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Why has this guide been developed?


This guide has been developed to address questions regarding the use of orders and delegation to facilitate interprofessional care by health professionals practicing in any setting across the province. It has been developed as a consensus document by HPRO and is designed to complement and assist with fulfilling guidelines, standards and regulations developed by each health profession college. For specifics and questions pertaining to each profession, refer to the respective college.


The guide is based on a framework of the fundamental cornerstones of health professional practice: patient interest and public protection achieved by regulated health professionals practicing independently and in teams in accordance with regulatory and legislative expectations for practice. The framework is illustrated as follows:




For the purposes of this guide:


  • Delegation refers to the delegation of controlled acts in accordance with the provisions in the Regulated Health Professions Act (RHPA).
  • Procedure is a broad term that refers to procedures, treatments, interventions and professional services provided by regulated health professionals.
  • Regulated health professionals include health professions governed by health regulatory colleges under the RHPA as well as social workers and social service workers practicing in the health care sector who are governed by the Ontario College of Social Workers and Social Service Workers under the Social Work and Social Service Work Act.

The guide has been designed to enable readers to choose where to focus.


  • Guidelines set out definitions, principles and processes when working with orders, directives and delegation, including algorithms and flow diagrams to facilitate practice.
  • The Templates are optional user ready tools to assist with establishing a directive, delegation or practices that are beyond principal expectations. They may be used independently with the guidelines available for backup.
  • The Frequently Asked Questions section provides a quick reference on common questions.

Directives and delegation can address evolving health care needs by extending authority to perform procedures within existing legislative frameworks. However, they are not always a viable solution for addressing evolving needs in part due to the administrative load incurred when using them. Therefore, as health care professionals evolve in their competence to perform procedures that address evolving needs, consideration must also be given to updating their legislative authority.







This guide is a consensus document developed by the Health Profession Regulators of Ontario. The Federation comprises the 26 health regulatory colleges that regulate health professionals in Ontario. Other stakeholders involved in the development of the guide included the Ontario College of Social Workers and Social Service Workers and the Ontario Hospital Association. For questions, contact the relevant college.


Health Profession Regulators of Ontario (HPRO)

301-396 Osborne St, PO Box 244, Beaverton ON  L0K 1A0 | Ph: 416-986-0576


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