1. INTRODUCTIONThis Code of Conduct establishes the standard of conduct which the State of Qatar expects from all healthcare professionals.
The Code encapsulates both the professional and ethical standards required, both of which are key elements to ensuring a safe and efficient healthcare delivery. The Code applies to the following healthcare professionals:A. PhysiciansB. Dentist C.
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PharmacistsD. NursesE. Allied Healthcare professionalsF.
Complementary Medicine G. Administrative StaffThe Code includes generally applicable principles as we all category specific principles. Qatar Council for Healthcare Professionals – According to the Emiri decree No.7 was declared in March 2013, which provided for the establishment of the Qatar Council for Healthcare professionals (QCHP) as an independent council rather than being a department within the Secretariat of the Supreme Council of Health; and the Sole authority responsible for regulating of all healthcare professionals working in both governmental and private healthcare sectors in the state of Qatar.2.
BACKGROUND AND APPLICATION OF CODE The Code, developed by the Fitness to Practice Department, QCHP to outline ethical responsibilities expected from all healthcare professionals who choose to practice in the State of Qatar. Code intent is to assist healthcare professional to deliver the required care and to benefit the broader community as it enables them to learn about the principles which healthcare professionals are expected to follow and apply in their routine work. This code is not a substitute for the provisions of legislation and case law. If there is any conflict between this code and the law, the law takes precedence.3. PURPOSE OF CODEThe purpose of the Code of Conduct for Healthcare professionals is to: 3.1.
To outline the standard of behavior expected of healthcare professional in State of Qatar.3.2.
To assist healthcare professionals to understand their responsibilities and obligations and provide guidance on expected behavior in the workplace.3.3.
To set a cohesive and consistent set of frameworks within which healthcare professionals can deliver quality care.3.4. To improve quality of healthcare delivery thus enhancing its reputation locally, regionally and internationally.
4. USE AND COMPLIANCE TO CODE 4.1.
Healthcare professionals shall be responsible for ensuring they understand and apply the Code in their day to day work. The Code shall be subject to periodical review, and efforts will be made to inform all stakeholders of this via website/email/circular/social media, etc. Healthcare professionals needs to ensure they too are utilizing the appropriate version. 4.
2. All healthcare professionals shall adhere to the code of conduct in their personal and professional conducts. Noncompliance by healthcare professionals with the duties and responsibilities set out in the Code of Conduct, they are putting their own registration and/or facility at risk.5.
CODE – CORE COMPONENT Qatar Code of Conduct for Healthcare Professionals is based on following core principle which are expected to be practice and adhere all time. 5.1. Patient care shall continue to remain the primary concern.5.2. To know and work within the framework of competence as per scope of practice and adhering current acceptable standards.
5.3. Ensure effective communication with patients/legal guardians and other professional and authority. 5.4. To be honest and truthful in portraying/providing information to employer, patients, community and legal authorities.
5.5. To ensure patient privacy and maintain confidentiality of information provided.
5.6. To maintain accurate and complete medical records for all the patients. 5.
7. To ensure any advertising information is truthful, accurate and shall not induce unnecessary demands for your services5.8. Respect your patient’s choice including second opinion, right to refuse and obtain informed consent to administer treatment. 5.9. Ensure high standard of personal conduct and behavior all time.
5.10. Treat patient/legal guardian/peer group as individuals and respect their dignity5.11. Health care professionals should not involve patients in personal issues or solicit for personal gain.
5.12. To be open to suggestion/grievance from patients and others to improve the standards care.
6. THE CODE ; OBLIGATIONSHealthcare professionals practicing in State of Qatar are expected to ensure the delivery of an efficient, safe and high-quality healthcare services. Healthcare professionals are accountable for their practice and are hence individually answerable for their actions and omissions. Following application of professional and ethical standards is paramount. 6.1. Respectful Care2 6.
1.1. To respect patient rights to receive appropriate treatment regardless of age, gender, religion, race, nationality or social status and, in an emergency, the ability to pay. 6.1.
2. Should provide health care services and treatment with appropriate attention, competence ; without unnecessary delay.6.
1.3. Should give essential physical, moral ; behavioral support. 6.1.4. Should respect patient’s dignity and privacy and treat them politely and considerately.
6.1.5. To be courteous, compassionate and honest and should respect the dignity, culture, ethnicity, values, religion and beliefs of the patient/client.6.1.6.
Shall not discriminate / harass between patients and colleagues on grounds of religious beliefs, culture, values, gender or nationality.6.1.7.
Should maintain appropriate professional boundaries in all relationships with patients/clients and their families.6.1.
8. Healthcare professionals shall encourage and respect the role of patients/legal guardian in shared decision-making process. To assist patient to choose most suitable preferences within the limits of lawful professional practice.6.
1.9. To ensure that his/her personal beliefs shall not prejudice patient’s care.6.2. Competency ; Awareness of Limitation4,9,10 6.
2.1. Healthcare Professionals shall ensure they are registered as per the laws and regulations of QCHP/MOPH, their practicing license is valid, and they are practicing within their scope of practice. 6.2.2. To undertake the activities that are within their scope of practice and to ensure patient safety is uncompromised.
Scope of practice is based on their education, knowledge, competency, extent of experience as per QCHP/Registration Policies.6.2.3. Practicing current evidence based scientific skills through updating personal ; group/team skills ; knowledge and pursue their medical education and training throughout the professional practice.6.2.
4. Should allocate, utilize and maintain appropriate resources in an effective and efficient manner to ensure patient safety. 6.
2.5. Healthcare Professionals should personally be accountable for the provision of safe and competent care. It is their responsibility to maintain the competence necessary for current practice and to practice in a safe, competent and professional manner.6.
2.6. Should participate in coordinating and promoting the activities of QCHP/MOPH; to ensure their practice and the patient care are aligned with the policies and procedures of QCHP/MOPH6.2.7. Healthcare Professionals should be aware of their personal limitations and deficiencies in knowledge and abilities and know when and whom to ask for supervision, assistance or consultation.
6.2.8. Shall not under any circumstances cause physical or psychological harm to a patient, their family and colleagues.
6.2.9. Health care professionals should know when and for whom to provide appropriate supervision.6.2.10.
Healthcare Professionals should not engage in unsupervised involvement in areas or situations where they are not adequately trained.6.2.11.
To effectively supervise tasks which is assigned to team members ensuring safety. 6.3. Continuing Professional Development56.
3.1 Healthcare Professionals shall engage in learning activities that continuously enhance their knowledge, skills, competencies, and performance across their scope of practice.6.3.2 Healthcare Professionals shall participate in appropriate learning activities to address their identified CPD needs and enhance their professional development.6.
3.3 Healthcare Professionals shall choose learning activities that are relevant to their professional roles and responsibilities and contribute to their career development.6.3.
4 Healthcare Professionals are required to continuously reflect on the evidence that informs their practice and identify the impact or outcome of engaging in learning activities (group learning, self-learning or assessment) on their knowledge, attitudes, skills, behavior or patient outcomes.6.3.5 Healthcare Professionals are expected to self-assess their professional practice needs using external data sources with feedback and the impact of their learning activities on practice.6.
3.6 Shall appropriately contribute to the professional development of colleagues and students.6.3.7 Should participate in task/mission assigned to them by QCHP that requires utilizing their expertise in his/her field.
6.4. Practice Professionally2,9,106.4.
1. Healthcare Professionals shall consistently demonstrate openness, honesty and ethical in their professional practice.6.4.2. Healthcare Professionals shall always act promptly to put matters right, if that is possible to ensure patient safety. 6.
4.3. When care plan does not go as intended, Healthcare Professionals have a responsibility to be open and honest in their communication with the patient/legal guardian. 6.4.
4. Healthcare Professionals shall maintain appropriate boundaries and not abuse their professional position to establish or pursue a physical or other inappropriate relationship with anybody under their care. This includes those close to the patient/client such as their caregivers, guardian or spouse or anyone under their supervision such as a student Healthcare Professionals or colleagues.6.4.
5. Healthcare Professionals shall avoid expressing personal beliefs including political, spiritual, religious or moral beliefs to patients/legal guardian or their caregivers in ways that exploit their vulnerability or that are likely to cause them distress.6.4.6. Shall work collaboratively within health care teams, and respect the skills, expertise and contributions of colleagues. 6.
4.7. When working as a member of a team, they shall communicate effectively and disseminate knowledge, skill and expertise as required for the benefit and safety of patients.
6.4.8.
Shall support colleagues who appropriately and professionally notify circumstances of unsafe and unethical practices. 6.4.
9. Healthcare Professionals shall understand their duty to support the community to deal in a sound manner with the reality of disease condition and its consequences.6.
4.10. Should give priority to the investigation and treatment of patients solely on the basis of clinical need. 6.4.11. Should respect the patient’s right to informed consent and to seeking a second opinion regarding the care they receive. 6.4.12. Where there is a suspicion or issue of child abuse or any other form of abuse or medicolegal case, Healthcare Professionals shall report such suspicions and to comply with Qatari regulatory requirements. 6.4.13. Should ensure that professional status is not used in the promotion of commercial products or services and that the status of being a Healthcare Professionals is not used for personal gain or any form of rewards / incentives that are not part of the stipulated conditions of his/her employment. Should not be taking advantage of privileged position for personal gain.6.4.14. Should have a responsibility to conduct themselves according to the Qatar laws and regulations as well as Islamic principals in what they do, and in their interaction with patients receiving care as well as with families, communities and other members of the health care team.6.5. Privacy & Confidentiality26.5.1. Healthcare Professionals shall ensure patient medical/personal information is kept private and confidential (subject to disclosures necessary for medical care and administration) & be viewed merely by the direct caregiver or authorized persons. Upon patient request family member or nominate a support person to be allowed during examination and discussion of their case.6.5.2. To ensure all required steps are taken to protect unauthorized access, use or accidental disclosure of your patient’s information.6.5.3. Shall respect the patient’s wish regarding the disclosure of information to family members and others.6.5.4. Healthcare Professionals shall always maintain privacy & respect during physical examination & treatment.6.5.5. Healthcare Professionals shall disclose any information regarding patients only with informed consent or as required by a court of law or appropriate constitutional authority.6.5.6. To ensure use of social media/other online platforms is consistent with the ethical and statutory obligations to protect patient information confidentiality and privacy.6.5.7. Healthcare Professionals shall consistently maintain confidentiality of information about colleagues & the organization.6.6. Ensure Safety 6.6.1. Healthcare professionals must practice in a safe manner; do not use any sedatives or other substances that may alter a capacity to practice safely at all times. In a situation where their health threatens their capacity to practice safely and competently, they have a responsibility to seek assistance to address their health needs.6.6.2. Shall conform to the national legislation in relation to self-prescribing. They should not treat themselves, other than in the way that any other member of the community would undertake self-treatment.6.6.3. Healthcare professionals shall protect patients, community, peer group and themselves by being immunized against communicable diseases. 6.6.4. Healthcare professionals should ensure they follow 6.6.4.1. If he/she knows or suspects that they have a health condition that could adversely affect their judgment or performance or could harm he/she shall consult a suitably qualified health professional. 6.6.4.2. He/she will follow the health-professional’s advice about investigations, treatment and changes to practice if necessary. They will not rely on their own assessment of the risk they possess to patients and colleagues.6.6.4.3. Shall act to identify and minimize the risk to themselves and patients. They shall work with other members of the team to promote a healthcare environment that is conducive to safe, therapeutic and ethical practice.6.6.5. Shall maintain personal safety and that of colleagues where necessary when caring for patients. If a patient poses a risk to the health or safety of the health professional, necessary steps to be taken to protect themselves before investigating or providing treatment. However, he/she shall not refuse to treat a patient who poses such a risk. 6.6.6. Healthcare Professionals observes/find the environment that could compromise standard of practice they shall report the to a supervisor, appropriate committee or if need to regulatory authority. 6.6.7. To ensure safety in an emergency, in or outside the work setting, he/she has a duty to provide care within the scope of practice. 6.7. Informed Consent2, 126.7.1. Healthcare professionals shall obtain informed consent before they provide patients with treatment or care.6.7.2. Healthcare Professionals must provide care in life threatening / emergency situations where treatment is necessary to preserve life without patient consent if they are unable to give it, provided the professional has the ability to demonstrate they are acting in the patient’s best interest. 6.7.3. Healthcare Professionals shall ensure patients participate in decisions about their care and treatment, including the right to refuse treatment (to the extent permitted by regulations). The patient’s consent or refusal must be documented in the patient’s medical record. 6.7.4. Healthcare Professionals to ensure that all patients receive precise and honest information about their condition and therefore make informed decisions about their own health care. 6.7.5. When obtaining informed consent, Healthcare Professionals shall ensure followings:6.7.5.1. Given by a competent patient / legal guardian / appropriate source6.7.5.2. Given voluntarily,6.7.5.3. Patient is informed about risk, benefits, alternative, likelihood of success, possible complication and treatment plan in a language which patient is able to comprehend and6.7.5.4. Shall document all discussions regarding consent in the patient/client care record. 6.8. Patient Record, Report Writing and Furnishing Evidence86.8.1. To maintain accurate and complete medical records with a date & time for all the patients consulted, visited and provided care for including the procedure performed and consent taken.6.8.2. Healthcare professionals shall be honest and trustworthy when writing reports, issuing sick leaves and when completing or signing forms or reports and other documents.6.8.3. Healthcare professionals shall do their best to make sure that any documents they write, or sign are not false or misleading; and will accordingly taking steps to ensure the integrity of such content prior to its authenticating by way of a signature. 6.8.4. Healthcare professionals shall be honest in all spoken and written statements if they are asked to give evidence or act as a witness in judicial proceeding or inquiries. 6.8.5. When acting as an expert witness, they shall make clear the limits of their knowledge and not give an opinion beyond those limits.6.9. End of Life Care 6.9.1. Healthcare Professionals shall participate in the care of the dying patient adhering to current best practice and considering of the wishes of the patient and their family and caregivers. 6.9.2. Healthcare professionals shall participate in in-depth insightful and culturally sensitive education and training in the optimal care of dying patients, when applicable.6.9.3. During end of lifecare Healthcare professionals shall deploy all possible efforts to relive symptoms of dying patient. 6.9.4. Healthcare professionals shall provide support for patients and their families even when it is not possible to deliver the outcome they wish for.6.9.5. Palliative care during end of lifecare shall be interdisciplinary in nature renders the needs of both patient and their family members. In caring for patients towards the end of their life, professionals shall understand the limits of health care to prolong life and if needed to recognize in consultation with their colleagues when efforts to prolong life may not benefit the patient in accordance with applicable Qatari law.6.9.6. Healthcare professionals shall be prepared to communicate bad news to patients and their families and provide support for them while they deal with this news.6.10. Caring for Children and Adolescent (Below 18 years of age) When administering care for children and adolescents below 18 years of age, Healthcare Professionals shall ensure following:6.10.1. Placing the interest and wellbeing of the child or adolescent first.6.10.2. Ensuring that they consider adolescents’ capacity for decision-making. 6.10.3. Healthcare Professionals shall ensure following that, when communicating with children and adolescents6.10.3.1. Treat them with respect and listen to them carefully6.10.3.2. Encourage questions and answer their questions to the best of their abilities6.10.3.3. Provide clear information that can be understood easily by children and/or adolescents6.10.3.4. Where there is a suspicion or issue of child abuse or any other form of abuse or medicolegal case, Healthcare Professionals shall report such suspicions and to comply with Qatari regulatory requirements. 6.11. Patients who may have additional/special needsHealthcare Professionals shall give more focus attention when caring for such patients (including those who do not have decision making capacity) who have additional/special needs and should be aware that such patients may be at greater risk that might involve:6.11.1. Paying special attention to communication to cater patient needs. 6.11.2. Being aware that increased advocacy may be necessary to ensure just access to healthcare.6.11.3. Recognizing that there may be a range of people involved in their care, such as caregivers, family members or a guardian, and involving them when appropriate. 6.11.4. Ensure appropriate care is taken for such vulnerable patient.6.12. Promoting Public Health116.12.1. Professionals shall contribute in promoting the mental and physical health of the community of State of Qatar. 6.12.2. Have a responsibility to promote community mental and physical health though education, screening, disease prevention and reporting notifiable disease to appropriate authority. 6.12.3. Healthcare professionals shall act as ambassadors and use relevant expertise and influence to protect and advance the health and wellbeing of patients, communities and populations.6.13. Managing Adverse Events3 Healthcare Professionals shall ensure followings during any adverse event. 6.13.1. To be open and honest in their communication with their patients/legal guardians. Explaining to the patient as promptly and fully as possible what has happened and the possible short-term and long-term consequences.6.13.2. Acting instantly to rectify the concern, if possible, including seeking necessary help and pursue appropriate advice from peer group or patient/family member.6.13.3. Acknowledging any patient / family member distress and providing appropriate support. 6.13.4. Complying with any relevant policies, procedures and reporting requirements.6.13.5. Reviewing adverse events and implementing corrective ; preventive measures to reduce the risk of recurrence of similar events. 6.13.6. Reporting adverse events to the relevant authority as necessary.6.14. Patient Compliant Management2,5 6.14.1. Healthcare professionals shall be open to suggestion/grievance/observation from patients and others about aspects of practice to improve the standards of their care.6.14.2. Healthcare professionals shall ensure that patients/legal guardians are aware of the processes for making a complaint to the provider. Also, unresolved compliant or if they are not satisfied with the outcome, concerns can be escalated to Fitness to Practice Department /QCHP.6.14.3. Healthcare Professionals shall ensure patients complaint are thoroughly and appropriately investigated in a timely manner and outcome is shared with patient / legal guardians. 6.14.4. Healthcare Professionals shall not allow a patient/legal guardians complaint to adversely affect the patient treatment plan. 6.14.5. To cooperate with any complaints policies, procedures and regulations that apply on their practice.6.15. Healthcare Research6 6.15.1. Healthcare professionals shall take part in research, which is helps in improving the health of individuals and the population as a whole. 6.15.2. Healthcare professionals shall ensure the research protocol has been approved by a properly constituted human research ethics committee recognized by MOPH.6.15.3. Healthcare professionals shall follow and adhere Qatari research governance guidelines set by Ministry of Public Health. 6.15.4. Healthcare professionals shall act with honesty and integrity and ensure the research is not contrary to the participants’ interests.6.15.5. Healthcare professionals shall adhere to the requirements on informed consent.6.15.6. Healthcare professionals shall seek advice when research involves children or adults who are unable to provide informed consent to ensure there are appropriate safeguards in place. This includes ensuring that a person empowered to make decisions on behalf of the participant have given informed consent or that there is other lawful authority to proceed.6.15.7. Healthcare professionals shall follow all aspects of the research protocol, including reporting adverse events promptly and any changes to the protocol.6.15.8. Healthcare professionals shall accept or issue only those payments approved by a research ethics committee.6.15.9. Healthcare professionals shall report evidence of fraud or misconduct in research to an appropriate person, committee or authority. 6.15.10. Healthcare professionals shall disclose to the participant any financial benefit they gain by the research.6.16. Conflict of Interest and Financial & Commercial Dealing6.16.1. Healthcare professionals shall declare any conflict of interest when recommended/required. Conflicts of interest may be financial, professional, personal, ethical, moral or religious. 6.16.2. Healthcare professionals shall act professionally and fairly in all financial and commercial dealings.6.16.3. Shall be honest and open in financial arrangements with patients. Healthcare Professionals shall not exploit a patient’s vulnerability or lack of healthcare knowledge when making charges for treatments or services. 6.16.4. Healthcare care professionals should not involve patients in personal issues or solicit for personal gain. Also, not to encourage patients to give, lend or bequeath money or gifts that will benefit them directly or indirectly. 6.16.5. Healthcare Professionals shall not pursue patient or family members to make donations to other people or organizations.6.16.6. Healthcare professionals shall act in the patient’s best interests when making referrals and when providing or arranging care.6.16.7. Healthcare professionals shall not offer inducements to colleagues to use their services nor will they expect or accept a fee from a health professional/organization to which they refer patients. 6.16.8. Healthcare professionals shall not ask for or accept any inducement, gift or hospitality from companies that sell or market drugs/equipment or any services that may affect or be seen to affect, the way they prescribe or recommend for, treating or referring patients. 6.16.9. Healthcare professionals shall not ask for or accept fees for meeting sales representatives.6.16.10. Shall be honest and open in financial and commercial matters relating to work, including dealings with patients, employer, insurers and other organizations or individuals. 6.16.11. Shall be honest if taking part in buying selling or using goods or services. Professionals shall declare any relevant financial or commercial interest that they or their family might have in the transaction. If Healthcare professionals endorse or sell any products, they shall declare their professional and financial interest in these products to the patient and not yield an unjustifiable profit. 6.17. Advertisements & Information to Public76.17.1. A Healthcare Professionals shall approach, with caution, advertisements about their health services or facility. They shall provide the information that patient’s need to improve their knowledge and choice without misrepresenting the quality or outcomes of treatments or services. 6.17.2. A Healthcare Professionals shall make sure that any information that they publish or is published to them about their healthcare services are factual and verifiable.6.17.3. A Healthcare Professional shall ensure portrait correct professional qualification, experience and expertise.6.17.4. A Healthcare Professional shall not make unjustifiable claims about the quality or outcomes of their services in any information they provide or convey to patient’s or their careers. 6.17.5. A Healthcare Professionals shall not inappropriately guarantee cures, exploit a patient’s vulnerability or lack of health care knowledge, or raise unrealistic expectations.6.17.6. A Healthcare Professionals shall not exploit or inappropriately induce people towards use of a particular service, for example, by arousing ill-founded fears about their future health or by claiming unique abilities.7. BREACH OF THE CODE7.1. If suspecting potential breaches of our Code, please advise us on a confidential basis by contacting FTP/QCHP.7.2. Having been notified the QCHP will ensure that appropriate steps are taken to address the matter. 7.3. Further details regarding how QCHP process in dealing with complaints and concerns can be found in FTP Booklet “PROTECTING THE PUBLIC AND PROMOTING HIGH STANDARDS OF PRACTICE”. 8. REFERENCE AND CROSS REFERENCE1. Article# 3 of Emiri Decree No. (7) Of the year 20132. Patients’ Bill of Rights and Responsibilities (PBRR) in 20153. Key Performance Indicators, Healthcare Service Performance Agreement 2016. 4. QCHP – AD Continuing Professional Development Program – A Manual for Healthcare Professionals.5. Compliant Management, Governmental Health Communication Center (GHCC), Fitness to Practice.6. Policies, Regulations and Guidelines for Research Involving Human, Department of Research, MOPH7. Medical Service Advertisement, Licensing of Healthcare Facilities, MOPH8. National Healthcare Facilities Licensing and Accreditation Program, Licensing Standards, 2016, MOPH9. Guidelines for Nurses and Nursing Regulations in the state of Qatar, QCHP10. Guidelines for Physicians, Dentists, Pharmacists and Allied Healthcare Professions (AHP), QCHP11. Enhanced Health Promotion and Disease Prevention, NHS 2018-2022, MOPH12. _________________________ Policy on Consent, MOPH
