Self-submission practice review

You will receive a notice reminder by email indicating when your practice review is due at least a month in advance of the deadline; deadlines are also listed under the Practice Review tab in your Member Profile (accessible by signing into www.theccoa.ca). You will be provided access to a submission portal that has the instructions on how to complete your review documents as well as how to upload them to the portal.

At a minimum, your practice visit (self-submission practice review) will occur every three to five years. Regulated chiropractors who have been with CCOA one year or less must complete their self-submission before the end of their first year of registration. If you are required to complete another type of practice visit, you will be provided written notice from CCOA and the necessary documents.

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)
1. 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.
2. 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.

The CCOA Record-keeping Requirements Guide identifies what the minimally acceptable levels of performance are required of regulated chiropractors. It also specifies how the Competence Committee reviews your submission and identifies areas of improvement which are provided in your results letter. It is recommended that you use the guide before and after your practice review. It is also a great reference tool for achieving 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.

Standard Practice Visit
Standard practice visits are conducted primarily through a self-submission practice review process. The self-submission process was developed by 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 chiropractors 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 process.

Second Practice Visit (follows all remedial practice visits)
If a regulated chiropractor 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 process.

Remedial Practice Visit with Coaching
If a regulated chiropractor 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 chiropractor must submit a remedial practice review with 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 chiropractor 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 chiropractor. 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 chiropractors who are solely practicing in another regulated jurisdiction(s) must provide CCOA their most recent peer assessment results from their other regulated jurisdiction(s). 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.

• The self-submission practice review outcomes (see table below).
• Any follow-up competence activity required by the regulated chiropractor.
• If information obtained from the practice visit has been referred to the Complaints Director.
• Direct a regulated chiropractor to complete specific continuing competence requirements within a specified time; or
• Direct a regulated chiropractor to complete any examinations, testing, assessment, education or counselling considered by the Competence Committee to be advisable; or
• Direct a regulated chiropractor to practice under the supervision of another regulated chiropractor; or prohibit a regulated chiropractor from supervising other regulated chiropractors or students providing professional services.

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

• CCOA Record-Keeping Requirements Guide
• Successful Charting (a series of articles):
  • Writing the Working Diagnosis   
  • SOAP Notes
  • The Written Treatment Plan
  • The Physical Exam
• CCOA Record-keeping Course