College of Chiropractors of Ontario

Home>News>Quality Assurance Update to Standards of Practice and Guidelines – June 2018

Please see the links below to access the updated documents.

Approved on April 24, 2018, Came into Effect June 20, 2018

Minor Amendments to Standard of Practice S-001: Chiropractic Scope of Practice

CCO Council approved minor amendments to incorporate material from Guideline G-004: Documentation of a Chiropractic Visit relating to the expectations of a chiropractic visit. Although this content is not new, it is important that the public have an understanding of what to expect from a chiropractic visit.

Minor Amendments to Standard of Practice S-002: Record Keeping

CCO Council approved minor amendments to incorporate material from Guideline G-004: Documentation of a Chiropractic Visit relating to the expectations that patient health records should “tell the story” and be unique to a particular patient experience, and avoid “template-like” records, particularly in electronic record keeping.

Amendments also include minor clerical changes, expanded expectations relating to chiropractic assessments, and a requirement that the record include information about who provided care and location of where care was delivered.

Revocation of Guideline G-004: Documentation of a Chiropractic Visit

CCO Council revoked Guideline G-004: Documentation of a Chiropractic Visit and incorporated its content into Standard of Practice S-001: Chiropractic Scope of Practice and S-001: Record Keeping to reduce redundancies in CCO policy.

New Guideline G-013: Chiropractic Assessments

The objective of this guideline is to further clarify the role, importance and reasons for different types of assessments as part of the chiropractic plan of care. Assessments and re-assessments are a critical component in evaluating a patient’s condition, assessing the effectiveness of chiropractic care, influencing clinical decision-making, discussing the patient’s goals and expectations, and affirming or revising care or a plan of care.

Current CCO standards of practice require a re-assessment to be conducted when clinically necessary, and in any event, no later than each 24th visit. However, this guideline expands the expectations involved in different types of assessments, including:

initial assessment
subsequent visits
comparative assessments
new condition/goal assessments
updated condition/goal assessment
discharge assessment (where applicable)

New Guideline G-014: Delegation, Assignment and Referral of Care

The objective of this guideline is to:

clarify that a chiropractor is not permitted to delegate a controlled act;
outline policies and procedures for the assigning of certain clinical procedures that are in the public domain to a properly trained clinical staff person; and
outline policies and procedures in the referral of care to another health care provider.

This guideline proposes to further clarify which professional activities may or may not be assigned to a staff person and the policies and procedures around assignment and referral of care. This includes requirements relating to: communication with patients, provision of clinical services, business practices, and record keeping.

Legislation and Ethics Examination and Regulatory Excellence for CCO Members Workshop

CCO has scheduled an online sitting of the Legislation and Ethics Examination for June 1, 2023. The deadline to apply for this examination is May 15, 2023. Due to the online delivery of the examination, candidates should make themselves available for the entire day. Please complete the application form and submit it to Ms Madeline Cheng, Registration Coordinator to apply for the examination. Please contact Ms Madeline Cheng at mcheng@cco.on.ca or 416-922-6355 ext. 113 for any questions.

More information about the legislation and ethics examination, including study material, can be found at the following link. Information about the June 1, 2023 sitting of the examination can be found at the following link.

Information about the online delivery of the examination can be found in the following document and video.

CCO will be holding a virtual workshop on Regulatory Excellence for CCO Members (formerly titled the Record Keeping Workshop) on June 2, 2023, 8:30 am – 1:00 pm. Please email Rose Bustria at rbustria@cco.on.ca if you are interested in attending this virtually.