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 helpdesk@bhs.org.au

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 educationresource@bhs.org.au

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: medwork@bhs.org.au

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