Acts and Regulations

2002-27 - General

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Full text
Current to 1 January 2024
NEW BRUNSWICK
REGULATION 2002-27
under the
Regional Health Authorities Act
(O.C. 2002-133)
Filed March 28, 2002
Under section 71 of the Regional Health Authorities Act, the Lieutenant-Governor in Council makes the following Regulation:
2012-6
Citation
1This Regulation may be cited as the General Regulation - Regional Health Authorities Act.
Definitions
2In this Regulation
“Act” means the Regional Health Authorities Act;(Loi)
“attending medical practitioner” means a member of the medical staff who has principal responsibility for the medical care of a patient;(médecin traitant)
“attending oral and maxillofacial surgeon” means a member of the medical staff who has principal responsibility for the medical care of a patient;(chirurgien buccal et maxillo-facial traitant)
“board of directors” Repealed: 2012-96
“chief executive officer” means the chief executive officer of a regional health authority;(directeur général)
“clinical record” means a written, electronic or printed record maintained by a regional health authority of the services rendered to a patient;(dossier clinique)
“dental practitioner” means a person lawfully entitled to practise dentistry in the Province, and includes a dental officer of the Canadian Forces serving in the Province;(dentiste)
“fiscal year” means the fiscal year of the regional health authority;(année financière)
“medical practitioner” means a person lawfully entitled to practise medicine in the Province, and includes a medical officer of the Canadian Forces serving in the Province;(médecin)
“medical staff” means medical practitioners, oral and maxillofacial surgeons, dental practitioners, nurse practitioners and midwives who are appointed by a board to the medical staff of a regional health authority and given privileges;(personnel médical)
“midwife” means a midwife as defined in the Midwifery Act;(sage-femme)
“mission statement” Repealed: 2012-6
“oral and maxillofacial surgeon” means a dental practitioner whose name is entered in the specialists register and who is the holder of a specialist’s licence in oral and maxillofacial surgery issued pursuant to the New Brunswick Dental Act, 1985, and includes a dental officer of the Canadian Forces serving in the Province, who specializes in oral and maxillofacial surgery;(chirurgien buccal et maxillo-facial)
“patient” Repealed: 2016-26
“privileges” means permission granted by a board to(privilèges)
(a) a medical practitioner to render medical care to a patient and to use the diagnostic services in a hospital facility or community health centre,
(b) an oral and maxillofacial surgeon to render medical care to a patient and to use the diagnostic services in a hospital facility,
(c) a dental practitioner to render dental care to a patient and to use the diagnostic services in a hospital facility or community health centre,
(c.1) a nurse practitioner to admit a patient to the extra-mural service delivered by a regional health authority or by a person under an agreement with the Minister and to use the diagnostic services in a hospital facility or community health centre, or
(d) a midwife to render health care to a patient and to use the diagnostic services in a hospital facility or community health centre.
2002-88; 2003-52; 2008-98; 2012-6; 2012-96; 2016-26; 2017-10; 2017, c.45, s.9; 2019, c.12, s.33; 2022, c.43, s.2
Extra-mural services
2017, c.45, s.9
2.1(1)The following services are prescribed for the purposes of paragraph (a) of the definition “extra-mural services” in section 1 of the Act:
(a) occupational therapy services for children in schools, daycares and outpatient settings;
(b) physiotherapy services for children in schools, daycares and outpatient settings;
(c) services for medical assistance in dying;
(d) medical services; and
(e) specialized therapeutic and nursing services.
2.1(2)The following services are prescribed for the purposes of paragraph (b) of the definition “extra-mural services” in section 1 of the Act:
(a) nursing services;
(b) occupational therapy services;
(c) physiotherapy services;
(d) clinical nutrition services;
(e) respiratory therapy services;
(f) social work services;
(g) speech-language pathology services for persons with a health care need requiring provision of the services in their home setting; and
(h) mobile diagnostic imaging services.
2017, c.45, s.9; 2023-32
Eligibility to be member of board of directors
Repealed: 2012-6
2012-6
3Repealed: 2012-6
2006, c.16, s.160; 2012-6
Appointment to board
Repealed: 2012-6
2009-81; 2012-6
4Repealed: 2012-6
2004-32; 2009-81; 2012-6
Repealed
5Repealed: 2009-81
2004-32; 2009-81
Mission statement of board
Repealed: 2012-6
2012-6
6Repealed: 2012-6
2012-6
Meetings of board of directors
Repealed: 2012-6
2012-6
7Repealed: 2012-6
2012-6
Minutes of board meetings
Repealed: 2012-6
2012-6
8Repealed: 2012-6
2012-6
Professional advisory committee
9(1)The board shall appoint the chairperson of the professional advisory committee.
9(2)Before appointing the chairperson of the professional advisory committee, the board shall obtain the recommendation of the committee and the chief executive officer.
9(3)The chief executive officer, or a designate of the chief executive officer, shall attend every meeting of the professional advisory committee, and may participate in, but not vote at, the meeting.
9(4)The professional advisory committee may establish sub-committees to assist it in its duties.
2012-96
Medical advisory committee
10(1)The board shall appoint no more than fifteen members to the medical advisory committee.
10(2)The board shall appoint the chairperson of the medical advisory committee.
10(3)Before appointing the chairperson of the medical advisory committee, the board shall obtain the recommendation of the committee and the chief executive officer.
10(4)The chief executive officer, or a designate of the chief executive officer, shall attend every meeting of the medical advisory committee, and may participate in, but not vote at, the meeting.
10(5)The medical advisory committee may establish sub-committees to assist it in its duties.
2012-96
Privileges of medical staff
11(1)A medical practitioner, an oral and maxillofacial surgeon, a dental practitioner, a nurse practitioner or a midwife who wishes to be appointed to the medical staff of a regional health authority shall apply to the board for appointment and for privileges in accordance with the by-laws of the board.
11(2)A board shall appoint one or more medical practitioners, oral and maxillofacial surgeons, dental practitioners, nurse practitioners or midwives to the medical staff in accordance with its by-laws.
11(2.1)An appointment under subsection (2) shall expire on the date of the second annual meeting of the board that follows the appointment or within such specified period as the board considers appropriate.
11(3)A board shall delineate, reduce, renew or extend the privileges that it grants to each member of the medical staff at least every two years, taking into consideration the needs and facilities of the regional health authority and the training and abilities of the medical practitioners, oral and maxillofacial surgeons, dental practitioners, nurse practitioners and midwives.
11(4)A board may at any time withdraw or alter the privileges it grants to any member of the medical staff in accordance with its by-laws.
11(5)A board may authorize the chief executive officer to grant appropriate temporary privileges until the next regular meeting of the board to a medical practitioner, an oral and maxillofacial surgeon, a dental practitioner, a nurse practitioner or a midwife who is not a member of the medical staff of the regional health authority in accordance with its by-laws.
11(6)The granting of temporary privileges under subsection (5) shall be reviewed by the board and the board may affirm, amend or revoke the temporary privileges.
11(7)Except in an emergency situation, a medical practitioner, an oral and maxillofacial surgeon, a dental practitioner, a nurse practitioner or a midwife may perform only those diagnostic and treatment procedures for which he or she has been granted privileges.
11(8)Subject to this section, only a member of the medical staff of a regional health authority may attend a patient in the hospital facilities operated by the regional health authority or use the facilities of the regional health authority for the care of a patient.
2003-52; 2008-98; 2012-96; 2016-26; 2017-10; 2019, c.12, s.33
11.1Notwithstanding subsection 11(8), a nurse or nurse practitioner employed by a regional health authority may attend a patient in an emergency room of a hospital facility operated by the regional health authority and may use the facilities of the regional health authority for the care of the patient.
2002-54; 2008-98
Condition of appointment to medical staff
12Before appointment by a board to the medical staff of a regional health authority, a medical practitioner, an oral and maxillofacial surgeon, a dental practitioner, a nurse practitioner or a midwife shall sign an acceptance of the regional health authority by-laws, policies, rules and regulations.
2003-52; 2012-96; 2016-26; 2017-10; 2019, c.12, s.33
Meetings of medical staff
13(1)The medical staff shall at each annual meeting of the medical staff,
(a) elect a president, vice-president and secretary from among themselves, and
(b) fix a time and place for
(i) the next annual meeting, and
(ii) the meetings of the medical staff to be held for the following year.
13(2)The president, vice-president and secretary of the medical staff shall hold office until the next annual meeting.
Meetings of medical staff
14(1)The medical staff of a regional health authority shall hold an annual meeting in each fiscal year and shall hold a full medical staff meeting at least quarterly.
14(2)Clinical departments of the medical staff shall meet at least eight times a year.
Meetings of medical staff
15The following matters shall be the basis of discussion at the medical staff meetings:
(a) a review of the medical and dental work in the various facilities operated by the regional health authority;
(b) a review of the medical and dental work in the extra-mural service delivered by the regional health authority or by a person under an agreement with the Minister;
(c) a review and analysis of the clinical experience of the medical staff in the various departments of each facility, with the clinical records of patients forming the basis of review and analysis;
(d) a review and analysis of cases ending fatally or unimproved;
(e) a review and analysis of any infections or complications that have occurred in each facility; and
(f) recommendations for improving the welfare of the patients and professional standards within each facility.
2003-52; 2008-98; 2017, c.45, s.9; 2022, c.43, s.2
Committees of medical staff
16The medical staff of a regional health authority shall establish the following committees for the purpose of advising the board on the maintenance of standards of medical services and dental services by the regional health authority:
(a) Repealed: 2002-82
(b) a clinical audit committee;
(c) a credentials committee; and
(d) any other committee the board considers appropriate.
2002-82; 2003-52; 2012-96
Transfer of care of patient
2008-98
17(1)Where a member of the medical staff is unable to care for a patient, the member shall arrange for another member of the medical staff having appropriate privileges to accept responsibility for the care of the patient and shall ensure that the transfer of responsibility is noted on the clinical record of the patient.
17(2)Where a chief executive officer has reason to believe that a member of the medical staff is unable to care for a patient and that the member is unable to or will refuse to transfer responsibility for the care of the patient to another member of the medical staff, the chief executive officer shall transfer responsibility for the care of the patient to another member of the medical staff.
2008-98
Duty to notify
18A board shall advise the College of Physicians and Surgeons of New Brunswick, the New Brunswick Dental Society, the Nurses Association of New Brunswick or the Midwifery Council of New Brunswick, as the case may be, and the board of the other regional health authority if
(a) the board withdraws or significantly modifies the privileges of a member of the medical staff for incompetence, negligence or misconduct, or
(b) a member of the medical staff resigns when the member’s competence or conduct is under investigation by the board.
2012-96; 2016-26; 2017-10
Duty to notify of danger
19Where a member of the medical staff refers any person to a regional health authority for admission knowing or suspecting that the person is or may become for any reason dangerous to himself or herself or to others, the member shall notify the chief executive officer or the senior administrative officer of the appropriate facility.
Orders for care
20(1)An attending medical practitioner, an attending oral and maxillofacial surgeon, a dental practitioner, a nurse practitioner or a midwife shall ensure that each order for care for a patient is
(a) in writing and attached to the clinical record of the patient in the section designated for those orders, and
(b) dated and signed by the attending medical practitioner, attending oral and maxillofacial surgeon, dental practitioner, nurse practitioner or midwife.
20(2)Notwithstanding subsection (1), a medical practitioner, an oral and maxillofacial surgeon, a nurse practitioner or a midwife may dictate orders for care by telephone to a person designated by the chief executive officer to take the orders.
20(3)A person to whom an order for care has been dictated by telephone shall transcribe the order, sign it and endorse on it the name of the medical practitioner, oral and maxillofacial surgeon, nurse practitioner or midwife who dictated the order as well as the date and time of receiving the order and attach it to the clinical record in the section designated for those orders.
20(4)A medical practitioner, an oral and maxillofacial surgeon, a nurse practitioner or a midwife who dictates an order for care under subsection (2) shall sign the order on the first visit to the facility after dictating the order.
2002-54; 2003-52; 2008-98; 2016-26; 2019, c.12, s.33
Orders for care
21(1)Notwithstanding subsection 20(1), an attending medical practitioner, an attending oral and maxillofacial surgeon, a dental practitioner, a nurse practitioner or a midwife may make an order for care on a computer system approved by the Minister if the system produces an order for care that is printed, dated and, subject to subsection (3), signed.
21(2)An attending medical practitioner, an attending oral and maxillofacial surgeon, a dental practitioner, a nurse practitioner or a midwife shall ensure that the printed order for care is attached to the clinical record of the patient in the section designated for such orders.
21(3)An order for care on an approved computer system shall be deemed to be signed by a medical practitioner, an oral and maxillofacial surgeon, a dental practitioner, a nurse practitioner or a midwife when he or she has entered the computer equivalent of his or her signature in the manner approved by the regional health authority.
21(4)Subsections 20(2), (3) and (4) apply with the necessary modifications to an order for care made on an approved computer system.
2002-54; 2003-52; 2008-98; 2016-26; 2019, c.12, s.33
Investigation into care of patient
2003-52; 2008-98
22The Minister may require a regional health authority
(a) to conduct an investigation into any complaint respecting the care of a patient, and
(b) to report its findings to the Minister.
2003-52; 2008-98
Patient records
2008-98
23(1)A regional health authority shall compile a clinical record for a patient that includes the following:
(a) patient identification on each document, whether electronic or otherwise, that forms part of the record;
(b) history of present and previous illnesses;
(c) results of physical examination;
(d) reports of
(i) consultations,
(ii) diagnostic tests, and
(iii) therapy provided;
(e) vital signs;
(f) medication sheets and protocols;
(f.1) health care directives;
(g) nurses’ notes and notes of all professionals involved in the care of the patient;
(h) final diagnosis;
(i) post mortem examination, if any;
(j) any other information required by the Minister.
23(2)Subsection (1) does not apply to a patient whose records are compiled pursuant to section 20 of New Brunswick Regulation 92-84 under the Hospital Act.
23(3)Section 22, section 23, other than paragraph 23(1)(a), and section 24 of New Brunswick Regulation 92-84 under the Hospital Act apply with the necessary modifications to records referred to in subsection (1).
2002-88; 2003-52; 2008-98; 2016, c.46, s.24
Release of information
Repealed: 2017, c.29, s.10
2017, c.29, s.10
24Repealed: 2017, c.29, s.10
2012-6; 2017, c.29, s.10
Equipment
25(1)Every regional health authority shall appoint a committee to inspect any item of equipment that may have become worn out, obsolete or unserviceable and to recommend whether it should be replaced or written off.
25(2)Upon receipt of the committee’s recommendation, the board shall by resolution direct whether the equipment shall be replaced or written off and determine the manner of its disposal.
2012-96
Equipment
26Every regional health authority shall maintain as part of its records a current inventory of all items of equipment.
Community health centres
2002-88
27Sections 20, 21, 23 and 24 do not apply in respect of community health centres.
2002-88
N.B. This Regulation is consolidated to May 18, 2023.