Professional Predicaments

Part 2 of a 3-Part Series
Part 1 of this series pertains to signing requirements for documents when an SLP or audiologist unexpectedly leaves the workplace. It can be accessed here.

Answer:

In typical circumstances, consistent with ACSLPA’s Standards of Practice and Code of Ethics, as a regulated audiologist, you can only sign for work where you have been directly involved in the event or service. This includes documentation such as formal reports, assessments, letters, intervention summaries (including hearing aid prescriptions and recommendations), discharge reports, and clinical record entries (i.e., chart or progress notes). It is important to note that RHAPs are not regulated by ACSLPA and adhere to the College of Hearing Aid Practitioners of Alberta’s (CHAPA) Standards of Practice.

Audiologists may sign on behalf of another individual when associated with supervisory responsibilities. For example, audiologists may supervise RHAPs who hold conditional practice permits with CHAPA, or when providing training re: restricted activities (Standard of Practice 6.2). However, supervision is not intended as an ongoing administration measure to ‘tick the box’ related to authorization requirements of an organization (i.e., private insurer or funding body). Therefore, signing audiological assessments or reviews and hearing aid prescriptions on behalf of another professional when it is unrelated to a supervisory context, or the situations addressed in Part 1 of this series, would be inconsistent with professional and ethical standards.

An audiologist may evaluate their comfort level in co-signing with a RHAP in specific circumstances where prioritizing the client’s best interest might justify this process (Standard of Practice 1.3 (j)). For example, minimizing the impact of the unavailability of local audiology services and/or the need for clients to repeat an assessment. It would be reasonable in this type of situation, if the audiologist required that they meet the client (in person or virtually) to inform their clinical judgment/interpretation. The audiologist would then be involved in the client’s care. Where two or more people are involved in client care (of the same or different disciplines), individual parties can document and sign for the care they provided, for which they have professional accountability (Code of Ethics 4.). ACSLPA recommends specifically indicating which activities were completed by whom, along with the professional title.

Some questions to contemplate when considering co-signing are listed below.

• Have you been directly involved with the client/patient? (in person or virtually)
• Do you have all the relevant information to accurately and comprehensively inform your clinical impression or interpretation?
• How familiar are you with the work processes of the individual you will be co-signing with?
• What specific wording in the documentation would accurately clarify the individual responsible for each service, professional designation, and rationale for their involvement?
• What are the risks to the client/patient or you, as a regulated audiologist?

In terms of documenting this situation, please refer to Part 1 of this series.

Regulated members are reminded that they may contact the College if they have questions or need further clarification. Please do not hesitate to reach out at any time using the Contact Us form.