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MLT scope of practice - FAQ

Frequently asked questions

What is the scope of practice for a cytotechnologist?

Medical laboratory technologists (MLTs) all share a common scope of practice and are individually accountable both to the employer and to the CMLTO for their conduct and for ensuring that they have the knowledge, skill and judgment to practice safely. 

The MLT Scope of Practice is defined in The Medical Laboratory Technology Act, 1991, as follows: “The practice of medical laboratory technology is the performance of laboratory investigations on the human body or on specimens taken from the human body and the evaluation of technical sufficiency of the investigations and their results.”

Employers may provide an MLT with education and training to enable an MLT to practice in areas that fall outside the speciality(ies) included on the MLT certificate of registration. MLTs are accountable to their employer and the College for their conduct and professional practice. The employer is also accountable for an MLT practising outside the speciality(ies) listed on their certificate of registration.

If a new molecular technique is being introduced in a microbiology laboratory, can an MLT with microbiology on his/her registration perform the test?

An MLT may do this provided they have the necessary knowledge, skills, and judgement. 
Specific laboratory techniques, and as such, an individual MLT’s ability to perform them are independent from the speciality on their certificate of registration. Under the Medical Laboratory Technology Act, 1993, all MLTs have the same scope of practice. If an MLT has the knowledge, skills, and judgement to perform a new technique safely and competently, then there is nothing inhibiting them from doing so.  

However, facility policies and training need to be considered and supervision of the individual would be a facility-specific management/staff decision based on the individual MLT’s knowledge, skills, and judgement in the area they are working in.

As a patient process improvement initiative, my facility has asked if an MLT could take vital signs along with drawing blood from a patient.

An MLT may do this provided they have the necessary knowledge, skills, and judgement.
The legislative and regulatory framework in Ontario enables MLTs to learn and perform new tasks if certain conditions are first met. For tasks involving legislative authority (such as ordering laboratory tests) or authorized acts (such as communicating a diagnosis), medical directives and delegation need to be used. Please refer to the medical directives and delegation (link to appropriate page) section of the CMLTO website for further information.

For tasks that do not involve legislative authority and do not pose a risk of serious bodily harm, such as taking vital signs, an MLT must ensure they have and maintain the necessary knowledge, skills, and judgement to perform the task safely and comply with relevant facility policies prior to undertaking the task. 

What can or needs to be done to enable reflex testing in the laboratory?
While ordering laboratory tests is not an authorized act in Ontario, and hence does not require a formal delegation, it is a legislated authority restricted to certain regulated health professionals. Authority for ordering laboratory tests is described by the Laboratory and Specimen Collection Centre Licensing Act, 1990. For an MLT to perform reflex testing in the laboratory, which involves automatically performing specified additional tests in defined circumstances, a medical directive need to be developed following established institutional policies and protocols.

Please refer to the medical directives and delegation page for further information.

Can an MLT release results directly to a patient?

Communicating a diagnosis is an authorized act under the Regulated Health Professions Act, 1991 (RHPA). Releasing test results directly to a patient is a form of communicating a diagnosis, an act which is not authorized to MLTs. Under the RHPA, it is possible to delegate a controlled act. To delegate a controlled act, a whole series of activities need to be undertaken including, but not limited to:

a) Having a regulated health professional who does have access to the specific controlled act (as defined by their discipline specific act) agree to delegate this act, following their own Colleges guidelines and/or regulations related to delegation (if there are any), and most importantly to take responsibility for the delegation. 

b) Developing, usually through the local institutions (in the case of hospitals this is often done through the Medical Advisory Committee (MAC)),  specific policies related to delegations and medical directives. An excellent resource to understand this process better has been developed by the Federation of Health Regulatory Colleges of Ontario (FHRCO) and can be accessed at http://mdguide.regulatedhealthprofessions.on.ca/why/default.asp.

c) Having an individual (regulated or not) who accepts the delegation, and through the process of training, education and assessment develops and maintains the knowledge, skills and judgement to perform the specific procedure safely. In the case of a regulated health professional, this must be done in accordance with any regulations and guidelines developed by their regulatory body. 

The CMLTO supports the underlying precepts of the RHPA, including the ability to safely delegate the performance of a controlled act so that patients receive the most appropriate care, from the most appropriate health professional.   

Please refer to the medical directives and delegation page for further information. 

2014 Medical Laboratory Technologist Scope of Practice Survey
The CMLTO launched the survey to evaluate the current knowledge of the MLT Scope of Practice and to explore MLTs’ involvement in professional practice activities within and beyond their current Scope of Practice. The online survey, which was composed of seven questions, was launched in July 2014 and closed on August 1, 2014. The online survey link was sent to 800 randomly selected Practising MLTs. Approximately 35.4% of MLTS surveyed, or 283 members, responded. Read the 2014 Medical Laboratory Technologist Scope of Practice Survey - Report (PDF) for further details.

Self-regulation poster

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