Scope of Practice
We all want physiotherapists to work to the top of their scope of practice. It is important to the community, to the health system, to our profession and to physiotherapists themselves that they do this. It uses precious health resources to their best.
In choosing to work at the top of their scope, physiotherapists take time to reflect on their practice. They want to continue to work within their scope and to uphold the safety and quality of their profession. They review the roles, functions, responsibilities, activities and decisions that they are educated, competent and authorised to perform.
To help them in this reflection, members of the APA have asked for a dynamic and easy-to-access source of information on what scope of practice is, and how to conceptualise it. The information here is a tool to support them in that.
Scope of practice is underpinned by professional competence. Additionally, scope of practice is affected by safeguards in the work setting, and the law, including legislation and regulation. Using this approach allows us to state our position on concepts such as sharing and declaring our professional practice, and advancing and extending our scope of practice.
Scope of practice needs to be dynamic in order to facilitate opportunities physiotherapists have to work at the top of their scope. As a result, our model is not prescriptive.
Describing the frontiers of physiotherapy highlights the possibilities for students and early graduates of physiotherapy when they are envisioning the future of their practice. It highlights the possibilities for innovators in our profession and those who seek to use their wisdom to strengthen the profession for the benefit of all Australians. It provides each physiotherapist with a tool to safely practise at the top of their professional potential.
From time to time physiotherapists ask themselves and people in their work environment, 'Is this within my scope of practice?'
This ‘self-test’ is designed to help answer that question - to support us assess whether a component of our practice is within our individual scope of practice.
Making this assessment is best done by considering the answers to all the questions, rather than the answer to one question in isolation.
The questions aim to create a structure for the sorts of ‘internal dialogue’ we might have about scope. If, for example, we were thinking about gait analysis, we'd think,
- "Have I learned to do this? Yes. At Uni. After that, I've done gait analysis consistently and kept abreast of new ideas in the field.'
- "My professional colleagues say I'm competent. We arrive at very similar outcomes when we analyse the gait of patients in similar situations.'
- "I know that the area needs to be checked so that there are no hazards that might result in a fall, and not to do an analysis where there are.'
- "I know to inspect the equipment before I use it, and not to use equipment standing outside the workshop. We put faulty equipment there.'
- "I'm happy with the fact that this all puts some limits on where and when I can do gait analysis.'
- "I know the legal context. I know, for example, that this is not one of the practices that is specifically protected by the Health Practitioner Regulation National Law.'
Physiotherapy Board of Australia code of conduct for registered health practitioners http://www.physiotherapyboard.gov.au/Codes-Guidelines.aspx
Evaluation of performance quality of an advanced scope physiotherapy role in a hospital emergency department https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516347/
Trust in physicians and medical institutions: what is it, can it be measured, and does it matter? https://www.ncbi.nlm.nih.gov/pubmed/11789119
Human error: models and management https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1117770/
Reframing professional boundaries in healthcare: a systematic review of facilitators and barriers to task reallocation from the domain of medicine to the nursing domain. https://www.ncbi.nlm.nih.gov/pubmed/24857559
Dynamic professional boundaries in the healthcare workforce. https://www.ncbi.nlm.nih.gov/pubmed/16313522