Practice visits

What is a practice visit?

A practice visit is a requirement of the Health Professions Act (HPA) and Chiropractor Profession Regulations that the CCOA accomplishes through the self-submission practice review process. 

All facilities and members of the chiropractic profession must meet the necessary requirements as set out by the CCOA and all practices and procedures must be consistent with the requirements of the HPA and CCOA Standards of Practice, Code of Ethics, Bylaws and Administrative Policies.


How and when to complete your self-submission

You will receive a notice reminder by email indicating when your practice review is due and which self-submission package you need to use. Download the appropriate package from the Resources section and complete as indicated.

At a minimum, your practice visit (self-submission practice review) will occur every three to five years. Regulated members who have been with the CCOA one year or less must complete their self-submission before the end of their first year of registration. Note: The email notice is a courtesy reminder; self-submission deadlines are always listed under the Practice Review tab in your Member Profile on www.theccoa.ca (Member login required).

If you will be required to complete a practice visit other than the type identified above, you will be provided written notice from the CCOA and the necessary documents. For example, remedial reviews typically occur within one year after the completion of the last review.


What are the contents of a self-submission?

You will need to provide the following information in your self-submission:

  1. Member information and Clinic Overview
  2. Declaration
  3. Clinic layout
  4. Clinic photographs
  5. Diagnostic equipment
  6. Clinic stationary
  7. Accounting & Billing
  8. Financial documents
  9. Treatment record abbreviations
  10. Patient files (record-keeping competency)
    • The primary focus of the review is your record-keeping. The Competency Committee, via a Clinical Advisor, will offer the most feedback on this section of your self-submission.
    • While you are gathering your patient files, use  the CCOA Record-Keeping Requirements Guide (found in the Resources section below) as a reference. The guide specifies exactly what the clinical advisor is looking for when reviewing your records.


How the CCOA Record-keeping Requirements Guide helps you meet practice standards

The CCOA Record-keeping Requirements Guide identifies what the minimally acceptable levels of performance are required of regulated members. It also specifies how the Competence Committee reviews your submission and provides areas of improvement based on their feedback in your results letter. Refer to the guide before and after your practice review and to help you meet record-keeping standards on a daily basis.

How to apply the guide in your practice

  1. Read the guide.
  2. Compare your clinical practice and decision-making against the direction in the guide.
  3. Scrutinize your clinical records against the guide.
  4. Make any changes necessary to address deficiencies that are observed.

What types of practice visits does the CCOA conduct?


Practice Visit

Standard practice visits are conducted primarily through a self-submission practice review process. The self-submission practice review process was developed by the CCOA to ensure minimum standards of practice and support quality assurance in our profession. The primary focus of this review is professional quality record-keeping.


Remedial Practice Visit

If regulated members are unsuccessful in their standard practice visit, a remedial practice visit will be carried out as soon as reasonably possible at the request of the Competence Committee or as the result of a discipline order. Supplemental practice visits are conducted primarily through a self-submission practice review process.


Second Practice visit (follows all remedial practice visits)

If a regulated member successfully completes their remedial practice visit, then a second practice visit is conducted primarily through a self-submission process. Second practice visits are conducted primarily through a self-submission practice review process.


Remedial Practice Visit with Coaching

If a regulated member fails a remedial practice visit, they will have a second remedial practice review, with the addition of direct communication with the Competence Committee and any delegate of that committee. The regulated member will also be responsible to submit a self-submission practice review and the regulated member will be required to submit a self‑assessment of their record-keeping practices and their steps to correct deficiencies in their practice.


On-Site Practice Visit

An unsuccessful remedial practice visit with coaching will result in an on-site practice visit. The regulated member will be required to submit a self-assessment of their record keeping practices and their steps to correct deficiencies. This self-assessment will be discussed and audited at the onsite practice visit.  The on-site peer practice visit will consist of a member of the Competence Committee, or someone appointed by them to attend in person the clinic of the regulated member. The peer reviewer will observe the clinic, interview staff, and audit the self-assessment submitted.


Alternate assessment of the Requirement for Practice Review

Regulated CCOA members who are solely practicing in another regulated jurisdiction must provide the CCOA their most recent practice visit results from their other regulated jurisdiction. Regulated members who practice primarily in other jurisdictions are required to provide other CCOA? self-submissions or documentation as determined by the Competence Committee or Registrar.


Practice Review results reporting

Practice review results are reported to the regulated member and the Registrar by the Competence Committee within 90 days. That date is noted in the member's profile under the Competence tab as the completed date.

The Competence Committee reporting includes:

  • The practice visit outcomes (see table below).
  • Any follow-up competence activity required by the regulated member.
  • If information obtained from the practice visit has been referred to the Complaints Director.

The Competence Committee may:

  • Ask a regulated member to complete specific continuing competence requirements within a specified time; or
  • Ask a regulated member to complete any examinations, testing, assessment, education or counselling considered by the Competence Committee to be advisable; or
  • Ask a regulated member to practice under the supervision of another general member; or prohibit a regulated member from supervising other regulated members or students providing professional services. 

What should you do once you receive your results?

The results letter serves two purposes:

  1. To provide the required reporting to you of what was observed relative to the Standards of Practice as interpreted by the CCOA Record-Keeping Requirements Guide.
  2. Recommendations made by the Clinical Advisor in the comments section that you need to use to improve your record-keeping combined with using the guide to make changes in your practice.

How to understand your results

Satisfactory results

Reported

Interpretation

Action required by the Regulated Member

Met Requirements

The practice visit results letter demonstrated appropriate record keeping, clinical decision-making in applying the Standards of Practice.

Seek out self-directed professional development that continues to lead to mastery in clinical practice and record-keeping.

Met Requirements with Comments

The practice visit results letter demonstrated appropriate record-keeping and clinical decision-making in applying the Standards of Practice.

The Competence Committee identified practices that require attention to continue to progress in your clinical competency.

Evaluate the comments and adapt your record keeping and clinical practice based on the comments provided.

Met Requirements with Concerns

The practice visit results letter identified that you barely met the minimal standard of practice. There are concerns in your practice identified by the Competence Committee that should be addressed in your record-keeping or clinical decision-making in applying Standards of Practice.

Evaluate your clinical records and incorporate the changes recommended by the Competency Committee.

Seek out self-directed professional development that builds clinical decision making relative to the Standards of Practice in practice areas of concern identified by the Competence Committee.

Unsatisfactory results

Reported

Interpretation

Action required by the Regulated Member

Did Not Meet Requirements

The practice visit results letter identified practice activity that the Competency Committee has determined does not meet requirements for record-keeping or clinical decision-making in applying the Standards of Practice.

Immediate change in the deficiencies identified by the Competence Committee must be made.

After you read your results letter, you should determine the changes that are needed, including, but not limited to the following actions:

Change your record-keeping by incorporating the changes recommended by the Clinical Advisor.

Evaluate your competency relative to activities identified in the results letter to determine which continuing competence courses you need to meet the Standards.

 

Resources and documents