete; written in a timely manner; and in compliance with applicable legislation and regulatory requirements.

EXPECTED OUTCOMEClients can expect that their physical therapy recordsareconfidential,accurate,complete,andcomply with applicable legislation and regulatory requirements.


a. Maintains and shares all documentation, correspondence, and records in compliance with applicable BC legislation and regulatory requirements (Personal Information Protection Act or Freedom of Information and Protection of Privacy Act) and the Privacy/ConfidentialityStandardofPractice.

b. Maintains legible, accurate, complete, and timely records related to all aspects of client care in either French or English.

c. Includes in the record detailed chronological information regarding the:

i. uniqueclientidentifieroneachpage of the client record;ii. client’s reason for attendance;iii. client’s relevant health, family, and

social history;iv. dates of each treatment session or

professional interaction, including missed or cancelled appointments, telephone, or electronic contact;

v. assessmentfindings;vi. treatment plan and goals;vii. tasks assigned to the supervisee;viii. details of treatment provided,

including modality parameters, client response to treatment, and results of reassessments; ix. details of all client education, advice

provided, and communication with or regarding the client; and x. identificationoftheprovider,including

the physical therapist’s title. d. Includessufficientdetailintherecordto

allow the client to be managed by another physical therapist.

e. May reference, rather than duplicate, information collected by another regulated health-care provider that the physical therapist has reviewed as relevant.

LEGISLATIVE REFERENCEFreedom of Information and Protection of Privacy Act, RSCB 1996, c. 165.Available here.

Limitation Act, SBC 2012, c. 13. Available here.

Personal Information Protection Act, SBC 2003, c. 63. Available here.

RELATED STANDARDS OF PRACTICEStandard 4. Communication

Standard 12. Legislative Compliance

Standard 13. Privacy/ Confidentiality

http://www.bclaws.ca/Recon/document/ID/freeside/96165_00


http://www.bclaws.ca/Recon/document/ID/freeside/00_03063_01


Standard 8. Documentation and Record-Keeping Cont’d

f. Uses terms, abbreviations, acronyms, anddiagramswhicharedefinedor described to promote understanding for others who may access a record.

g. Identifiestheproviderofphysicaltherapy services, including supervisees, via tracking and documentation mechanisms.

h. Reviews and countersigns record entries made by physical therapy students.

i. Identifiesinamultidisciplinaryrecord the portion for which the physical therapist is responsible for writing.

j. Confirmsthatallcorrespondence(e.g., electronic communication, social media) and documentation is professionally written in compliance with applicable legislation and regulatory requirements.

k. Secures all personal information (while in use, storage, or during transfer) through the appropriate use of physical, technical, and electronic security mechanisms (e.g., passwords,encryption,lockedoffices/file cabinets) to protect the privacy of client information.

l. Verifiesthatallrecordshaveanaudittrail that clearly captures access and documentation of alterations made to the record clearly identifying:

i. who made the change or addition; andii. date the change was made.

m. Makesareasonableefforttoconfirmthatall professional correspondence is sent to the intended recipient.

n. Maintainscompleteandaccuratefinancial records for every circumstance in which they provide treatment, render any service, sell, or provide a product. Financial records must include:

i. identificationoftheserviceprovider and/ organization, date of service, and product or service provided;

ii. client’suniqueidentification;iii. fee for product or service, including

any interest charges or discounts provided; and

iv. date payment was received and any balance owing.

o. Retains records (e.g., appointment, client, financial)foraminimumofsixteen(16) years from the date of the last entry or the time limitation for actions against a registered health-care professional, as provided for in the Limitation Act (SBC 2012), chapter 13, as amended, whichever is the greater. Records concerning minors mustberetaineduntiltheirageofmajority is reached (nineteen (19) years in British Columbia) plus sixteen (16) years.

p. Ensures retention of records in an accessible manner that enables the record to be retrieved and copied upon request.

q. NotifiestheCollegeofPhysicalTherapists in British Columbia within twenty-one (21) calendar days of the date of closing a practice or ceasing to practise in the location where the clinical records of the practice are stored.

r. Disposes of records in a manner that maintainsprivacyandconfidentialityof personal information.

LEGISLATIVE REFERENCEFreedom of Information and Protection of Privacy Act, RSCB 1996, c. 165.Available here.

Limitation Act, SBC 2012, c. 13. Available here.

Personal Information Protection Act, SBC 2003, c. 63. Available here.

RELATED STANDARDS OF PRACTICEStandard 4. Communication

Standard 12. Legislative Compliance


http://www.bclaws.ca/Recon/document/ID/freeside/96165_00




Standard 8. Documentation and Record-Keeping Cont’d

s. Provides a copy of the complete clinical or financialrecordtotheclientortheir authorized representative upon request and appropriate consent.

t. Documents that equipment used in physical therapy practice is routinely inspected, maintained, and calibrated on a regular basis, according to applicable legislation and manufacturers’ recommendations, and retains equipment records.

u. In absence of an agreement to the contrary, the ownership right to a clinical record remains with the clinic/facility/institution where the record was compiled.



STANDARDThe physical therapist incorporates evidence-informed practice in all aspects of physical therapy service delivery.

EXPECTED OUTCOMEClients can expect that the physical therapy services they receive are informed by consideration of the best available evidence, client needs, and the personal knowledge and experience of the physical therapist.


a. Incorporates current physical therapy– related evidence into client-centred care by reviewing relevant research/information andintegratingfindingsintoassessmentand intervention plans.

b. Integrates critical thinking and professional judgementintoclient-centredcare,evaluates their practice in terms of client outcomes, andmodifiesapproachesaccordingly.




Standard 7. Consent


Standard 10. Fees and Billing





STANDARDThe physical therapist is responsible for ensuring that the fees charged for physical therapy services aretransparentandjustifiable,enablingclientstomake informed choices.

EXPECTED OUTCOMEClients can expect that fee schedules and billing practices for physical therapy services are transparent,justifiable,andclearlycommunicated.


a. Clearly communicates applicable fees to clients prior to the provision of physical therapy services.

b. Provides a fee schedule that includes transparent and accurate information about billing policies and all potential charges (e.g., assessments, reports, cancellations, equipment, any additional specialized fees).

c. Provides clients with clear, transparent, accurate, and comprehensive invoices/ receipts, in a timely manner.

d. Maintainsaccurateandcompletefinancial records related to the provision of services.

e. Is responsible for all billing under their registration number, identifying and correcting any errors in a timely manner.

f. Confirmsprocessesareinplacetoresolve issues arising from billing disputes.

g. Ensures fees are only charged for services provided.






Standard 11. Infection Control

STANDARDThe physical therapist complies with infection prevention and control measures to support the health and safety of clients, health-care providers, themselves, and others.

EXPECTED OUTCOMEClients can expect that the measures in place for infection prevention and control during the provision of physical therapy services are in compliance with applicable provincial legislation, regulatory, and/or workplace requirements.


a. Acquires the education, training, and proficiencytoapplyinfectionpreventionand control techniques in physical therapy practice (e.g., when needling, suctioning).

b. Adheres to best practices of infection prevention and control in physical therapy practice, according to applicable provincial legislation, regulatory, and/or workplace requirements.

c. Maintains the cleanliness of all spaces, equipment, and devices, according to appropriate legislation, infection prevention and control standards/policies, and manufacturers’ recommendations.

d. Disposes of devices and materials, according to best practices and established protocols.

e. Uses routine practices (e.g., hand-washing, point-of-care risk assessment, use of personal protective equipment) to minimize or prevent the spread of acquired infections in the health-care setting.

RELATED STANDARDS OF PRACTICEStandard 8. Documentation and Record-Keeping

Standard 15. Quality Improvement

Standard 16. Risk Management

Standard 17. Safety

LEGISLATIVE REFERENCEBC Centre for Disease Control. (2011). Communicable Disease Control Manual. Available here.

British Columbia Ministry of Health. (2011). Best Practice Guidelines for Cleaning, Disinfection and Sterilization of Critical and Semi-critical Medical Devices in BC Health Authorities. Available here.

http://www.bccdc.ca/health-professionals/clinical-resources/communicable-disease-control-manual

http://www.health.gov.bc.ca/library/publicationshttp://www.health.gov.bc.ca/library/publications/year/2011/Best-practice-guidelines-cleaning.pdf



RELATED STANDARDS OF PRACTICEStandard 6. Conflict of Interest

Standard 7. Consent


Standard 17. Safety

Standard 19. Use of Title

STANDARDThe physical therapist practises in compliance with all the legislative and regulatory requirements of theirjurisdiction.

EXPECTED OUTCOMEClients can expect that the services they receive are delivered by a registered physical therapist who is in compliance with legislation and regulatory requirements applicable to their practice.


a. Maintains current registration with the appropriate physical therapy regulatory organization.

b. Is knowledgeable of and complies with relevant federal/provincial/territorial legislation (e.g., privacy legislation, health profession acts) applicable to their practice.

c. Practises in accordance with physical therapy regulatory requirements (e.g., scope of practice, Code of Ethics, Standards of Practice, continuing competence, mandatory reporting, use of title).

d. Practices dry needling only if authorized and rostered.

e. Takes responsibility and is accountable for their actions.

f. Conducts themselves in a manner that promotes respect for the profession.


RELATED STANDARDS OF PRACTICEStandard 6. Conflict of Interest

Standard 7. Consent


Standard 17. Safety



STANDARDThe physical therapist respects clients’ rights to privacy and confidentialityof personal information, includinghealth,financial,andotherinformationbypractising in compliance with applicable legislation and regulatory requirements.

EXPECTED OUTCOMEClients can expect that their personal information willbemaintainedprivatelyandconfidentiallyin accordance with applicable legislation and regulatory requirements.


a. Complies with all relevant federal and provincial legislation and regulatory requirements associated with privacy andconfidentialityofclients’personal information.

b. Protects clients’ privacy and personal information at all times.

c. Maintains security of all client documentation/records (e.g., paper, electronic) at all times (e.g., during data collection, storage, transfer, disposal).

d. Obtains and documents clients’ informed consentpriortodisclosingconfidential information to other parties, including communicating and sharing information electronically in accordance with applicable legislation and regulatory requirements.

e. Only accesses relevant client information/ data when providing professional services forthespecificclient,inkeepingwith legislative compliance.


Standard 7. Consent



LEGISLATIVE REFERENCEFreedom of Information and Protection of Privacy Act, RSBC 1996, c. 165. Available here. Personal Information Protection Act, SBC 2003, c. 63.Available here. Personal Information Protection and Electronic Documents Act, SC 2000, c. 5. Available here.

Interpretive documents available from the Office of the Privacy Commissioner of Canada






https://laws-lois.justice.gc.ca/eng/acts/p-8.6/

https://www.priv.gc.ca/en/privacy-topics/privacy-laws-in-canada/the-personal-information-protection-and-electronic-documents-act-pipeda/



Standard 14. Professional Boundaries & Sexual Misconduct

STANDARDThe physical therapist acts with professional integrity and maintains appropriate professional boundaries, avoiding professional misconduct of a sexual nature3

with clients, colleagues, students, and others.

EXPECTED OUTCOMEClients can expect to be treated with integrity and respect, and that the physical therapist will maintain professional boundaries appropriate to the therapeutic relationship in all interactions.Colleagues, students, and others can expect to be treated with integrity and respect, and that the physical therapist will maintain professional boundaries in all interactions.


a. Demonstrates sensitivity, accountability, integrity, honesty, compassion, and respect in all professional interactions.

b. Explains to clients beforehand any procedures that could be misinterpreted (e.g., removal of clothing, touching, physical closeness) and obtains ongoing informed consent.

c. Respects the client’s right to withdraw consent at any time.

d. Stops a procedure or treatment immediately if the client demonstrates unease and re-establishes consent.

e. Demonstrates understanding of the impact of power, trust, respect, and physical closeness on relationships with clients.

3Professional misconduct of a sexual nature includes:(a) sexual intercourse or other forms of physical sexual relations between the physical therapist and the client;(b) touching of a sexual nature of the client by the physical therapist; and(c) behaviour or remarks of a sexual nature by the physical therapist toward the client.Please note that professional misconduct of a sexual nature does not apply to touching, behaviours, or comments that are of a clinical nature and are appropriate to the care provided.




Standard 7. Consent

f. Demonstrates understanding of the impact of power, trust, and respect on relationships with colleagues, students, and others.

g. Treats clients, colleagues, students, and others with respect, avoiding all situations, comments, and/or actions (e.g., sexual, racial) that could be perceived as unprofessional, in violation of human rights, or discriminatory.

h. Establishes and maintains professional boundaries and does not make abusive, suggestive, or harassing comments or engage in inappropriate physical contact or sexual advances with clients, colleagues, students, and others.

i. Manages situations of real, potential, or perceivedconflictsofinterestwherethe relationship with clients, colleagues, students, and others could be compromised.

j. Ends any therapeutic relationship with clients where professional boundaries cannot be maintained or re-established by transferring care, as required.

k. Confirmsthatanyexchangesusing electronic communication and social media are appropriate for therapeutic relationships established with clients.



STANDARDThe physical therapist engages in quality improvement activities to promote quality physical therapy services.

EXPECTED OUTCOMEClients can expect that quality improvement activities are part of physical therapy practice. PERFORMANCE REQUIREMENTSThe physical therapist:

a. Accesses and applies relevant information to improve client care and the delivery of physical therapy services.

b. Engages in continuous quality improvement processes to enhance client care, as appropriate.

c. Supports the development of new evidence and best practices by participating in clinical research and program evaluation, as appropriate.






Standard 7. Consent



STANDARDThe physical therapist participates in risk management activities to promote quality physical therapy services.

EXPECTED OUTCOMEClients can expect that they will be informed of risks inherent to their care, measures will be taken to minimize risks, and they will be safe in the care of the physical therapist.


a. Verifiesthattherearepoliciesand procedures in place related to risk and crisis management and that they are knowledgeable about these procedures.

b. Identifiespotentialrisksinthework environment and incorporates appropriate measures to mitigate/manage these risks(e.g.,breachesofprivacy/confidentiality; environmental hazards; solo practice; aggressive clients; and treatment risks).

c. Participates in emergency preparedness and response training appropriate to the practice setting(e.g.,firedrills,CPR).

d. Recognizes the occurrence of near misses and adverse events (e.g., hot-pack burns, falls) and responds immediately to minimize the impact on the client.

e. Documents near misses and adverse events and completes reports appropriate to the practice setting.


Standard 7. Consent


Standard 17. Safety

f. Contributes to the collection of data to identify, manage, and prevent potential risks and adverse events relevant to the practice setting.

g. Discloses details of any adverse events to the client promptly and transparently, according to best practice guidelines and employer policies and procedures.



Standard 7. Consent


Standard 17. Safety

Standard 17. Safety

STANDARDThe physical therapist promotes and maintains a safe environment for clients, health-care providers, themselves, and others to support quality services.

EXPECTED OUTCOMEClients can expect to be safe in the care of the physical therapist and in the practice environment. PERFORMANCE REQUIREMENTSThe physical therapist:

a. Adheres to safety best practices and applicable legislation, to promote a safe practice environment.

b. Maintains competency in safety protocols by participating in appropriate training related to safe environments, including adherence to occupational health and workplace safety legislation.

c. Maintains a clean, accessible, and safe environment which promotes the safety of clients through all aspects of physical therapy service delivery.

d. Uses routine practices relevant to their practice context (e.g., personal protective equipment).

e. Verifiesclients’identitiestoconfirmthatthe intended services are provided to the appropriate individuals.

f. Informs clients about how to call for assistance if help is required during services.

g. Incorporates appropriate measures to maintain the health and safety of clients, themselves, and other colleagues during the provision of physical therapy services.



Standard 7. Consent




h. Complies with reporting procedures related to near misses and incidents occurring in the workplace.

i. Verifiesanddocumentsthatequipment used in physical therapy practice is maintained, inspected, and calibrated on a regular basis, according to applicable legislation and manufacturers’ recommendations.

j. Applies the appropriate safety procedures when using equipment in physical therapy practice.



STANDARDThe physical therapist is responsible and accountable for the physical therapy services provided by personnel working under their supervision (supervisees).

EXPECTED OUTCOMEClients can expect that they are informed of the role of supervisees and that the services provided by supervisees are supervised by the physical therapist.


a. Assesses the knowledge and skills of supervisees and assigns only those tasks and activities that fall within the supervisor’s and supervisee’s competence.

b. Communicates to clients the roles, responsibilities, and accountability of supervisees participating in the delivery of physical therapy services.

c. Uses mechanisms (e.g., name tags, introduction), so that supervisees are readily identifiable.

d. Assesses clients to determine those appropriate to receive services from supervisees, assigns tasks, and supervises accordingly.

e. Obtains clients’ informed consent for the delivery of services by supervisees.

f. Employs supervision strategies (direct and indirect) to maintain client safety and the provision of quality care which take into account the competence of the supervisee, the client care needs, and other factors related to the practice environment.

g. Establishes ongoing communication processes with supervisees.

h. Monitors documentation by supervisees to confirmthatthisdocumentationisin accordance with regulatory requirements.

i. Regularly monitors and evaluates the delivery of services by supervisees.

j. Reassesses clients, monitors outcomes, documents, and reassigns service delivery, as determined by clients’ needs.

k. Does not assign the following activities to unregulated health-care providers in supervisee roles:

i. restricted activities authorized to physical therapists through the Health Professions Act;

ii. interpretation of referrals, diagnosis, or prognosis;

iii. interpretation of assessment findings,treatmentproceduresand treatment goals, and the planning, development,ormodificationof treatment plans;



Standard 7. Consent

Standard 17. Safety


Standard 18. Supervision Cont’d

iv. initial discussion of treatment rationale,clinicalfindings,and prognosis with clients;

v. those that are the responsibility of the physical therapist;

vi. discharge planning; or,vii. any task or procedure that requires

continuousclinicaljudgement(i.e., interventions that include an evaluative component that immediatelyinfluencestheclient’s treatment plan).

l. Reassigns the supervision of supervisees when the physical therapist is not available to supervise.

m. Advises clients and employers that delivery of physical therapy services by supervisees must be discontinued when the physical therapist is no longer involved in client care.



Standard 7. Consent

Standard 17. Safety



STANDARDThe physical therapist uses their title, credentials, and other designations to clearly identify themselves to clients, other health-care providers, and the public.

EXPECTED OUTCOMEClients can expect that the physical therapist uses their protectedtitletofacilitateclearidentificationduringphysical therapy service delivery.


a. Is registered with the College of Physical Therapists of British Columbia when using the protected title.

b. Identifiesthemselvesusingtheprotected title, as outlined by the Health Professions Act, Physical Therapists Regulation.

c. May not use the title “Doctor” or “Dr.” in the provision or communication of physical therapy services to the public.

d. May use their entry level physical therapy credential (e.g., MSc.PT) and may follow that credential with any other academic degree conferred by a recognized post- secondary institution in Canada or a degree that would be recognized as equivalent to a degree conferred in Canada.

e. May include communication of additional educational achievements in a clear and complete manner as to be understood by the public, without the use of abbreviations. For example: Fellow of the Canadian Academy of Manipulative Therapists,CertifiedHandTherapist.

LEGISLATIVE REFERENCEHealth Professions Act, RSBC 1996, c. 183. Available here. Physical Therapists Regulation, 288/2008.Available here.

RELATED STANDARDS OF PRACTICEStandard 12. Legislative Responsibilities

f. Uses clinical specialist designations in accordance with regulatory requirements.

g. Reports the unauthorized use of the protected title to the College of Physical Therapists of British Columbia.


http://www.bclaws.ca/EPLibraries/bclaws_new/document/ID/freeside/288_2008


LEGISLATIVE REFERENCEHealth Professions Act, RSBC 1996, c. 183. Available here. Physical Therapists Regulation, 288/2008.Available here.

RELATED STANDARDS OF PRACTICEStandard 12. Legislative Responsibilities

Glossary⁴

Adverse event refers 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.”

Client-centred approach refers to “an approach which recognizes the physical therapist’s expertise and values, respect for and partnership with the people receiving physical therapy care, including the client’s ability to make key choices in services delivered.”

Clients are recipients of physical therapy 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.

Collaborative practice refers to “the process of developingandmaintainingeffectiveinterprofessionalworking relationships with learners, practitioners, patients/families, and communities to enable optimal health outcomes. Elements of collaboration include respect, trust, shared decision-making, and partnerships.”

Competenceisthehabitualandjudicioususeofcommunication, knowledge, technical skills, clinical reasoning,emotions,values,andreflectionindailypracticeforthebenefitoftheindividualandcommunitybeing served. Competence depends on habits of mind, including attentiveness, critical curiosity, self-awareness, and presence. Professional competence is developmental, impermanent, and context-dependent.

Competency is the ability to perform a practice task with aspecifiedlevelofproficiency.

Complementary refers to the “use of two things when each adds something to the other or helps to make the other better: going together well: working well together.”

Comprehensive refers to “complete; including all or nearly all elements or aspects of something.”

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 relateddiseaseorinjury.”

Confidentiality “is the assurance that certain information thatmayincludeasubject’sidentity,health,behavior,or lifestyle information, or a Sponsor’s proprietary information would not be disclosed without permission fromthesubject(orsponsor).”

Conflicts of interest refer to situations that arise when the physical therapist has a relationship or interest that maybeseenasimproperlyinfluencingtheirprofessionaljudgementorabilitytoactinthebestinterestoftheclient.

Dry needling is a broad term that refers to a treatment techniquethatusessolidfilamentneedlestopuncturethe skin for therapeutic purposes. It includes a range of approaches, such as acupuncture, trigger point dry needling, intramuscular stimulation.

Electronic communication, social media refer to “software, applications (including those running on mobile devices), e-mail and websites, which enable users to interact, create and exchange information online.”

4 Original sources/references are available upon request.


http://www.bclaws.ca/EPLibraries/bclaws_new/document/ID/freeside/288_2008


Glossary While not strictly speaking, electronic communication or social media, the use of videography, or the taking and communication of photographs are included in this definitionrelatingtotechnology.

Evidence-informed practice is “derived from evidence-based practice” and involves “clinical problem solving and decision-making informed by integrating best available evidence, client context and the personal knowledge and experience of the physical therapist.”

Infection prevention and control refer to “measures practiced by healthcare personnel intended to prevent spread, transmission and acquisition of infectious agents or pathogens between patients, from healthcare workers to patients, and from patients to healthcare workers in the healthcare setting.”

Informed consent refers to “receiving client or their legally authorized representative’s permission to proceed with an agreed course of physical therapy 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.”

Interventions refer to physical therapy 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.”

Near miss refers to “a patient safety incident that did not reach the patient. Replaces close call.”

Personal information refers to “information about anidentifiableindividualthatisincludedinanyformincluding….information relating to the education or the medical, criminal or employment history of the individual orinformationrelatingtofinancialtransactionsinwhichthe individual has been involved…”

Personal protective equipment refers to the use of items such as gloves, gowns, and goggles to protect the physical therapist during client treatment.

Physical therapy services are “services provided by or under the direction of a physical therapist. This includes client assessment and intervention, and related communication with and reporting to various parties for the purposes of delivering patient care.”

Physical therapy service delivery refers to the period from the initial client assessment to discharge from services provided by the physical therapist.

Plain language refers to “communication your audience canunderstandthefirsttimetheyreadorhearit.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:

a. Find what they need;b. Understandwhattheyfind;andc. Usewhattheyfindtomeettheirneeds.”

Privacy refers to “a person’s desire to control the access of others to themselves. Privacy protects access to the person, whereasconfidentialityprotectsaccesstothedata.”

Professional boundaries set the limitations around relationships between clients and health-care providers to ensure the delivery of safe, ethical client-centred care. Professional boundaries are characterized by respectful, trusting, and ethical interactions with patients that are free of abuse, sexual and/or romantic encounters.


GlossaryProficiency 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” 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 combinedandcontinuouseffortsofallstakeholders—health care professionals, patients and their families, researchers,planners,andeducators—tomakebetterand sustained improvements.”

Regulated members refer to physical therapists registered with a provincial/territorial regulatory organization.

Risk management referstothe“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”.

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-careworkers,otherstaff,visitorsandcontractors.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.

Standardized measures refer to “measurement tools that aredesignedforaspecificpurposeinagivenpopulation.Information is provided regarding the administration, scoring, interpretation, and psychometric properties for each measure.”

Supervisees refer to students, assistants, and other support personnel.

Therapeutic relationship refers to the relationship that exists between a physical therapist and a patient 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 patient in any way.

Timely refers to “happening at the correct or most useful time: not happening too late.”