Acts and Regulations

2002-27 - General

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NEW BRUNSWICK
REGULATION 2002-27
under the
Regional Health Authorities Act
(O.C. 2002-133)
Filed March 28, 2002
Under section 72 of the Regional Health Authorities Act, the Lieutenant-Governor in Council makes the following Regulation:
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 bucco-dentaire et maxillo-facial traitant)
“board of directors” means the board of directors of a regional health authority; (conseil d’administration)
“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 and dental practitioners who are appointed by a board of directors to the medical staff of a regional health authority and given privileges;(personnel médical)
“mission statement” means a summary statement adopted by a board of directors which outlines the general goals and objectives of a regional health authority in relation to services rendered to patients, teaching, research and health promotion;(déclaration d’objectifs généraux)
“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 bucco-dentaire et maxillo-facial)
“patient” means a person who receives health services from a regional health authority; (patient)
“privileges” means permission granted by a board of directors to a medical practitioner to render medical care to a patient and to use the diagnostic services in one or more hospital facilities or community health centres or to an oral and maxillofacial surgeon to render medical care to a patient and to use the diagnostic services in one or more hospital facilities or to a dental practitioner to render dental care to a patient and to use the diagnostic services in one or more hospital facilities or community health centers.(privilèges)
2002-88; 2003-52; 2008-98
Eligibility to be member of board of directors
3The following persons are not eligible to be a member of a board of directors of a regional health authority:
(a) an employee of a regional health authority;
(b) a person who has privileges with a regional health authority;
(c) an employee in the Department of Health;
(d) a member of the Legislative Assembly of New Brunswick or of the House of Commons or the Senate.
2006, c.16, s.160
Terms of office of board members
4(1)Where a regional health authority is first established under this Act, the Minister shall appoint the members of the first board of directors as follows:
(a) eight members to serve until the annual meeting of the regional health authority in June, 2004,
(b) three members to serve until the annual meeting of the regional health authority in June, 2005, and
(c) four members to serve until the annual meeting of the regional health authority in June, 2006.
4(2)After the expiry of the appointments under subsection (1), the term of office of a member, whether elected or appointed, shall commence at the annual meeting of the regional health authority and expire at the annual meeting of that regional health authority held four years after the term commenced.
4(3)Where a religious order owns, in whole or in part, a hospital facility that is operated by a regional health authority, the Minister shall ensure that one of the persons appointed under paragraph (1)(b) or (c) is from names submitted by the religious order.
4(4)When making appointments to a board of directors of a regional health authority, the Minister shall ensure that the appointments do not result in more than eight members on the board who are from the largest urban centre of the health region for which that authority is responsible.
4(5)For the purposes of subsection (4), “largest urban centre” means
(a) with respect to Health Region 1, the area consisting of Moncton, Dieppe and Riverview,
(b) with respect to Health Region 2, the area consisting of Saint John, Rothesay and Quispamsis,
(c) with respect to Health Region 3, the area consisting of Fredericton and New Maryland,
(d) with respect to Health Region 4, the City of Edmundston,
(e) with respect to Health Region 5, the area consisting of Campbellton, Atholville and Tide Head,
(f) with respect to Health Region 6, the area consisting of Bathurst and Beresford, and
(g) with respect to Health Region 7, the City of Miramichi.
2004-32
Terms of office of board members
5(1)No person who is appointed to a board of directors shall serve more than eight consecutive years as a member of the board.
5(2)Repealed: 2004-32
5(3)A person who has served eight consecutive years on a board is not eligible to be appointed again as a member until one year after the person has ceased to serve as an appointed member.
5(4)For the purpose of this section, “eight consecutive years” means the period of years from the time of first appointment to the annual meeting of the regional health authority eight years later.
2004-32
Mission statement of board
6Before serving on a board of directors, a person shall accept in writing any mission statement approved by the board of directors and such person shall serve on the board in accordance with the spirit and intent of the mission statement.
Meetings of board of directors
7The board of directors shall meet a minimum of eight times per year.
Minutes of board meetings
8(1)A regional health authority shall ensure that the minutes of the meetings of the board of directors are made available in both official languages to members of the public.
8(2)Subsection (1) does not apply to minutes that derive from those portions of a meeting that are not open to members of the public.
Professional advisory committee
9(1)The board of directors 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.
Medical advisory committee
10(1)The board of directors shall appoint no more than fifteen members to the medical advisory committee.
10(2)The board of directors 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.
Privileges of medical staff
11(1)A medical practitioner, oral and maxillofacial surgeon or dental practitioner who wishes to be appointed to the medical staff of a regional health authority shall apply to the board of directors for appointment to the medical staff and for privileges.
11(2)A board of directors shall appoint one or more medical practitioners, oral and maxillofacial surgeons or dental practitioners to the medical staff and the appointments shall expire at the date of the next annual meeting of the board.
11(3)A board of directors shall annually delineate, reduce, renew or extend the privileges which it grants to each member of the medical staff, 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 and dental practitioners.
11(4)A board of directors may at any time withdraw or alter the privileges it grants to any member of the medical staff.
11(5)A board of directors may authorize the chief executive officer of the regional health authority to grant appropriate temporary privileges until the next regular meeting of the board of directors to a medical practitioner, oral and maxillofacial surgeon or dental practitioner who is not a member of the medical staff of the regional health authority.
11(6)The granting of temporary privileges to a medical practitioner, oral and maxillofacial surgeon or dental practitioner who is not a member of the medical staff shall be reviewed by the board of directors and the board may affirm, amend, modify or revoke any temporary privileges granted to the medical practitioner, oral and maxillofacial surgeon or dental practitioner.
11(7)A medical practitioner, oral and maxillofacial surgeon or dental practitioner, except in an emergency situation, may perform only those diagnostic and treatment procedures for which the medical practitioner, oral and maxillofacial surgeon or dental practitioner has been granted privileges.
11(8)Subject to this section, only a medical practitioner, oral and maxillofacial surgeon or dental practitioner who has been appointed by the board of directors to the medical staff of the regional health authority may attend a patient in the hospital facilities operated by the authority or use the facilities of the regional health authority for the care of a patient.
2003-52; 2008-98
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 of directors to the medical staff of a regional health authority, a medical practitioner, oral and maxillofacial surgeon or dental practitioner shall sign an acceptance of the regional health authority by-laws, policies, rules and regulations.
2003-52
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 program delivered by the regional health authority;
(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
Committees of medical staff
16The medical staff of a regional health authority shall establish the following committees for the purpose of advising the board of directors 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 of directors considers appropriate.
2002-82; 2003-52
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 governing professional body
18A board of directors shall advise the College of Physicians and Surgeons of New Brunswick or the New Brunswick Dental Society whenever a member of the medical staff
(a) has privileges withdrawn or significantly modified for incompetence, negligence or misconduct, or
(b) resigns when the member’s competence or conduct is under investigation by the board of directors.
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 or a nurse practitioner 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, the attending oral and maxillofacial surgeon, the dental practitioner or the nurse practitioner.
20(2)Notwithstanding subsection (1), a medical practitioner, oral and maxillofacial surgeon or nurse practitioner 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 or nurse practitioner 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)Where a medical practitioner, oral and maxillofacial surgeon or nurse practitioner has dictated an order for care by telephone under subsection (2), he or she shall sign the order on the first visit to the facility after dictating the order.
2002-54; 2003-52; 2008-98
Orders for care
21(1)Notwithstanding subsection 20(1), an attending medical practitioner, an attending oral and maxillofacial surgeon, a dental practitioner or a nurse practitioner 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 or a nurse practitioner 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, oral and maxillofacial surgeon, dental practitioner or nurse practitioner 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
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;
(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
Release of information
24For the purposes of section 65 of the Act, section 21 of New Brunswick Regulation 92-84 under the Hospital Act applies with the necessary modifications to the disclosure of information relating to, or the medical condition of, an individual.
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 of directors shall by resolution direct whether the equipment shall be replaced or written off and determine the manner of its disposal.
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 August 29, 2008.