The above links will take you to the Center for the Health Professions site.

Scopes of Practice for Health Care Professionals:
New Directions and Innovations

Background

The laws, regulations and policies that make up professional "scopes of practice" specify which health professions may offer which services in which settings. Established primarily to protect patients and consumers, these institutional boundaries can separate the professions and create barriers to access. The insular perspective of the current framework hinders flexibility and innovation in addressing health care needs and workforce shortages. The complex nature of scopes of practice calls for collaborative approaches to exploring possible avenues for change. These possibilities include looking to existing scopes of practice that are less restrictive, but have not compromised safety or quality of care.

Summary of Activities

In May 2007, the UCSF Center for the Health Professions began a year-long project, "Scopes of Practice for Health Care Professionals: New Directions and Innovations." To meet the objectives of the project, the Center will produce - and the California HealthCare Foundation will publish - a series of research briefs focused on legal and regulatory scope of practice issues for California's health care professions. First, we will describe promising scope of practice models in other states, countries, and institutions and explore the impacts of these models on access, quality and cost of care. Secondly, the Center will create a state-by-state comparison of nurse practitioner scopes of practice, which vary widely among states. The summary will include each state's regulations with regard to independent practice and prescriptive authority. Thirdly, the Center will investigate situations where scopes of practice laws are often challenged by practical realities. Finally, the Center will explore scope of practice opportunities in California, by describing potential demonstration projects designed to target areas for improvement. We will begin this piece by identifying professions that may be capable of providing higher levels of service than they are allowed to render under their current scopes of practice and review the options such professions might have to demonstrate their competence.

Publications

For publications related to this project, including “Chart Overview of Nurse Practitioner Scopes of Practice in the United States”, “Overview of Nurse Practitioner Scopes of Practice in the United States – Discussion” and “Promising Scope of Practice Models for the Health Professions”, please see the Center’s publications page at http://futurehealth.ucsf.edu/publications/index.html.

This grant is funded by the California HealthCare Foundation.

For more information, please contact Sharon Christian at schristian@thecenter.ucsf.edu.