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Transcript of Intern Orientation - Ballarat Health...
2016
Medical Education Team - Michelle Bodey - MEO
Ballarat Health Services
2016
Intern Orientation Tuesday 5th January – Friday 8th January
– –
SESSION TIMES: SESSION TOPIC: PRESENTER(S): LOCATION:
8.00am – 8.15am Welcome to Ballarat Health Services Andrew Kinnersly &
Linda Danvers ERC
Seminar Rooms 1 & 2
8.15am – 9.15am How to be a Good Intern
Tim Darby ERC
Seminar Rooms 1 & 2
9.15am - 9.30am HMO Society Holly Murphy & 2016
Candidate ERC
Seminar Rooms 1 & 2
9.30am – 10.00am Clinical Escalation Policy
The Deteriorating Patient Andrew Tongs
ERC Seminar Rooms 1 & 2
10.00am – 10.30am Observations of Practice
Clinical Skills Check Denielle Beardmore &
Wendy Porteous ERC
Seminar Rooms 1 & 2
10.30am – 11.00am
MORNING TEA
ERC - Foyer
11.00am – 11.30am Management of the Medical Patient Danielle Robinson ERC
Seminar Rooms 1 & 2
11.30am – 12.00pm Management of the Surgical Patient Jayson Moloney ERC
Seminar Rooms 1 & 2
12.00pm – 12.30pm Management of the Emergency Patient Andrew Crellin ERC
Seminar Rooms 1 & 2
12.30pm – 1.30pm
LUNCH
ERC - Foyer
1.30pm – 1.45pm Infection Control Catrice Grahame ERC
Seminar Rooms 1 & 2
1.45pm – 2.45pm Pharmacy
Medication Safety – Every Day, Every Patient
Jaclyn Baker & The Pharmacy Team
ERC Seminar Rooms 1 & 2
2.45pm – 3.15pm Pathology Marnie Kerseboom ERC
Seminar Rooms 1 & 2
3.15pm – 3.30pm
AFTERNOON TEA
ERC - Foyer
3.30pm – 4.00pm
HR Identification Swipe Cards
IT Remote Email
Access Michelle Bodey
IT Dept. &
HR Dept.
4.00pm – 4.30pm Fire and Emergency Management Don Garlick ERC
Seminar Rooms 1 & 2
4.30pm Hospital Tour Linda Danvers ERC
Seminar Rooms 1 & 2
6.00pm
EVENING FUNCTION
The Yacht Club Wendouree Pde
– –
GROUP 1 GROUP 2 GROUP 3
Sambridhi Adhikari Samuel Hawthorne Erin Maylin
Rajjit Ahluwalia Fiona Ip Alexandra Nikolskuy
Lilana Bray Bradd Jimmink Christian Orlowski
Ariel Dahan Damian Johnson Benjamin Scott
Matthew Denton Uditha Kariyawasam Adrianus Thio
Juen Li Ding Alvin Kong Danielle Todd
Sophie Duin Yee Wen Kong Nicole van der Nagel
Jessica Dunn Rebecca Langmaid Keryn Walters
John Ford Shelton Leung Caitlin Webb
Joelle Guertin Holly Lewis Colin Mitchell
Session 1 - 8.00am IT –Training Room
Session 2 – 8.00am Seminar Rooms 1 & 2
Session 3 – 8.00am ERC Lecture Theatre
Topic: BOSSnet Presenter: Claire Bridson Topic: Clinical Coding – HIS Presenter: Pauline Basilio
GROUP 1
Topic: H/R – Bullying and Harassment in the workplace Presenter: Ann-Maree Porter Topic: Payroll and Salary Packaging Presenter: Melissa MacPherson Topic: ROSTERON Presenter: Victoria Fara
GROUP 2
Topic: Medical Legalities Presenter: Linda Danvers Topic: Phuong Pan Presenter: Mentoring Topic: Medical Education Presenter: Michelle Bodey & Zoe Howell
GROUP 3
10.30am – MORNING TEA – ERC FOYER
Session 1 - 11.00am IT –Training Room
Session 2 –11.00am Seminar Rooms 1 & 2
Session 3 – 11.00am ERC Lecture Theatre
Topic: BOSSnet Presenter: Claire Bridson Topic: Clinical Coding – HIS Presenter: Pauline Basilio
GROUP 3
Topic: H/R – Bullying and Harassment in the workplace Presenter: Ann-Maree Porter Topic: Payroll and Salary Packaging Presenter: Melissa MacPherson Topic: ROSTERON Presenter: Victoria Fara
GROUP 1
Topic: Medical Legalities Presenter: Linda Danvers Topic: Medical Education & Mentoring Presenter: Michelle Bodey & Zoe Howell
GROUP 2
1.30pm LUNCH – ERC FOYER
Session 1 – 2.30pm IT –Training Room
Session 2 –2.30pm Seminar Rooms 1 & 2
Session 3 – 2.30pm ERC Lecture Theatre
Topic: BOSSnet Presenter: Claire Bridson Topic: Clinical Coding – HIS Presenter: Pauline Basilio
GROUP 2
Topic: H/R – Bullying and Harassment in the workplace Presenter: Ann-Maree Porter Topic: Payroll and Salary Packaging Presenter: Melissa MacPherson Topic: ROSTERON Presenter: Victoria Fara
GROUP 3
Topic: Medical Legalities Presenter: Linda Danvers Topic: Medical Education & Mentoring Presenter: Michelle Bodey & Zoe Howell
GROUP 1
5pm Conclusion
– –
SESSION TIMES: SESSION TOPIC: PRESENTER(S): LOCATION:
8.30am – 9.00am MET Call Andrew Tongs ERC
Seminar Rooms 1 & 2
THURSDAY GROUPS
GROUP 1 GROUP 2 GROUP 3 GROUP 4
Sambridhi Adhikari John Ford Yee Wen Kong Benjamin Scott
Rajjit Ahluwalia Joelle Guertin Rebecca Langmaid Adrianus Thio
Lilana Bray Samuel Hawthorne Shelton Leung Danielle Todd
Ariel Dahan Fiona Ip Holly Lewis Nicole van der Nagel
Matthew Denton Bradd Jimmink Erin Maylin Keryn Walters
Juen Li Ding Damian Johnson Alexandra Nikolskuy Caitlin Webb
Sophie Duin Uditha Kariyawasam Christian Orlowski Colin Mitchell
Jessica Dunn Alvin Kong
SKILLS AND UNIT SESSIONS
9.00am Clinical Skills Room – Level 1 Topic: BLS Assessment Presenter: Andrew Tongs
Group 1
9.00am Clinical Skills Room -
Ground Topic: IV & Suturing session Presenter: Andrew Crellin
Group 2
9.00am Theatre Reception
Topic: Theatre Orientation Presenter: Belinda Mende
Group 3
9.00am Radiology Reception
Topic: Radiology Orientation
Presenter: Huy Ho Bao Nguyen
Group 4
10.30am - MORNING TEA – ERC FOYER 11.00am
Clinical Skills Room – Level 1 Topic: BLS Assessment Presenter: Andrew Tongs
Group 2
11.00am Clinical Skills Room -
Ground
Topic: IV & Suturing session Presenter: Andrew Crellin
Group 3
11.00am Theatre Reception
Topic: Theatre Orientation Presenter: Belinda Mende
Group 4
11.00am Radiology Reception
Topic: Radiology Orientation
Presenter: Huy Ho Bao Nguyen
Group 1
12.30pm – LUNCH – ERC FOYER 1.30pm
Clinical Skills Room – Level 1
Topic: BLS Assessment Presenter: Andrew Tongs
Group 3
1.30pm Clinical Skills Room -
Ground
Topic: IV & Suturing session Presenter: Rajesh Sannappareddy
Group 4
1.30pm Theatre Reception
Topic: Theatre Orientation Presenter: Belinda Mende
Group 1
1.30pm Radiology Reception
Topic: Radiology Orientation
Presenter: Huy Ho Bao Nguyen
Group 2
3.00pm – AFTERNOON TEA – ERC FOYER 3.30pm
Clinical Skills Room – Level 1
Topic: BLS Assessment Presenter: Andrew Tongs
Group 4
3.30pm Clinical Skills Room -
Ground
Topic: IV & Suturing session Presenter: Rajesh Sannappareddy
Group 1
3.30pm Theatre Reception
Topic: Theatre Orientation Presenter: Belinda Mende
Group 2
3.30pm Radiology Reception
Topic: Radiology Orientation
Presenter: Huy Ho Bao Nguyen
Group 3
5.00pm Conclusion
– –
SESSION TIMES: SESSION TOPIC: PRESENTER(S): LOCATION:
7.30am – 8.00am Introduction to Units and Wards
Angie Spencer Nursing Director – Acute Patient
Services &
Meredith Theobald Nursing Director – Sub Acute
(Bed Based) Service
ERC Seminar Rooms 1 & 2
then on to
Wards and Departments
8.00am – 2.30pm
Ward and Department Orientation &
Shadowing with 2015 Interns
Angie Spencer & Meredith Theobald will escort
Interns and handover to Units
Emergency Dept.
General Surgery
Orthopaedics
Medical
Sub-Acute (from 8.30am)
2.30pm – 2.45pm
AFTERNOON TEA
ERC - Foyer
2.45pm – 3.25pm
Junior Medical Workforce JMO Expectations
Time Sheets
Rosters
Leave (annual and sick) and Change of Roster form
General Professionalism
Victoria Fara &
Michelle Bodey
ERC Seminar Rooms 1 & 2
3.25pm – 3.30pm Final Wrap Linda Danvers
& Michelle Bodey
ERC Seminar Rooms 1 & 2
Session: How to be a Good Intern – time management, outpatients, pre-admissions clinic, ordering and following up investigations and other administration duties Presenter: Tim Darby
Notes:
Session: HMO Society Presenter: 2015 Holly Murphy - 2016 Natalie Smith & Sam Cooke
Notes:
Session: Clinical Escalation Policy – The Deteriorating Patient Presenter: Andrew Tongs
Topic: Standard 9: The deteriorating patient
Author/presenter: Andrew Tongs
Introduction
In this session we cover topics that are mandatory to ensure compliance with the NSQHS Standard 9
Learning objectives
1. To become familiar with and know how to use the Observation and Response Charts. 2. To gain an understanding with responding to a page regarding patient deterioration and the hospital
policies around this. 3. Learn how to use the ISBAR tool and how to implement it every day practice.
Case based learning – de-identified/hypothetical cases (if applicable)
At Ballarat Health Services we maintain an education resource website and we have self-directed workbooks for
use by clinical staff. Our case in the spotlight series on the education website is used to provide case based
learning, and to help you learn some of the concepts above in a clinical context. Please complete these cases
during the year
Self-directed learning
http://educationresource.bhs.org.au/hmo_2_3wardafterhours
Case in the Spotlight 7
Case in the Spotlight 8
References/suggested pre reading or further reading
Recognising and responding to clinical deterioration – National Standard 2
Session: Observations of Practice Presenter: Denielle Beardmore & Wendy Porteous
Topic: Observations of Practice
Presenter: Denielle Beardmore
Introduction
At Ballarat Health Services we have identified several educational requirements of staff that are mandatory and or
required by the organisation as part of your Safety and Quality Care roles. The identified titles are written into a
matrix that clearly identifies the level of staff member and the education or training that is to be undertaken and
how often this should occur.
The recording of completion is documented on the BHS LMS that is viewed and monitored by your Supervisor and
Clinical Director, the Executive Staff Council and the Board of Management.
All medical staff participate in a direct observation of clinical practice which allows medical officers to complete
their usual days work observed undertaking things such as hand hygiene, handing over patient information using
ISBAR, identifying a patient correctly and completing a medication chart. The measure of this performance is
based in best practice and should not interfere with your normal routine.
If there are areas of practice that are demonstrated below standard then the medical officer will be informed and
a plan established to raise standards. The recommendation may be online learning, verbal feedback or simulated
practice. The clinical observation audit is offered again to demonstrate improvement or achievement.
Learning objectives
In this session we will be discussing the requirements of professional practice and the adherence to professional
standards.
Understands why appropriate standard of professional practice is required.
Can describe the BHS structure of the matrix for learning identified for mandatory organization specific
learning.
Is able to reflect on personal experiences, actions and decision making.
Acts as a role model of professional behavior particularly in relation to seeking out feedback, participating
in performance assessment processes.
Applies principals of evidence based practice and hierarchy of evidence.
Session: The Management of a Medical Patient Presenter: Danielle Robinson
Notes:
Session: The Management of a Surgical Patient Presenter: Jayson Moloney
Notes:
Session: The Management of the Emergency Patient Presenter: Andrew Crellin
Topic: Introduction to the Emergency Department
Introduction
Welcome to the Ballarat Health Services Emergency Department. The ED is constantly growing with 120-200
patients seen per day, resulting in 25-30 admissions per day. The department maintains 18 cubicles, 2
Resuscitation bays, procedure & consult rooms and 5 cubical FastTrack. ED also manages an 8 bed Short Stay Unit.
Learning objectives
1. The important aspects of departmental communications and professionalism. 2. How effective team work will help us all achieve the best in patient care. 3. Dealing with Conflict.
Self-directed learning
The Ballarat Health Services Education Resource site has numerous learning resources for Emergency Medicine.
These include lectures, tutorials/MCQ and an ECG and XR collection.
http://educationresource.bhs.org.au/emergency
Position Description
There is a detailed HMO position description available on the JMO portal site for more details about working in
the BHS ED. http://escope.bhs.org.au/
(Login to the site is required – bhs, password – escope)
Session: Infection Control Presenter: Catrice Grahame
Infection Prevention and Control
Learning objectives
1. Importance of staff immunisation and staff health. 2. Blood and body fluid (BBF) exposure management 3. To be aware of infection control management of patients with infectious diseases and multi-resistant
organisms.
Staff health:
BHS utilises a risk based workforce immunisation program in accordance with the current National Health and Medical Research Council Australian immunisation guidelines and requirements of the National Safety and Quality Health Service Standards.
NCP0151 Staff Immunisations
CPP0389 Health Care Worker with an infectious Disease
The Australian Immunisation Handbook 10th Ed, National Health and Medical Research Council
Management of Blood and Body Fluid exposures
NCP0050
CPP0288 Sharps- handling and disposal
Management of patients with infectious disease and Multi resistant organisms.
General Docs Specific Docs
CPP0420 Standard precautions CPP0105 Tuberculosis
CPP0394 Transmission Based precautions
CPP0398 Chicken Pox/Shingles (varicella/Zoster) Infection control Practices
CPG0015 Multi resistant Organisms CPP0117 Clostridium Difficile
CID0011 Why am I in Isolation? CPP0399 Gastroenteritis
CPG0033 guidelines for the control of infectious diseases (The Blue Book)
CPP0282 Influenza
CPG0012 Respiratory Syncytial Virus (RSV)
CPG0115 Meningococcal Disease
National health and Medical Research Council Guidelines for the Prevention and Control of Infection in Healthcare 2010
Patient-centred risk management strategy for multi-resistant organisms, state of Victoria, Department of Health, 2011.
Session: Medication Safety – Every Day, Every Patient Presenter: Jaclyn Baker and The Pharmacy Team
Topic: Medication Safety: Every Patient, Every Day
Best Possible Medication History, National Medication Inpatient Chart & Discharge
Prescription training
Author/presenter: Jaclyn Baker, Deputy Director of Pharmacy (QUM & Dispensary Services)
Introduction
This session is intended to review intern’s applied knowledge of taking a “Best Possible Medication History”, completion of the medication chart (NIMC) and preparing a discharge prescription.
Learning objectives
1. To complete an MR701.1 (Best Possible Medication History and Reconciliation form) with all required information.
2. To complete a medication chart (NIMC) utilising the safety features provided in its design. 3. To increase awareness of other medication safety concepts such as unsafe abbreviations. 4. To prepare a discharge prescription that meets legal and hospital requirements. 5. To receive feedback on the execution of the above tasks.
Case based learning – de-identified/hypothetical cases (if applicable)
At our institution we maintain an education resource website and we have self-directed workbooks for use by clinical staff. Our case in the spotlight series on the education website is used to provide case based learning, please complete these cases during the year. Case 7 highlights this issue.
Summary – what you really need to know
A Best Possible Medication History is required upon admission for all patients.
It is the responsibility of the admitting medical team to take this History as a part of their admission, and record the information accurately on the Best Possible Medication History and Reconciliation form (MR701.1).
Pharmacists will review the information collected (and adjust/supplement as required) and undertake medication reconciliation of the medication chart (that is, matching up the medications that the patient took at home, with those that are currently prescribed).
The medication chart (NIMC) is designed to enhance safe prescribing. Key principles are; o Print patient name under the Patient Identification Sticker. o Complete the allergy section fully (including details of the reaction). o Prescribe generically (some exemptions exist). o Print your name and contact details clearly. o Enter the administration times that match your intended frequency. o Always indicate which brand of warfarin is required (Coumadin or Marevan)
The discharge prescription must be a complete list of the patient’s intended discharge medications, and must meet all PBS, legal and BHS policy requirements.
Self-directed learning
At BHS the following National Prescribing Service modules are mandatory;
Medication Safety training
National Inpatient Medication Chart (NIMC)
Get it right! Taking a Best Possible Medication History. Please provide your certificates to Michelle Bodey – Medical Education Officer as soon as possible.
Session: Pathology Presenter: Marnie Kerseboom & Wendy McLeod
Topic: Blood Transfusion Key Principles
Introduction
Australia has one of the safest blood supplies in the world. However, the transfusion of blood and
blood products is not without risk and can lead to complications and adverse outcomes for patients.
Blood and blood products should only be given when clearly indicated and expected benefits to the patient
outweigh the potential hazards.
Learning objectives
Standard 7 of the National Safety and Quality Healthcare Standards mandates how hospitals and clinicians should
manage blood and blood product transfusion.
To understand that governance and systems for blood and blood products exist.
To understand the process for prescribing blood products and appropriate clinical use.
To develop an understanding of documenting patient record information.
To understand the processes in place for managing blood and blood product safety –through receipt,
storage, collection and transport of blood and blood products and be aware of minimising unnecessary
wastage of blood and blood products.
To have an understanding of the information that may be provided to patients including the risks, benefits
and alternatives relating to blood products.
The following information and links will assist the HMO in managing blood and blood product transfusions.
Governance Documentation for Blood and Blood Product Transfusions
POL0012 Blood Components – Cross matching for Transfusion
CPP0209 Blood and Blood Product Transfusion
CPP0097 Massive Transfusion
Zero Tolerance
Know the requirements for taking a pre-transfusion blood sample. Samples that do not meet requirements shall
be discarded by the laboratory and a repeat sample requested.
Blood Bank Samples
Group and Hold vs Cross Match
Request either a Group and Hold Serum or Cross match, but not both.
Group and Hold is the first part of a cross match, where blood group and antibody screen is done.
Only order units to be cross matched if you intend to transfuse.
Fresh Frozen Plasma (FFP)
FFP will be issued on request, but please ensure you intend to transfuse. FFP that is thawed and not
transfused is often discarded, leading to high wastage rates.
If Prothrombinex is available, FFP is not required for Warfarin reversal. Refer to An update of consensus
guidelines for warfarin reversal
2 units of FFP will be thawed on activation of the Massive Transfusion Protocol
Prescription and Consent
All blood and blood product transfusions must be prescribed on the Blood Orders Form MR683.0
A patient’s transfusion history must be documented on the Blood Orders Form MR683.0
Unless an emergency situation, signed consent must be obtained prior to transfusion using the Blood
Transfusion Consent Form MR360.03
A patient information leaflet is attached to the consent form and should be given to the patient at the
time of consent.
Platelets should be ordered as 1 bag (contains an adult dose of platelets that should increase the platelet
count by 20,000 – 40,000).
Single Unit Transfusion
The aim of transfusion is to relieve symptoms of anaemia and replace blood volume in the trauma patient.
Every bag of blood has the potential to cause harm, so restrictive transfusion practice can be applied in
most situations.
The practice of single unit transfusion can be applied to stable, normovolaemic adult patients, in an
inpatient setting, who do not have clinically significant bleeding.
Each unit transfused should be an independent clinical decision
Managing Transfusion Reactions
Acute Transfusion Reactions Flowchart
Acute Transfusion Reactions Poster
Transfusion Reaction Pathology Request Form
Patient Blood Management Guidelines (NH&MRC)
Module 1 – Critical Bleeding / Massive Transfusion
Module 2 – Perioperative
Module 3 – Medical
Module 4 – Critical Care
Module 5 – Obstetrics and Maternity (final stages of development Sep 2014)
Module 6 – Paediatrics / Neonates (currently under development Sep 2014)
Resources/Self-directed learning
BloodSafe eLearning
Australian Blood Service
Blood Component Information Booklet
Iron Deficiency Anaemia Algorithm app for iPad and smartphones
http://educationresource.bhs.org.au/blood-transfusion-key-principles
Session: Fire and Emergency Management Presenter: Don Garlick
Fire & Emergency Management Training (FEMT)
Ballarat Health Services has a mandatory requirement that their entire staffs complete Fire &
Emergency Management Training (FEMT) annually.
In the event of any emergency clients, patients, residents and visitors will look to BHS staff members to provide
direction in what they need to do and to safely guide them as needed. By being fully conversant with
BHS emergency management procedures, plans and methods BHS staff members will achieve safe outcomes for
all.
How can I complete my mandatory annual FEMT requirement?
There are a number of ways staff can complete their annual requirement including
FEMT ONLINE (e3Learning)
BHS staff have access to a range of online learning modules in the BHS Online
Learning portal.
You can login at any time & any location!
Generic Login Details are:
Username: your payroll ID number
Password: bhs
FEMT Basic
Workbook
Session: BOSSnet
Presenter: Claire Bridson IT HELP DESK For Connectivity and Access Issues Ex 94786 IT Helpdesk [email protected]
Session: Clinical Documentation and Coding Presenter: Pauline Basilio
Topic: Clinical Documentation, Casemix & Privacy
Author/presenter: Pauline Basilio/Kylie Holcombe
Introduction
Clinical Documentation is a core component of safe and effective clinical care and is used for many other purposes
including casemix funding. Ensuring the security of confidential information and protecting patient privacy is the
responsibility of all BHS employees.
Learning objectives
1. Understand the importance of good clinical documentation and how to achieve it 2. Understand the relationship between clinical documentation and hospital funding 3. Awareness of obligations in accessing and using confidential patient information
Clinical Documentation
Is important for;
communication between the clinical care team
support of current and future care of the patient
provision of evidence for evaluation of care and medicolegal matters
compliance with legal obligations
quality of care and performance measurement data
assignment of clinical codes and casemix funding
Clinical Documentation should be; comprehensive, concise, structured to convey key information, sufficient to
meet above purposes
Entries in the medical record should be; legible, include date/time/signature/designation, made at least once per
24 hours, in blue/black ball point pen, no white out to be used
Casemix
Casemix funding applies to all acute inpatient episodes.
2014/15 – 37,000 episodes, 27,325 WIES, $122 million of funding.
Clinical coding is the translation of episode documentation to ICD-10-AM codes → DRG → WIES
There is a direct relationship between documentation of episode and hospital funding
Casemix data is also used for quality of care and performance measurement data, research and clinical audit.
Clinical Coding
Clear documentation is required to assign accurate codes for each condition and substantiate the code
assignment in the event of an external audit.
Principal diagnosis – the diagnosis chiefly responsible for the admission
one diagnosis which best reflects the reason for admission
if multiple diagnoses apply, then the most significant should be selected as the principal
for elective surgery the principal diagnosis is the condition for which the surgery was performed
terms such as ‘deceased’, ‘functional decline’ or ‘inability to cope’ should not be used as principal diagnoses
Comorbidities
a pre-existing condition requiring treatment or alteration of treatment, investigation and/or increased clinical
care
differentiate between current/active comorbidities meeting above criteria and past history
where possible link the condition with the treatment or management required
use definitive diagnostic statements e.g. not K2.8 but hypokalaemia or ↓K or respiratory/renal failure as
acute or chronic
Complications
if post-operative, specify if it is directly related to the procedure
intra-operative complications – document adhesions (& origin) and division or accidental puncture/tear,
haemorrhage and any other unexpected/unplanned intervention and why this was done
Procedures – all interventions - surgical, endoscopies and radiological
Privacy
Obligation – Privacy legislation (Health Records Act), BHS Privacy Policy, Medical Board of Australia – Code of
Conduct. All BHS employees have a responsibility to protect patient privacy.
Access confidential information only for a valid, work related purpose. This excludes accessing your own
record or that of family members as this is for personal reasons.
Ensure unit lists and loose information are secured, BOSSnet sessions not left open, information not accessed
or released inappropriately.
Social Media – do not discuss patient information on social media. Refer BHS and AMA Social Media Policies.
Do not take photographs of patients or documents on personal mobile phone.
References/suggested pre reading or further reading
More Casemix information: http://bhsnet/node/4382
Clinical Document Policy:
http://webapps/airapps/Services/au/org/bhs/govdoc/HTMLViewer.php?id=-30098~intranet-search
Privacy Policy: http://webapps/airapps/Services/au/org/bhs/govdoc/HTMLViewer.php?id=-29372~intranet-search
Session: Professional Conduct/HR Presenter: Ann-Maree Porter
Professional Conduct in the Work Place
At BHS we value every employee’s right to be treated with respect, dignity and courtesy. You have the right to come to a workplace that is free of harassment and discrimination; we both have a responsibility to ensure that this happens. This partnership requires everyone to understand the rules to achieve a professional standard of workplace conduct. Ballarat Health Services is committed to eliminating and preventing all forms of inappropriate behaviour between mangers/supervisors, employees, co-workers, employee/client interactions and employee interactions with any other common workplace participants. Examples of professional and unprofessional behaviour are as follows:
Professional behaviour includes:
Treating everyone with respect, dignity and courtesy
Being sensitive to different points of view and cultures
Including, rather than excluding people because of their lack of perceived fit with the work group.
Moving from ‘blame’ to problem solving, as a way of dealing with mistakes
Avoiding stereotyping people into limiting boxes
Valuing diversity - the similarities in differences, and the differences in similarities
Making decisions based on merit, choosing only because of an ability to do the job
Remembering the basic courtesies of ‘please’, ‘thank-you’ or ‘I’m sorry’ Unprofessional behaviour includes:
Racial graffiti, comments or jokes
Sending e-mail with sexual or racial messages
Crude jokes, gestures and sexual innuendo
Requests for sexual favours, unwanted sexual attention
Ridiculing people on return to work programs
Touching, leering, invading personal space
Yelling and screaming or deliberately ignoring people
Malicious rumours
Bullying, swearing and physical threats acknowledging people’s contribution
Do you need to speak to someone?
If you believe you are experiencing an issue or a problem with another person’s conduct in the workplace, it is important that you try and resolve the issue as soon as possible. In general, it is usual for a staff member to approach their manager in the first instance to discuss problems they are having at work. You may wish to contact the EEO Contact officer in the Safety Department or the Human Resource Department and speak the appropriate person. To help resolve your issue, it is helpful to ask yourself what outcome you are looking for, for example, do you
simply want to find out your options are to manage the issue yourself? Do you want a third party to help discuss
the issue with the other person involved? Do you want to make a formal complaint?
Session: Payroll and Salary Packaging Presenter: Melissa MacPherson
NOTES:
Session: ROSTERON Presenter: Victoria Fara
NOTES:
Session: Medical Legalities Presenter: Linda Danvers
Death Certificates and Coronial Depositions
After the death of an in-patient, the task of either completing the death certificate or making a
Coronial deposition will often be the responsibility of the intern.
Direct links to on-line death certificate and Coronial eMedical deposition forms can be found on the BHS
intranet, under the “forms” tab. Alternatively you can go to the Births, Deaths & Marriages www.bdm.vic.gov.au
or Coroner’s Court Victoria web-sites
https://onform.com.au/content/onform/agencies/CoronersCourtofVictoria/forms/emedical-depositionform.html
to access the forms
Death certificates:
To complete a death certificate you must be: “A doctor who was responsible for a person’s medical care immediately before death, or who examines the body of a deceased person after death, must, within 48 hours after the death, notify the Registrar of the death and of the cause of death in a form and manner approved by the Registrar and specifying any prescribed particulars” - Births, Deaths and Marriages Registration Act1996.
Discuss the cause of death and antecedent causes/associated causes with your Registrar and/or Consultant before accessing the form and ensure death is not reportable to the Coroner – any queries phone the Coroners Admissions and Enquiries on 1300 309 519.
Access the on-line form – you will need your AHPRA registration number to enter the form.
Complete form and print off and sign a hard copy – this is required for the patient to be transferred to the Funeral Director and then Cemetery – then submit form electronically to BD&M.
Coronial Depositions:
Make yourself familiar with the criteria of reportable and reviewable deaths.
If you are reporting a death to the Coroner, please make the family/next of kin aware of this – reassure them that the Coroner and Funeral Director will liaise to minimise any disruption to their arrangements.
To report a death or for further advice call Coronial Admissions & Enquiries on 1300 309 519 (24/7).
You will be provided with a unique identifying number for that patient.
Access Coronial eMedical Deposition form and enter the unique identifying number, then complete deposition and submit.
The Coroner’s office will contact the local police, who will attend the hospital. They may ask to speak with you to confirm details. They also need a patient identification form completed.
A few important things:
Always print off and sign the electronic death certificate, to allow the patient to be released to the funeral director
Never ever write fracture, fall, accident, injury or over-dose on a death certificate – if these things contributed to a death, then it is reportable to the coroner
Any correspondence or request from BD&M, the Coroner’s Office or the Police for further statements etc should immediately be directed to Medical Administration to deal with on your behalf
If you need to correct an error on a submitted death certificate eg incorrect date of birth, name spelled
incorrectly, there is a process for doing this on the first page of the on-line death certificate link on the intranet –
see “help guide” http://www.bdm.vic.gov.au/home/medical+practitioners+online+help+guide#Correcting
submitted details
Session: Intern Mentoring Program (External) Presenter: Phuong Pham
NOTES:
Mentoring Programs Available for Medical Staff Dr Claire Hepper & Sophie Ping are external mentors for all Interns and HMOs. They are available to give advice
and support, whether it is a work related issue or career advice. Contact information will be provided separately.
HMO’s as your mentor. Each year BHS HMO’s nominate themselves as a
mentor for the Interns for any question, issues or advice. See eScope for
more information: http://escope.bhs.org.au/
There is an array of resources available on the BHS education resource site:
http://educationresource.bhs.org.au/hmo/welfare that we recommend you take some time to look at.
Session: Medical Education and BHS Mentoring Presenter: Michelle Bodey and Zoe Howell
Medical Education in 2016
We coordinate an education program that meets all the requirements of PMCV, and Medical Board. However we
believe you will see a program that is innovative, that has a culture of feedback driving improvements that benefit
our learners. Our program includes sessions delivered by junior medical staff, sessions aimed at welfare, careers,
and professionalism, and audience participation systems. We evaluate satisfaction with the program, but also use
various methods to evaluate the effectiveness of the teaching sessions.
“you did a great job teaching, but did they learn anything?”
Here’s some of what we have for you;
1. HMO 1/2 program weekly
Last year’s annual program + bigger + better 2. The PMCV HMO2/3 curriculum
Expanding our program for prevocational trainees. http://www.pmcv.com.au/computer-matching-service/resources/711-supporting-safe-transition-
guidelines/file
E.g FACE to FACE sessions to include simulation, crisis resource management, deteriorating patient.
E.g PROMPT training in ICU, O&G and anaesthesia and paediatrics 3. Unit education
Every unit should provide orientation, education, performance appraisals, and feedback. The Medical Education
Unit supports the units and the junior medical staff are regular and valuable contributors in providing updates for
incoming medical staff e.g ROVERs
4. Free Open Access Medical Education, no password Education resources on website open access [email protected]
This includes online lectures with learning objectives, and hyperlinks to useful resources, ECGs, XRs, ABGs, clinical
case examples, regular spotlight cases
5. Self-directed workbooks Embedded in the ED program for 3 years, used to assist demonstrating learning +/- logbook element for
performance discussion and appraisals, we are hoping to introduce these in other areas. To be successful they
require Senior and junior medical staff authorship and contributions
Online learning portfolios are increasingly common in prevocational and vocational training in various specialty
areas.
6. Mandatory competencies – accreditation + safe minimum standards The Medical Education Unit works very closely with ensure our staff has access to training, which may include
online modules and face to face ALS and simulation training.
7. The future Our Medical Education Unit is co-located with the Centre for Education and Training. We are part of a large team
and this allows us to be a part of the Best Practice Clinical Learning Environment.
Dr. Jaycen Cruickshank, Director of Clinical Training, Supervisor of Intern Training
Session: MET Call Presenter: Andrew Tongs
MET Call
Introduction
BHS has established processes for recognition and response to clinical deterioration. This includes; implementing
ongoing staff education, appropriate and regular physiological observations and monitoring of all patients,
established thresholds for early detection of clinical deterioration, a standardized system for calling for assistance
and timely response to calls.
The hospital clinical protocol has been developed and written in accordance with NSQHS Standards, in particular
Standard 9 – Recognising and responding to clinical Deterioration in Acute Health Care. The Clinical Practice
Protocol is available on the Governance Document System.
Learning objectives
Roles and responsibilities of the MET call
Resuscitation teams and resuscitation equipment. (This is available to ALL patients, staff and visitors who suffer a medical emergency allowing rapid medical assessment and appropriate intervention.)
All staff should be aware of the MET / Respond Blue clinical criteria and know how to activate the appropriate emergency response (MET or Respond Blue)
Roles and Responsibility of MET
Ask about the reason for the call and how the team can help, Assess the aetiology of the deterioration
Begin basic investigations and resuscitation therapy
Call for further assistance of required / call consultant of parent medical unit
Discuss advance care planning, Decide where the patient needs to be managed and Document the MET and subsequent requirements for frequency of observations
Explain the cause of MET and management plan to the patient and ward staff
Follow up which doctor will follow up the patient and the criteria for re-notification via the fluorescent pink sticker (responsibility of medical registrar to complete and place in the medical record)
Graciously thank the staff at the MET response
Resuscitation Team includes:
Medical Registrar - team leader, as outlined below
Anaesthetic Registrar - responsible for airway assessment / management and IV access.
ICU Registrar / Resident - positioned at the bedside with a hands on roll in patient assessment, procedures and explaining to the patient what is happening.
MET Liaison Nurse (during hours of service
ALS trained Critical Care Nurse/s - as for MET Liaison Nurse
Surgical HMO (overnight only 1800 - 0800hrs) - hands on roll directed by the team leader
Paediatric Registrar (for Paediatric Responses) - team leader for Paediatric Response
Patient Flow Co-ordinator - attends all MET / Respond Blue / Paediatric Responses out of hours (1630 - 0800hrs).
The resuscitation team has shared responsibility for airway protection, optimising breathing, oxygenation and circulation, diagnosis utilising the pooled knowledge and skill of team members with the medical registrar coordinating all clinical activities. Other duties of the team may include obtaining IV access, blood and other sampling, organising any therapeutic intervention or transfer as required and liaising with treating team.
The Team Leader: The above team responds to MET, Respond Blue and Paediatric Responses at the Acute site. The team leader for all MET / Respond Blue is the Medical Registrar allocated for the day who carry a designated
MET / Respond Blue pager. The team leader must be easily identified by wearing the red tabard or identification sticker.
Activation of a MET / Respond Blue
A MET / Respond Blue can be activated by ANY member of staff without consultation of any other nursing, medical or senior staff. Acute site:
Dial 94444
State the response (MET or Respond Blue) / the ward or location / the bed number e.g. MET response,
2N, bed 202B Paediatric Response Acute site:
Dial 94444
State Paediatric Response / the ward or location / the bed number e.g. Paediatric response, 2S, bed
Outback 1 Sub-Acute site:
Dial 93777
State the response (MET or Response Blue) / the ward or location / the bed number e.g. MET
Response, Peter Heinz Centre, Pool Paediatric Response Sub-Acute site:
Dial 93777
State Paediatric response / the ward or location / the bed number e.g. Paediatric Response, Peter
Heinz Centre, Pool Residential Aged Care:
Dial 0-000
State "I need an ambulance" and provide the name and street address of the facility e.g. I need an
ambulance to Hailey House, 703 Norman Street, Ballarat
Upgrading a MET Call switch on 94444 (Acute) / 93777 (Sub-Acute)
State Upgrade MET to Respond Blue / the ward or location / the bed number e.g. Upgrade MET to
Respond Blue, 2N, bed 202B
Stand down / All clear
At the conclusion of the MET / Respond Blue, the team leader is the designated staff member with the authority to call All Clear. The decision is made by the team leader in consultation and agreement from the resuscitation team. The authority to call All Clear is then given to the Switchboard Operator via 94444 stating MET / Respond Blue ALL CLEAR / ward location / bed number involved.
Session: Junior Medical Workforce Presenter: Victoria Fara
MWU Office details Location: BRICC level 4
Office hours: Monday – Friday 08.00 – 16.30
Email: [email protected]
Phone: 5320 6748 (96748)
Please use the generic email for all leave requests, pay queries, emailing of timesheets and general queries.
ria Fara – Junior Medical Workforce Manage
WE WELCOME YOU ALL TO THE BHS TEAM
AND
THANK YOU FOR YOUR FEEDBACK