Post Graduate Medical Education. Monday 23rd October 2004 ...

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  • Where? Who attends? Who runs it? What to be taught?
  • Identified group Mandatory
  • Post Graduate Medical Education. Monday 23rd October 2004 ...

    1. 1. Morning handover Getting cereal or getting serious?
    2. 2. <ul><li>Andrew Steer </li></ul><ul><li>Chief Resident & Infectious diseases fellow </li></ul><ul><li>Royal Children’s Hospital, Melbourne </li></ul><ul><li>Jenny Gough </li></ul><ul><li>Lecturer & Medical Education Officer </li></ul><ul><li>Royal Children’s Hospital, Melbourne </li></ul>
    3. 3. Background <ul><li>Routine part of the day </li></ul><ul><li>Important processes occur during handover: </li></ul><ul><ul><li>Clinical communication about admitted and sick patients </li></ul></ul><ul><ul><li>Identification of patient care problems </li></ul></ul><ul><ul><li>Education of junior staff </li></ul></ul>
    4. 4. Background <ul><li>Prior to 2002, handover took place in the resident’s quarters over breakfast </li></ul><ul><li>Handover was adequate, but missed opportunity </li></ul>
    5. 5. The old system
    6. 7. Impetus for change <ul><li>Missed opportunity for education of junior medical staff </li></ul><ul><li>Missed opportunity for “quality assurance” for clinical care </li></ul>
    7. 8. A simple plan… <ul><li>Where? </li></ul><ul><li>Who will attend? </li></ul><ul><li>Who will run it? </li></ul><ul><li>How will it run ? </li></ul><ul><li>What scope of education? </li></ul>
    8. 9. 1. Where? <ul><li>Move away from the resident’s quarters </li></ul><ul><li>Move to a room close to the clinical area that is used also for teaching </li></ul><ul><li>Round table </li></ul>
    9. 10. 2. Who? <ul><li>Registrars and residents </li></ul><ul><ul><li>4 general medical units </li></ul></ul><ul><ul><li>Gastroenterology </li></ul></ul><ul><ul><li>Neurology </li></ul></ul><ul><ul><li>Respiratory </li></ul></ul><ul><ul><li>Adolescent </li></ul></ul><ul><ul><li>Renal </li></ul></ul><ul><ul><li>Endocrinology </li></ul></ul><ul><li>Night staff </li></ul>
    10. 11. 3. Who? <ul><li>The general paediatric fellow </li></ul><ul><li>Consultants </li></ul>
    11. 12. 4. What? <ul><li>Protected time </li></ul><ul><li>Start on time AND finish on time </li></ul><ul><li>Structure </li></ul><ul><ul><li>New admissions </li></ul></ul><ul><ul><li>Problem patients </li></ul></ul><ul><ul><li>Teaching </li></ul></ul>
    12. 13. 5. Scope of education <ul><li>Opportunistic </li></ul><ul><ul><li>Case-based </li></ul></ul><ul><ul><li>Particularly for night staff </li></ul></ul><ul><li>Follow-up </li></ul><ul><ul><li>Prepared presentations </li></ul></ul><ul><ul><li>Timely </li></ul></ul><ul><li>Formal </li></ul>
    13. 14. The new system
    14. 16. Challenges <ul><li>Resistance to a new system </li></ul><ul><li>Trials </li></ul><ul><li>Consultant attendance </li></ul><ul><li>Time </li></ul>
    15. 17. Unexpected benefits <ul><li>Communication with nursing staff </li></ul><ul><li>Access to resident staff </li></ul><ul><ul><li>Patient safety initiatives </li></ul></ul><ul><li>Team morale </li></ul>
    16. 18. Further improvements <ul><li>Technology </li></ul><ul><ul><li>Large screen X-ray viewer </li></ul></ul><ul><ul><li>Patient lists and summaries </li></ul></ul><ul><li>Scheduled education events </li></ul><ul><ul><li>Lectures and presentations from senior medical staff </li></ul></ul>
    17. 19. Thanks <ul><li>General Paediatric fellows </li></ul><ul><ul><li>James Rice 2001 </li></ul></ul><ul><ul><li>Regina Cooke 2002 </li></ul></ul><ul><ul><li>Kai Steinmann 2003 </li></ul></ul><ul><ul><li>Jane Munro 2004 </li></ul></ul><ul><li>Registrars and residents </li></ul>

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