RD Lab Test Ordering Authority Update

Posted: March 29, 2018

Posted 29 March, 2018

In 2008, the College and Dietitians of Canada made a submission to the Ministry of Health and Long-Term Care (Ministry) regarding a proposed change to the dietitian scope of practice to include the authority to request laboratory tests. This authority did not proceed at that time.

December 2017, New Information Submitted

In September 2017, the Ministry informed the College that as part of their Patients First: Action Plan for Health Care, they are reviewing scope of practice requests previously submitted, but not yet implemented, by regulated health professions. In early November 2017, the College met with the Ministry staff responsible for activities related to the proposed scope of practice changes for dietitians. The Ministry provided their new Model for the Evaluation of Scopes of Practice in Ontario (MESPO), a rigorous framework that guides their decision-making regarding scope of practice change requests. In applying its MESPO framework to the 2008 submission, the Ministry identified some areas that require further clarification.

On December 21, 2017, using the MESPO framework, the College submitted our response to the Ministry’s request for information regarding the proposed scope of practice expansion to permit Registered Dietitians to directly order laboratory tests in support of nutrition care assessment and monitoring. To view the submission, click here.

On February 14, 2018, at the Ministry’s request, College staff met with policy personnel responsible for reviewing our December 2017 submission. The Ministry requested us to submit further information to help support their analysis and to address foreseeable questions from cabinet.

Requested information included:

  • A 2018 lab test list to forecast the anticipated costs associated with this new authority.
  • Anticipated quality assurance activities the College would undertake to ensure continued safety and quality of care.
  • An approximate 10-year history of the entry level competencies that RDs have in place demonstrating competence for lab test ordering.
  • Further consultation with third party organizations (e.g. long-term care facilities, family health teams, diabetes education centres) and the public.
  • How the College foresees evaluating the outcome should this new lab test ordering authority for RDs proceed.

The College was informed that the Ministry’s request for an updated lab test list is for cost forecasting purposes. We will submit a revised lab test list based on the extensive feedback received in our Nov-Dec 2017 member consultation survey. It is still our hope that this authority proceeds for RDs without a defined list of lab tests outlined in regulation. We reiterated our rationale as outlined in the Dec 2017 submission to the Ministry’s policy staff at the Feb 14, 2018 meeting.

College staff are currently compiling the Ministry’s requested information. Our goal is to submit this in early March 2018.

Ministry staff were unable to provide specific timelines as to when/if this authority would be implemented. We will continue to keep our members and other stakeholders informed of any further developments as new updates becomes available.