Open Forum

Hi!

I chair the Scope of Care and Task Allocation Committee for our outpatient organization. Our organization has been working on scope for about 5 years and continues to maintain and update a published task list. I want to thank all AAACN members who have shared their work in this arena, as it has been invaluable to standing up our processes and committee. For those of you who are unfamiliar with scope of care "wrangling" and to give background, the purpose of the scope of care and task allocation committee within my organization is to review tasks performed in the ambulatory setting, determine which clinical role can perform the task (RN, LPN, MA, Athletic Trainer, or Ophthalmic Technician), and update the Clinical Task List. Tasks and Scope decisions are guided by the Indiana Nurse Practice Act, Indiana Medical Practice Act, Lippincott, our Health Risk Retention Group, our entity's legal department when needed, and evidence-based practice literature. We use a set of evidence-based practice questions to vet each task and invite subject matter experts to present those tasks when necessary.  I think it is important to note that most of our outpatient practices are not under the Joint Commission (although we try our best to align with JC standards). This is a nurse-led initiative, with executive outpatient CNO sponsorship. When there is a practice change (i.e. the task should only be done by X and Y role, but not Z roles), we take this information back through another committee for recommendations on communication and thoughts, and then meet with the departments that change affects the most to understand how to collaboratively move that change forward (FTE, scheduling, staffing, etc.). As you can imagine, this is not easy work.

QUESTIONs: Do any of you have policies in place around scope/role and or the authority of the committee or decision makers to determine scope and role? 

How is your organization working to ensure licensed and unlicensed team members remain in scope in light of workforce shortages? 

Thank you so much! 

Our organization has a scope committee that consists of licensed clinical staff.  We review all requests related to clinical tasks for our non-licensed staff to ensure that the staff work at top of scope without exceeding.  It has worked very well for us.  

Hi!

I chair the Scope of Care and Task Allocation Committee for our outpatient organization. Our organization has been working on scope for about 5 years and continues to maintain and update a published task list. I want to thank all AAACN members who have shared their work in this arena, as it has been invaluable to standing up our processes and committee. For those of you who are unfamiliar with scope of care "wrangling" and to give background, the purpose of the scope of care and task allocation committee within my organization is to review tasks performed in the ambulatory setting, determine which clinical role can perform the task (RN, LPN, MA, Athletic Trainer, or Ophthalmic Technician), and update the Clinical Task List. Tasks and Scope decisions are guided by the Indiana Nurse Practice Act, Indiana Medical Practice Act, Lippincott, our Health Risk Retention Group, our entity's legal department when needed, and evidence-based practice literature. We use a set of evidence-based practice questions to vet each task and invite subject matter experts to present those tasks when necessary.  I think it is important to note that most of our outpatient practices are not under the Joint Commission (although we try our best to align with JC standards). This is a nurse-led initiative, with executive outpatient CNO sponsorship. When there is a practice change (i.e. the task should only be done by X and Y role, but not Z roles), we take this information back through another committee for recommendations on communication and thoughts, and then meet with the departments that change affects the most to understand how to collaboratively move that change forward (FTE, scheduling, staffing, etc.). As you can imagine, this is not easy work.

QUESTIONs: Do any of you have policies in place around scope/role and or the authority of the committee or decision makers to determine scope and role? 

How is your organization working to ensure licensed and unlicensed team members remain in scope in light of workforce shortages? 

Thank you so much! 

Hi!

I chair the Scope of Care and Task Allocation Committee for our outpatient organization. Our organization has been working on scope for about 5 years and continues to maintain and update a published task list. I want to thank all AAACN members who have shared their work in this arena, as it has been invaluable to standing up our processes and committee. For those of you who are unfamiliar with scope of care "wrangling" and to give background, the purpose of the scope of care and task allocation committee within my organization is to review tasks performed in the ambulatory setting, determine which clinical role can perform the task (RN, LPN, MA, Athletic Trainer, or Ophthalmic Technician), and update the Clinical Task List. Tasks and Scope decisions are guided by the Indiana Nurse Practice Act, Indiana Medical Practice Act, Lippincott, our Health Risk Retention Group, our entity's legal department when needed, and evidence-based practice literature. We use a set of evidence-based practice questions to vet each task and invite subject matter experts to present those tasks when necessary.  I think it is important to note that most of our outpatient practices are not under the Joint Commission (although we try our best to align with JC standards). This is a nurse-led initiative, with executive outpatient CNO sponsorship. When there is a practice change (i.e. the task should only be done by X and Y role, but not Z roles), we take this information back through another committee for recommendations on communication and thoughts, and then meet with the departments that change affects the most to understand how to collaboratively move that change forward (FTE, scheduling, staffing, etc.). As you can imagine, this is not easy work.

QUESTIONs: Do any of you have policies in place around scope/role and or the authority of the committee or decision makers to determine scope and role? 

How is your organization working to ensure licensed and unlicensed team members remain in scope in light of workforce shortages? 

Thank you so much! 

Hi Margaret,

Would you be willing to share your set of evidence-based practice questions to me?

I too chair our Scope Review Committee.  We have revised our process for reviewing questions, requests, and new skills.  Our Scope Committe has representation from our Clinical Education Team, EMR Education Team, Quality & Safety Team, Risk, Medical Director, Onboarding Team etc.

When associates are requesting a new skill to be performed, we ask them to complete an SBAR in PowerPoint form which they present to the committee.  The committee has time to ask clarifying questions and make a decision about the task.

Any updates or change in practice is sent through our Clinical Education Newsletter along with a Skills Matrix we keep on our SharePoint page.

You are correct in stating, "this is not easy work."

Please let me know if you have questions and I'd love to see your set of evidence-based questions.

Thank you!

Hi!

I chair the Scope of Care and Task Allocation Committee for our outpatient organization. Our organization has been working on scope for about 5 years and continues to maintain and update a published task list. I want to thank all AAACN members who have shared their work in this arena, as it has been invaluable to standing up our processes and committee. For those of you who are unfamiliar with scope of care "wrangling" and to give background, the purpose of the scope of care and task allocation committee within my organization is to review tasks performed in the ambulatory setting, determine which clinical role can perform the task (RN, LPN, MA, Athletic Trainer, or Ophthalmic Technician), and update the Clinical Task List. Tasks and Scope decisions are guided by the Indiana Nurse Practice Act, Indiana Medical Practice Act, Lippincott, our Health Risk Retention Group, our entity's legal department when needed, and evidence-based practice literature. We use a set of evidence-based practice questions to vet each task and invite subject matter experts to present those tasks when necessary.  I think it is important to note that most of our outpatient practices are not under the Joint Commission (although we try our best to align with JC standards). This is a nurse-led initiative, with executive outpatient CNO sponsorship. When there is a practice change (i.e. the task should only be done by X and Y role, but not Z roles), we take this information back through another committee for recommendations on communication and thoughts, and then meet with the departments that change affects the most to understand how to collaboratively move that change forward (FTE, scheduling, staffing, etc.). As you can imagine, this is not easy work.

QUESTIONs: Do any of you have policies in place around scope/role and or the authority of the committee or decision makers to determine scope and role? 

How is your organization working to ensure licensed and unlicensed team members remain in scope in light of workforce shortages? 

Thank you so much!