SlideShare una empresa de Scribd logo
1 de 10
Descargar para leer sin conexión
cetiscape
                          CLINICAL EDUCATION
                          & TRAINING INSTITUTE


     Issue 3  February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 1 

Intergenerational health systems: securing a sustainable future
Thursday 10 February 2011, John Loewenthal Auditorium, Westmead Hospital

“The world has changed; we are living longer and the burden
of chronic illness is rising. A revolution in health systems                      Future thinkers at the forum
technology and delivery may be our only hope for future                           	
                                                                                   Centre for Health Innovation and Partnership (CHIP)
generations.” — so read the banner at the Intergenerational
                                                                                  	
                                                                                   Clinical Education and Training Institute (CETI)
Health Systems Forum, an unprecedented gathering of
government, education, community and business groups in                           	
                                                                                   Regional Development Australia-Sydney
western Sydney.                                                                   	
                                                                                   NSW Government Education and Training
The forum sought a common set of directions to address                            	
                                                                                   Western Sydney Institute of Technical and Further
some of the major issues affecting health and community                                Education
care, focusing on the potential of digital technologies to                        	
                                                                                   College of Health Sciences, University of Western
better coordinate, integrate and improve services.                                     Sydney
In his opening remarks, Professor Glen Maberly, Director                          	
                                                                                   Penrith Business Alliance
of the Centre for Health Innovation and Partnership,                              	
                                                                                   Western Sydney Community Forum
reminded everyone that demographic change presented                               	
                                                                                   Western Sydney Local Hospital Network
huge challenges for public budgets, as health care costs                          	
                                                                                   Nepean Blue Mountains Local Hospital Network
(already 28% of the NSW state budget) threatened to grow
unsustainably. Smarter health care was the alternative.
                                                                                digital devices like the iPhone — and what we need to do is
“I will be happy when we stop talking about technology
                                                                                take relatively simple steps to connect health workers to the
and start talking about smart systems,” Professor Steven
                                                                                information potentially available to them.”
Boyages, CETI Chief Executive, said in his address to the
forum. “The technical means for improved health care don’t                      Professor Branko Celler, Dean of the College of Health
have to be invented — they are ubiquitous, on the internet, on                  Sciences at University of Western Sydney, described the




  In this issue
                                                                                	
                                                                                 Safety with injectable medicines                           6
  	
   Intergenerational health systems: securing a sustainable
                                                                                	
                                                                                 Nursing grand rounds via videoconference                   7
     future                                                              1
                                                                                	
                                                                                 Emergency department demand increases                      7
  	
   Postgraduate clinical placements                                      2
                                                                                	 making a difference
                                                                                 HSP                                                        8
  	
   Above and beyond                                                      3
                                                                                	
                                                                                 Survey of General Practitioner Procedural Training
  	
   Scholarships for doctors in rural training                            3
                                                                                    Program                                                 8
  	
   Improving care for patients with osteoporosis                         4
                                                                                	
                                                                                 Diploma of Rehabilitation                                  9
  	
   Coming: 5th NSW Rural Allied Health Conference                        5
                                                                                	
                                                                                 Karma – a prevocational general practice placement
  	
   Coming: NSW Prevocational Medical Education Forum 5                              experience                                            10
  	
   Sepsis kills                                                          6




                                     Building 12, Gladesville Hospital, Victoria Road, Gladesville NSW, 2111            Editor: Craig Bingham
                                     Locked Bag 5022, Gladesville NSW 1675                                              02 9844 6511
              CLINICAL EDUCATION
              & TRAINING INSTITUTE   p: (02) 9844 6551 f: (02) 9844 6544 e: info@ceti.nsw.gov.au                        cbingham@ceti.nsw.gov.au
cetiscape
                             February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 2 
            CLINICAL EDUCATION
                  Issue 3
            & TRAINING INSTITUTE




potential of telehealth to empower patients to manage their                the future as an opportunity for the development of a stronger,
health from homes with the aid of clinicians connected by                  smarter health care industry in Sydney’s west.
phone. He hopes to see a Cooperative Research Centre
                                                                           The forum initiated a wideranging discussion about the
in Telehealth established at UWS to drive evidence-based
                                                                           possibilities for cooperative action to realise smarter health
adoption of this aid to effective and efficient patient care.
                                                                           systems, which many participants saw as resting on “power
Mr Paul Brennan of the Penrith Business Alliance drew                      to the people” — more information for health care consumers,
attention to the health-care corridor that runs from Westmead              and more engagement of consumers in managing their
Hospital to Nepean Hospital, Penrith, taking in UWS and the                health. The positive benefits and potential pitfalls of a patient
western clinical school of Sydney University. This is Sydney’s             controlled electronic health record were debated at length.
demographic centre and an area populated with skilled workers
                                                                           A communiqué issued by the forum will be available soon.
who need local employment. Mr Brennan saw the challenges of


  The destiny of our demography: from pyramid to ... coffin?
  A future with more elderly in the population, and a smaller proportion of workers: demographics cited by Glen Maberly from a Productivity
  Commission report.




Postgraduate clinical placements
When the NSW Health Care Advisory Council met on                           general practice, community settings, specialist and private
Thursday 9 December 2010, CETI Chief Executive Professor                   practice and private hospitals.
Steven Boyages and Dr Marie Louise Stokes presented a                      Several initiatives have already been implemented. Up to 50
report on the increasing numbers of medical graduates in                   prevocational general practice training places in NSW will be
NSW requiring placement for clinical training as the new                   funded by the Commonwealth from 2011, based mainly in
medical schools produce their first graduates.                             rural and regional areas. CETI has developed a streamlined
Provided clinical training opportunities are expanded, there is            accreditation process for general practices and regional training
                                                                           providers wishing to offer clinical placements for junior doctors.
an opportunity for the increase in medical graduate numbers to
address workforce shortages in rural and regional areas, and               CETI’s Rural Division will centrally coordinate the NSW Rural
in disciplines such as general practice, emergency medicine,               General Practitioner Procedural Training Program to support
psychiatry, geriatrics and palliative care. Strategies under               the rural GP procedural workforce.
consideration to increase postgraduate clinical placements                 The Health Care Advisory Council reiterated the importance
include shift rostering, new models of service, increasing the             of developing effective strategies to retain the medical
number of facilities offering placements, and expanding the                graduate workforce in rural areas, and to invest in paediatrics
range of alternative training settings, which could include                and general practice.
cetiscape
                            February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 3 
           CLINICAL EDUCATION
                 Issue 3
           & TRAINING INSTITUTE




Above and beyond
“I will go to any lengths looking for a cure                                     More information about Cure Cancer Australia
for cancer – I’m even prepared to climb                                          can be found at <http://www.cure.org.au>.
mountains!” says Associate Professor
                                                                                 Michael is a longstanding member of
Michael Agrez, a colorectal surgeon at John
                                                                                 CETI’s Prevocational Training Council,
Hunter Hospital, and one of Australia’s
                                                                                 and has recently joined the Prevocational
most dedicated Directors of Prevocational
                                                                                 Accreditation Committee. At John Hunter
Education and Training.
                                                                                 Hospital, he was an early adopter of the
In July, Michael is climbing Kilimanjaro                                         Australian Curriculum Framework for Junior
(Africa’s tallest mountain) to raise money for                                   Doctors, piloting implementation of the
the Cure Cancer Foundation.                                                      framework in new term descriptions and
You can sponsor Michael by visiting                                              reflective portfolios for trainees, and gathering
<https://www.gofundraise.com.au/AgrezM>.                                         new data about the experiences that trainees
                                                                                 gain (or sometimes do not gain) in their core
Cure Cancer Australia commenced in 1967
                                                                                 training terms.
and is an independent Foundation for cancer
research with its own Medical Grants Advisory      Michael Agrez, shown here     Michael’s ambitious climb to conquer cancer
Committee to select projects with the greatest     training for the assault on   is typical of his energy and community spirit,
potential that have been submitted by young        Kilimanjaro in his mountain   and CETI will be cheering him on all the way.
post-doctoral researchers.                         climbing kit.




Scholarships for doctors in rural training                                         CETI :
	 you be working in two or more rural terms this year? Are you
 Will                                                                                        The Clinical Education
   in a CETI network training program?                                                       and Training Institute
	 you can answer yes to both questions then you may be entitled
 If                                                                                          (CETI)EDUCATION
                                                                                              CLINICAL
                                                                                                         is a statutory health
                                                                                              & TRAINING INSTITUTE

   to apply for a rural scholarship of up to $6,000, depending on                            corporation established
   your level of training.                                                                   by the NSW government
The Rural Scholarship Fund supports medical trainees committed to training                   to promote excellence
and providing patient care in rural locations in NSW.                                        in clinical education and
                                                                                             training.
Prevocational (PGY1 or 2), basic physician, paediatric physician, emergency
medicine (new for 2011), pre-specialist surgical and psychiatry (basic and                   CETI collaborates with
advanced) trainees can apply.                                                                universities, colleges,
Applicants must complete a minimum number of regional and/or remote                          clinicalINSTITUTE
                                                                                                         leaders, hospitals,
                                                                                              CLINICAL EDUCATION
                                                                                              & TRAINING

terms in NSW Health facilities in the 2011 clinical year as follows:                         health services and the
	
 Prevocational trainees — 2 terms
                                                                                             community to achieve
                                                                                             better health through
	
 Basic trainees — 2 3-month terms
                                                                                             education, training and
	
 Advanced trainees — a full clinical year.                                                   development of a clinical
Trainees who will complete the minimum number of terms and are in a                          workforce that meets the
CETI networked training program can apply for a rural scholarship. If their                  healthcare needs of the
application is successful they will receive payments of:                                     people of NSW. 
	
 $1500 for prevocational trainees
                                                                                             CETI innovates to improve
	
 $5000 for basic trainees                                                                    communication, capacity
	
 $6000 for advanced trainees.                                                                and competency in health
                                                                                              CLINICAL EDUCATION
                                                                                              & TRAINING INSTITUTE

Applications for the Rural Scholarship Fund open at the end of February and                  care by promoting blended
close on 15 April 2011.                                                                      learning approaches,
                                                                                             including face-to-face
For more information, follow the links on the CETI website or contact Andrea
                                                                                             teaching, simulation and
Ross (02 9844 6530) or Kirsten Campbell (02 9844 6536) at CETI.
                                                                                             e-learning.
cetiscape
                             February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 4 
            CLINICAL EDUCATION
                  Issue 3
            & TRAINING INSTITUTE




Improving care for patients with osteoporosis
CETI is working with the Agency for Clinical Innovation (ACI)
to help bring potentially life-saving preventive care to elderly
patients with brittle bone injuries or fractures. Although the
risk increases with advancing age, the largest impact on the
community is in relation to the relatively young old.
This month ACI and its Musculoskeletal Network launched a
new model of care to prevent the risk of repeat fractures in
patients with osteoporosis.
The bones of people with osteoporosis are fragile and brittle,
with a significantly higher likelihood of fracture from even
minimal impact or injury.
It is estimated that 2.2 million Australians have osteoporosis,         Pictured left to right: Professor Markus Seibel, Professor Lyn
which affects half of all women aged over 60 and one in three           March, Robyn Speerin (Network Manager of ACI’s Musculoskeletal
older men. The economic cost was estimated in 2007 at                   Network), The Hon. Carmel Tebbutt BEc MP, Minister for Health
$7 billion, including more than $1.5 billion in direct health costs.    and Deputy Premier, and Professor John Eisman. Photo: ACI.
About half of all patients who have one osteoporotic bone
fracture will have another.
                                                                       support for junior doctors at the front line to identify,
In NSW, 35% of patients who were admitted to hospital with             investigate and treat patients with osteoporosis.
a minimal trauma fracture between 2002 and 2008 were
                                                                       A working group has been convened to develop a curriculum
subsequently admitted to the same hospital with a refracture.
                                                                       under the leadership of Orthopaedic Surgeon Dr Kerin
This accounted for 16,225 admissions, with an average
                                                                       Fielding, with representation from endocrinology, rheumatology,
length of stay of 22 days. These data do not include patients
                                                                       gerontology, falls prevention, curriculum development and
admitted with a refracture to a different hospital.
                                                                       information technology. The web-based curriculum is close to
Many people who have multiple osteoporotic fractures have              completion and will be available to NSW Health staff online.
ongoing pain and disability, reduced quality of life and die           Users will be able to work their way through topics at their own
prematurely.                                                           pace and at any time of the day or night.
While the increased risk of refracture is well known and               The Chief Executive of ACI, Dr Hunter Watt, said the new
evidence-based guidelines highlight the need to intervene at           model of care addressed one of the biggest health issues for
the time of the first fracture, in far too many cases it is simply     elderly people in NSW.
not happening.
                                                                       “This is a huge issue. People who suffer osteoporotic fractures
National audits have repeatedly shown that only 20%–30%                often are faced with chronic pain, are less able to manage
of female patients, and even fewer male patients, are being            activities of daily living, and risk losing their independence and
identified at first fracture for preventive care. This means           developing other chronic conditions because of immobility. Their
that more than four out of five people presenting at health            risk of premature death also is very real.”
services with an osteoporotic fracture are being denied the
                                                                       “ACI funded this model-of-care project and the
health benefits of effective fracture prevention.
                                                                       Musculoskeletal Network worked with medical, nursing and
The NSW Model of Care for Osteoporotic Refracture                      allied health clinicians and consumers from across the State,
Prevention is an easy-to-use guide to best practice care for           as well as stakeholder groups such as Arthritis NSW and
doctors, nurses, other health professionals and managers               Osteoporosis NSW, to make it happen.”
across the NSW health system. It aims to ensure that all
                                                                       “The challenge now is implementation and we are delighted
patients presenting with brittle bone fracture are assessed and
                                                                       that CETI is working so closely with us on the need to
offered advice and treatment to prevent further fractures. This
                                                                       educate front-line clinicians.”
may include bone density scanning, measurement of vitamin
D levels, assessment of calcium intake and thyroid function,           Professor Lyn March, a senior rheumatologist from Royal
disease management advice and self management support.                 North Shore Hospital and one of the authors of the
                                                                       guide, said it was designed to address a very real area of
High quality services already are in place at Concord, St
                                                                       underperformance in the health system.
Vincent’s, Royal Prince Alfred, Royal Newcastle Centre and
the Mid North Coast Local Health Network.                              “It is not acceptable that when the markers are so clear and
                                                                       so much can be done to prevent refracture, so many people
CETI is working with ACI to address one of the keys to
                                                                       with osteoporosis continue to miss out.”
implementation of the model of care — education and
cetiscape
                             February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 5 
            CLINICAL EDUCATION
                  Issue 3
            & TRAINING INSTITUTE




“That is condemning many thousands of people to a future of          families. Why wouldn’t you do it? I am delighted that we are
pain, inability to perform normal activities of daily living, loss   now at the implementation stage.”
of independence, developing other chronic diseases and
                                                                     “Early identification of people in NSW who have osteoporosis
dying prematurely.”
                                                                     is a critical component of the new model of care because it
“It also means that Australians continue to pay billions of          will enable early treatment, which can reduce further fractures
dollars in health care costs and loss of productivity for issues     by up to 50%.”
that can be prevented.”
“This model of care has been shown in many trials, including in
Australia, to reduce medical complications, reduce readmissions
to hospital and reduce the number of premature deaths. It also
has been shown to improve quality of life of individuals and their




Coming events
                                                               îStrong foundations in shifting sands
                                                                     5th NSW Rural Allied Health Conference
                                                                     The Glasshouse, Port Macquarie, 9–11 November 2011

î
Principles and practice
NSW Prevocational Medical Education Forum
                                                                     Proudly presented by CETI’s Rural Division
                                                                     Rural allied health services bring together a blend of
11–12 August 2011
                                                                     multidisciplinary skills requiring a flexible approach to
At this year’s prevocational forum, medical educators,               cooperation, coordination and collaboration. Interdisciplinary
directors of training and administrators will share their            rural health partnerships have become strong foundations
experience, workshop the issues that matter and hear                 which will continue to sustain quality care in shifting sands,
practical advice from leaders in JMO education.                      the transitional period of the current national health reform.

In 2010, CETI commissioned an external review of the                 This conference will provide an opportunity for all allied health
prevocational training networks. In November, the review             staff, managers and education
team reported that it “found an extra-ordinary level of              providers to demonstrate
commitment of individuals and institutions at all levels to          how collaborative health
prevocational training across the NSW health system.”                partnerships create models of
                                                                     care which achieve positive
The team delivered inspiring recommendations for renovation          patient journeys.
of prevocational training that it hoped would multiply the
                                                                     This conference is designed
effectiveness of this commitment. During 2011, CETI is working
                                                                     to attract rural and remote
with its partners in the local health networks to unlock the
                                                                     allied health clinicians from new graduates to senior
potential identified in the review.
                                                                     managers, and those who work in partnership with allied
                                                                     health services.
On the agenda
	 learning model in prevocational training: who learns
  The                                                                Pre-conference workshops
    what, when, how.
                                                                     There will be a choice of pre-conference workshops to attend
	
 Tuning the networks for smoother performance                        on Tuesday 8 and Wednesday 9 November. Come along,
	
 Workable methods of assessing trainees and evaluating               share experiences and take home some practical information
    programs: building better feedback                               to put straight into practice with your team.
	
 Maximising the benefit of general practice training terms
                                                                     Call for abstracts in March
	
 Innovations in training and education.
                                                                     In March authors will be invited to submit an abstract relevant
For more information, please contact Craig Bingham
                                                                     to the theme Strong Foundations in Shifting Sands, using
(02 9844 6511, cbingham@ceti.nsw.gov.au) or visit the
                                                                     examples of established rural collaborative partnerships
website <www.ceti.nsw.gov.au/prevocational>.                         which achieve positive patient outcomes. First time
                                                                     presenters welcome.
                                                                     For more information please contact Jenny Preece (02 6692
                                                                     7716, jenny.preece@ncahs.health.nsw.gov.au) or visit the
                                                                     website <www.ircst.health.nsw.gov.au>.
cetiscape
                             February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 6 
            CLINICAL EDUCATION
                  Issue 3
            & TRAINING INSTITUTE




Sepsis kills
ACI and CEC joint project to improve the recognition and
management of severe infection and sepsis

Appropriate and timely recognition and management of                 A pilot study using the draft
patients with sepsis is a significant problem in healthcare.         sepsis pathway and a staff
Sepsis is associated with high morbidity and mortality; severe       education program has been
sepsis and septic shock have a mortality of around 25%.1 In          undertaken in emergency
another study, the mortality rate for patients with septic shock     departments at John Hunter,
increased by 7.6% for every hour of delay in commencing              Liverpool, Concord and Prince
antibiotic therapy.2                                                 of Wales Hospitals. Preliminary
                                                                     audit results have been very encouraging, with a marked
Sepsis has been identified by the NSW Root Cause Analysis
                                                                     reduction in time to administration of intravenous antibiotics
Review Committee as a recurrent emerging problem. The
                                                                     and heightened staff awareness of sepsis and the need for
Clinical Excellence Commission Clinical Focus Report on the
                                                                     prompt treatment. There has been wide consultation with
Recognition and Management of Sepsis3 found significant
                                                                     rural clinical groups and the pilot study is being extended to a
deficits in a range of clinical settings, with a higher proportion
                                                                     rural site. Staff feedback from the pilot study and audit results
of problems being reported in the emergency department.
                                                                     are informing the finalisation of the draft sepsis pathway,
Key clinicians and other experts have identified improving           education resources and project support for the state-wide
recognition and management of sepsis as a high priority              implementation in May 2011.
for local health networks. In response, the Agency for
                                                                     For more information please contact Dr Tony Burrell, Director
Clinical Innovation and Clinical Excellence Commission
                                                                     Patient Safety (02 9269 5550, tony.burrell@cec.health.nsw.
are collaborating with the newly-formed Emergency
                                                                     gov.au) or Mary Fullick, Project Manager (02 9269 5542,
Care Institute on a joint initiative. The project will enable
                                                                     mary.fullick@cec.health.nsw.gov.au).
a consensus approach to improving the recognition and
management of sepsis at a state level.                               1 The Australasian Resuscitation in Sepsis Evaluation (ARISE) Investigators
                                                                       and the Australian and New Zealand Intensive Care Society (ANZICS) Adult
The goals for the project are to reduce preventable harm to            Patient Database (APD) Management Committee. The outcome of patients
                                                                       with sepsis and septic shock presenting to emergency departments in
patients through early recognition of sepsis, appropriate fluid
                                                                       Australia and New Zealand. Critical Care and Resuscitation 2007; 9: 8-18.
resuscitation and reduced time to administration of antibiotics.
                                                                     2 Kumar A, Roberts D, Wood KE, et al. Duration of hypotension before initiation
Phase 1 of the project will focus on emergency departments
                                                                       of effective antimicrobial therapy is the critical determinant of survival in
and Phase 2 will focus on improving the recognition and                human septic shock. Critical Care Medicine 2006; 34: 1589-1596.
management of sepsis for inpatients. Education for junior staff      3 Clinical Excellence Commission, 2009.
will be a key component of the project.
A generic adult sepsis pathway has been developed
following wide clinical consultation. The pathway aims
to support recognition of severe infection and sepsis in
the emergency setting and to give clear guidelines for
notification, escalation and initial management. The sepsis          Safety with injectable medicines
pathway promotes:
                                                                     New National Recommendations for User-applied Labelling
	 flagging of severe infection and sepsis at triage
 early                                                               of Injectable Medicines, Fluids and Lines propose standards
	
 involvement of senior clinicians in diagnosis and                   for handling injectable medicines to ensure that patients
   management                                                        are never inadvertently injected with the wrong medicine or
	
 appropriate and timely fluid resuscitation                          injected by the wrong route.
	
 prompt administration of antibiotics (goal is within one            The recommendations and support materials can be found
   hour of triage)                                                   at <http://www.health.gov.au/internet/safety/publishing.nsf/
	
 serum lactate monitoring to assist diagnosis and ongoing            Content/PriorityProgram-06_UaLIMFL>
   monitoring                                                        CETI supports this initiative and is consulting with its partners
	
 referral of care to appropriate clinical teams, including           in the NSW health system to ensure that clinical training has
   retrieval if appropriate.                                         embraced the labelling standards.
cetiscape
                            February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 7 
           CLINICAL EDUCATION
                 Issue 3
           & TRAINING INSTITUTE




Nursing grand rounds via videoconference
Jenny Preece
Rural and Remote Health Project Officer, CETI Rural Division, Dorrigo Multi-Purpose Service

In 2008, NSW Health Nursing Office, in collaboration with         Evaluation of NCAHS nursing grand rounds at 18 months has
the NSW Institute of Rural Clinical Services and Teaching         found that networking with peers, nurses educating nurses and
(IRCST, now the CETI Rural Division) identified mentoring         sharing experiences in the management of actual cases has
and supervision of rural and remote nursing staff from            been a very practical approach to focusing on best practice.
smaller facilities across NSW as an area to be addressed,         Reflection on team and individual clinical practice and identifying
particularly where triaging and initial emergency management      lessons learned from each episode of care has often influenced
of patients is frequently undertaken in the absence of a          change in clinical processes. The regular communication
medical officer.                                                  between sites has created an accepted form of peer review.
                                                                  Isolated rural nurses feel more comfortable sharing and
In 2009, IRCST introduced rural and remote nursing grand
rounds via videoconference linking nurses from eight              analysing experiences with professionally isolated colleagues
isolated health facilities in North Coast Area Health Service     and comment they now feel part of an extended team.
(NCAHS) for generalist case presentations and discussion of       Over time, the operational framework developed in NCAHS
interesting or challenging patient journeys of relevance to the   was consolidated into an implementation toolkit to enable the
rural setting. Nurses are rostered monthly to present a patient   spread of nursing grand rounds across NSW.
journey for discussion, with guest speakers presenting a
case-based inservice at regular intervals as an educational       Rural and remote nursing grand rounds via videoconference
component. Presentations can involve the use of PowerPoint        have now expanded to include smaller sites across the
or simply tell the patient story. Keeping the sessions case-      former Greater Western Area Health and Greater Southern
oriented — a rural patient’s story told by rural nurses —         Area Health Services, with Hunter New England proposing to
ensures that discussions are relevant and meaningful.             implement the program in 2011.




Emergency department
demand increases
The recent “Christmas rush” in NSW public hospital                There is typically less elective surgery performed in public
emergency departments was intense, with the number of             hospitals towards the end of each year and this held true in
patients seen eclipsing those treated at the height of the        2010. The proportion of patients receiving elective surgery
2009 swine flu pandemic.                                          on time remained stable and there has been a decrease
                                                                  since last quarter in the time patients wait for non-urgent
More than half a million patients attended NSW emergency
                                                                  surgery. Wait times for urgent and semi-urgent elective
departments from October to December 2010, according to
                                                                  surgery have remained relatively unchanged.
Hospital Quarterly, Issue 3, the most recent report from the
Bureau of Health Information. This is nearly 30,000 more than     The report and related materials, including performance profiles
in the previous quarter, nearly 21,000 more than the same time    for individual hospitals, are available at <www.bhi.nsw.gov.au>.
last year, and nearly 18,000 more than in July to September
2009, when the swine flu pandemic was at its peak.
Bureau Chief Executive Dr Diane Watson said attendances
during the quarter were at a two-year high, with increased
numbers generally seen across October and November                          UM
                                                                                      Need the advice, support or creative
                                                                         FOR
as well as a Christmas holiday spike. In the face of extra           JMO              thinking of a representative group
pressure, emergency departments generally held their                NEW SOUTH WALES
                                                                                      of junior doctors?
performance. Patients were seen within recommended time
frames for all triage categories, except triage category 3          Contact the JMO Forum via CETI’s Prevocational
(patients with a potentially life threatening condition).           Program Coordinator: Craig Bingham
                                                                    (cbingham@ceti.nsw.gov.au, 9844 6511).
cetiscape
                             February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 8 
            CLINICAL EDUCATION
                  Issue 3
            & TRAINING INSTITUTE




HSP making a difference
                 Dr Simon Leslie, Medical Director at                 He now feels much
                 Shellharbour Hospital and Chair of the               less threatened and
                 Hospital Skills Program State Training                                           HOSPITAL SKILLS PROGRAM
                                                                      understands that he
                 Council, reports.                                    is being supported to       Three hundred and fifteen medical
                   One of our CMOs thanked me yesterday,              improve and will not be     officers are now enrolled in
                   enthused about the Hospital Skills Program         unfairly judged. He feels   CETI’s Hospital Skills Program
                   (HSP) and the benefits to him. He had just         part of a group that is     and are enjoying the benefits
                   attended a half day in theatres re-skilling in     learning and improving      of more training opportunities,
                   airway management and could not speak highly       together. He has greater    better recognition and an
                                                                                                  improved career pathway. For
enough of the experience and the benefits to him. He was also         enthusiasm for work and
                                                                                                  more information, speak to Acting
full of praise for the education day last week at Wollongong          continuing professional
                                                                                                  Program Coordinator Alpana
University and also for the simulation course he was sent to          development, he has         Singh (02 9844 6551, asingh@
attend at Royal North Shore Hospital last year. His face was          engaged with other          ceti.nsw.gov.au) or visit <www.
beaming and he was obviously very excited.                            team members and            ceti.nsw.gov.au/hospitalskills>.
This was a doctor who before the HSP had worked solely                become willing to work
on weekends, feeling isolated and even somewhat paranoid              at any time of the week.
because his only contact with “administration” in the past            This is just one example of how the Hospital Skills Program is
was with regard to complaints about him. His habit was to             making a difference for our doctors.
avoid any oversight or scrutiny and his resultant negative
attitude affected his relationship with other staff.




Survey of General Practitioner Procedural Training Program
The GP Procedural Training Program is being evaluated                 Feedback gained from the survey will inform the future growth
through a survey of participants.                                     and development of the program, enhancing its contribution
                                                                      to a sustainable rural GP procedural workforce.
The program, now coordinated through the CETI Rural
Division, has had 285 participants since 2003. It provides            Ms Linda Cutler is the Executive Director of the program
GPs and GP registrars with experience in procedural general           which was transferred to the Rural and Remote Division
practice to equip them to practise in rural NSW. Participants         of CETI in December 2010. Many will recall that Linda is
                                                                      the former Executive Director of the NSW Institute of Rural
train on a full time, part-time or flexible basis in rural training
                                                                      Clinical Services & Teaching (IRCST), which has now been
hospitals in one or more of the following five specialties:
                                                                      brought under the CETI umbrella.
	
 Anaesthetics
                                                                      For more information about the survey or the GP Procedural
	
 Emergency Medicine
                                                                      Training Program, contact: Margaret Starr, Program
	
 Obstetrics                                                           Coordinator, CETI (02 9844 6548, mstarr@ceti.nsw.gov.au).
	
 Surgery
	
 Mental Health.
The survey of participants who have completed their training
will be conducted by the NSW Health Department’s trained
telephone interviewers. The survey asks about:
	 trainee’s experience of the program and the extent to
 the
   which they are currently using the skills gained though the
   training
	 the program has contributed to the GP procedural
 how
   workforce in NSW
	 the program has contributed to participants’ career
 how
                                                                                                     16th Australasian
   decisions                                                                                         Prevocational Medical Education Forum
                                                                                                     6-9 November 2011 Auckland, New Zealand
	
 suggestions for improving the program.
cetiscape
                            February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 9 
           CLINICAL EDUCATION
                 Issue 3
           & TRAINING INSTITUTE




New Diploma of Rehabilitation
Sue Steele-Smith
Education Consultant and Manager, Royal Rehabilitation College
Royal Rehabilitation Centre Sydney


The Royal Rehabilitation College                                                         The diploma also provides an
has developed a unique, nationally                                                       opportunity for specialised training of
recognised Diploma of Rehabilitation.                                                    allied health assistants to meet the
The diploma provides a practical,                                                        increasing demand for rehabilitation
multidisciplinary, flexible, accessible                                                  services due to the ageing and
and relevant program for those                                                           growing population.
seeking an accredited qualification in
                                                                                         The Royal Rehabilitation College
rehabilitation.
                                                                                         is a health-industry-based private
The Royal Rehabilitation College was                                                     registered training organisation that
able to gain national accreditation for                                                  is part of the Royal Rehabilitation
this course because an equivalent                                                        Centre Sydney. The college
multidisciplinary course did not exist                                                   specialises in the training and
within Australia.                                                                        assessment of the Certificate IV
                                                                                         in Allied Health Assistance, with
The diploma is a self-paced course
                                                                                         over 200 participants nationally.
offered by distance education,
                                                                                         This experience with clinicians
which provides the greatest flexibility
                                                                                         throughout NSW and Australia has
around participant needs. The
                                                                                         highlighted the need for specific
course content was developed by
                                                                                         practical training in rehabilitation.
experienced rehabilitation clinicians
                                                                                         The concept, development and
working at the Royal Rehabilitation
                                                                                         accreditation of the Diploma of
Centre Sydney. Core units provide
                                           Rehab in action.                              Rehabilitation is the result of this
the foundation for working in a
                                                                                         experience.
rehabilitation environment, while
there are elective options in spinal                                                     The Royal Rehabilitation Centre
injury, neurology, cardiopulmonary,                                                      Sydney provides specialist
orthopaedics, oncology, community,                                                       rehabilitation and disability services
mental health and aged care. There                                                       for people with complex and long
are also units on goal-directed care,                                                    term health care needs, traumatic
health promotion and prevention and                                                      brain injury and spinal cord injury.
research skills.                                                                         Royal Rehab engages in extensive
                                                                                         education and research to improve
The diploma provides an opportunity
                                                                                         the rehabilitation outcomes for its
to refresh and enhance skills or
                                                                                         clients and, as a teaching hospital,
to retrain. It provides professional
                                                                                         Royal Rehab has strong partnerships
development with a practical
                                                                                         with the University of Sydney’s
rehabilitation focus and a chance
                                                                                         academic units.
to enhance skills and knowledge of
new areas of rehabilitation within an                                                    Registrations for the Diploma of
interdisciplinary learning environment.                                                  Rehabilitation are now open for
Support for this distance course                                                         2011. For further information on
has come from clinicians working                                                         this fantastic learning opportunity
in rehabilitation who are interested                                                     contact Royal Rehabilitation College
in validating their skills or who are                                                    (02 9808 9626, enquiries@
returning to the workforce after                                                         royalrehab.com.au) or see
extended leave, and from others                                                          <www.royalrehab.com.au/college/
interested in moving into rehabilitation                                                 courses.html>.
from another speciality.                   Spinal rehabilitation.
cetiscape
                             February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 10 
            CLINICAL EDUCATION
                  Issue 3
            & TRAINING INSTITUTE




Karma — a prevocational general practice placement experience
                        Stella Tang was a Resident Medical                     complex care that demands medical prioritisation of their
                        Officer at Westmead Hospital when                      chronic conditions. How can someone learn this without the
                        she did a term in general practice. She                exposure and the appropriate guidance?
                        is now a general practice registrar in
                                                                               My time at TMC provided broad-based teaching and insight
                        Westnet network.
                                                                               into how our health care system works. It encompassed more
                      The first day of my PGPPP term I                         dedicated one-on-one teaching by passionate mentors on a
                      found myself wondering if I had made                     vast range of medical subspecialties than any other medical
                      a HUGE mistake in choosing a general                     terms I have experienced. This was surrounded by a familial
                      practice rotation. The last two years of                 environment of comradeship and up-to-date medical practice in
                      my hospital training had disciplined me                  weekly clinical “grand-round” meetings of case presentations, in
                      into an efficient and effective discharging              addition to access to quality nursing and allied health services
                      machine moulded by the likings of                        on site (diabetic educator, podiatrist, psychotherapist, mental
consultants and their specialities. The words “follow up with                  health nurse). This was a term that developed my confidence
your GP”, “that’s something your GP can look into”, “discuss                   in patient management and also fine-tuned my clinical and
that with your GP, it’s not an emergency problem”, “Your                       interpersonal skills in diagnosing, interpreting and managing
GP can refer you”, flashed before my eyes, and I began to                      common medical problems.
wonder if this was Karma.
                                                                               I found it rewarding to see the outcome of my decisions
As inconceivable as it may be to some, I found myself being                    through continued and ongoing patient care, but my term
drawn into the complexities and value of community-based                       in general practice also emphasised the importance of
teaching in my placement at Toormina Medical Centre (TMC).                     establishing a good work and life balance. The freedom it
Now I wonder why general practice isn’t a core rotation, as it is              provided with organising my own patient load, having devoted
the only “speciality” that treats the patient as a whole, not just             lunch breaks and the regularity of working “normal” office
in bits. General practice is the integral hub that interacts with all          hours was a stupendous luxury after the last two years of
these specialities (the ‘bits’). It’s the speciality that witnesses a          unrostered overtimes. All in all, I cannot fault this rotation and
patient’s journey from birth to death and the speciality that has              regardless of what “specialist” training you are endeavouring
the privilege to treat all the generations of a family at one time.            to strive towards “holistic” patient care such as I was learning
                                                                               and practising at TMC is what good medicine is about, and
Our core population in healthcare is ageing day by day as our
                                                                               good medicine is what good doctors practice.
advances in medical intervention continue. This means that
our patients not only have multiple morbidities, but require                   After all, there’s Karma …




  cetiscape is published monthly by email and online:                          The submission deadline for each issue is the middle of
  www.ceti.nsw.gov.au/cetiscape                                                the month. Articles can be submitted as Word documents.
                                                                               Pictures and logos should be sent separately, using the
                                                                               best available file. For logos, this is often an EPS file.
  Contributions: cetiscape invites contributions on all                        Picture files should be sent at the highest resolution
  aspects of clinical education and training, in particular:                   available.
  	
   Short news stories: achievements, launches, events.                         Articles submitted to cetiscape are subject to editing
      (100 to 300 words, photos and illustrations desirable)                   (proofs are shown to the authors).
  	
   Reviews or editorials commenting upon issues related
      to health workforce education, training and development                  To subscribe or unsubscribe:
      (300 to 1000 words, photos and illustrations desirable).                 email cbingham@ceti.nsw.gov.au



                                    Building 12, Gladesville Hospital, Victoria Road, Gladesville NSW, 2111               Editor: Craig Bingham
                                    Locked Bag 5022, Gladesville NSW 1675                                                 02 9844 6511
             CLINICAL EDUCATION
             & TRAINING INSTITUTE   p: (02) 9844 6551 f: (02) 9844 6544 e: info@ceti.nsw.gov.au                           cbingham@ceti.nsw.gov.au

Más contenido relacionado

La actualidad más candente

Cancer Care Congress Latest Agenda
Cancer Care Congress Latest AgendaCancer Care Congress Latest Agenda
Cancer Care Congress Latest Agendakatewarner
 
Health Care Unbound- july 2010 - San Diego
Health Care Unbound- july 2010 - San DiegoHealth Care Unbound- july 2010 - San Diego
Health Care Unbound- july 2010 - San DiegoHAPPYneuron, Inc.
 
Intergenerational health systems program
Intergenerational health systems programIntergenerational health systems program
Intergenerational health systems programCETIshare
 
Aidstar one case-study_linkingart_india
Aidstar one case-study_linkingart_indiaAidstar one case-study_linkingart_india
Aidstar one case-study_linkingart_indiaAIDSTAROne
 
Simplyhealth back care factsheet for buisnesses
Simplyhealth back care factsheet for buisnessesSimplyhealth back care factsheet for buisnesses
Simplyhealth back care factsheet for buisnessesSimplyhealthUK
 
3.0 felissa goldstein schoolpresentationfor gpt32013
3.0 felissa goldstein schoolpresentationfor gpt320133.0 felissa goldstein schoolpresentationfor gpt32013
3.0 felissa goldstein schoolpresentationfor gpt32013Samantha Haas
 
Gwen O´Shaughnessy - USA - Wednesday 30 - Oral Presentations Misc. B
Gwen O´Shaughnessy - USA - Wednesday 30 - Oral Presentations Misc. BGwen O´Shaughnessy - USA - Wednesday 30 - Oral Presentations Misc. B
Gwen O´Shaughnessy - USA - Wednesday 30 - Oral Presentations Misc. Bincucai_isodp
 
WCMT Fellowship Report - Specialist Spinal Vocational Rehabilitation
WCMT Fellowship Report - Specialist Spinal Vocational RehabilitationWCMT Fellowship Report - Specialist Spinal Vocational Rehabilitation
WCMT Fellowship Report - Specialist Spinal Vocational RehabilitationMelissa Kelly
 
NWL NHS Hospital Consultation, 2012
NWL NHS Hospital Consultation, 2012NWL NHS Hospital Consultation, 2012
NWL NHS Hospital Consultation, 2012Keith Marshall
 

La actualidad más candente (10)

Cancer Care Congress Latest Agenda
Cancer Care Congress Latest AgendaCancer Care Congress Latest Agenda
Cancer Care Congress Latest Agenda
 
Health Care Unbound- july 2010 - San Diego
Health Care Unbound- july 2010 - San DiegoHealth Care Unbound- july 2010 - San Diego
Health Care Unbound- july 2010 - San Diego
 
Tb ihomeless final
Tb ihomeless finalTb ihomeless final
Tb ihomeless final
 
Intergenerational health systems program
Intergenerational health systems programIntergenerational health systems program
Intergenerational health systems program
 
Aidstar one case-study_linkingart_india
Aidstar one case-study_linkingart_indiaAidstar one case-study_linkingart_india
Aidstar one case-study_linkingart_india
 
Simplyhealth back care factsheet for buisnesses
Simplyhealth back care factsheet for buisnessesSimplyhealth back care factsheet for buisnesses
Simplyhealth back care factsheet for buisnesses
 
3.0 felissa goldstein schoolpresentationfor gpt32013
3.0 felissa goldstein schoolpresentationfor gpt320133.0 felissa goldstein schoolpresentationfor gpt32013
3.0 felissa goldstein schoolpresentationfor gpt32013
 
Gwen O´Shaughnessy - USA - Wednesday 30 - Oral Presentations Misc. B
Gwen O´Shaughnessy - USA - Wednesday 30 - Oral Presentations Misc. BGwen O´Shaughnessy - USA - Wednesday 30 - Oral Presentations Misc. B
Gwen O´Shaughnessy - USA - Wednesday 30 - Oral Presentations Misc. B
 
WCMT Fellowship Report - Specialist Spinal Vocational Rehabilitation
WCMT Fellowship Report - Specialist Spinal Vocational RehabilitationWCMT Fellowship Report - Specialist Spinal Vocational Rehabilitation
WCMT Fellowship Report - Specialist Spinal Vocational Rehabilitation
 
NWL NHS Hospital Consultation, 2012
NWL NHS Hospital Consultation, 2012NWL NHS Hospital Consultation, 2012
NWL NHS Hospital Consultation, 2012
 

Similar a Cetiscape 3 February 2011

CETI Allied Health Directorate
CETI Allied Health DirectorateCETI Allied Health Directorate
CETI Allied Health DirectorateHealthXn
 
Patient Flow Safety
Patient Flow SafetyPatient Flow Safety
Patient Flow Safetyprimary
 
Building the evidence: developing the winning principles for children and you...
Building the evidence: developing the winning principles for children and you...Building the evidence: developing the winning principles for children and you...
Building the evidence: developing the winning principles for children and you...NHS Improvement
 
Future of Healthcare - Crown Point - Interprofessional Teams
Future of Healthcare - Crown Point - Interprofessional TeamsFuture of Healthcare - Crown Point - Interprofessional Teams
Future of Healthcare - Crown Point - Interprofessional Teamsusffw
 
Mass HIway Implementation Grants Presentation - March 2013
Mass HIway Implementation Grants Presentation - March 2013Mass HIway Implementation Grants Presentation - March 2013
Mass HIway Implementation Grants Presentation - March 2013Think DCS
 
Healthy Ageing, Chronic Disease Management, and Co-production of Health and C...
Healthy Ageing, Chronic Disease Management, and Co-production of Health and C...Healthy Ageing, Chronic Disease Management, and Co-production of Health and C...
Healthy Ageing, Chronic Disease Management, and Co-production of Health and C...MCIHealthyLiving
 
Intergrated public health care model ppp case study in kenya
Intergrated public health care model  ppp case study in kenyaIntergrated public health care model  ppp case study in kenya
Intergrated public health care model ppp case study in kenyaeastafricaphilanthropy
 
Strengthening health systems for equitable eye care
Strengthening health systems for equitable eye careStrengthening health systems for equitable eye care
Strengthening health systems for equitable eye careSandeep Buttan
 
R bleddyn v rees international opportunities for healthcare services, researc...
R bleddyn v rees international opportunities for healthcare services, researc...R bleddyn v rees international opportunities for healthcare services, researc...
R bleddyn v rees international opportunities for healthcare services, researc...angewatkins
 

Similar a Cetiscape 3 February 2011 (20)

Cetiscape 6 July 2011
Cetiscape 6 July 2011 Cetiscape 6 July 2011
Cetiscape 6 July 2011
 
Cetiscape 1 October 2010
Cetiscape 1 October 2010 Cetiscape 1 October 2010
Cetiscape 1 October 2010
 
Cetiscape 5 May 2011
Cetiscape 5 May 2011Cetiscape 5 May 2011
Cetiscape 5 May 2011
 
CETI Allied Health Directorate
CETI Allied Health DirectorateCETI Allied Health Directorate
CETI Allied Health Directorate
 
Patient Flow Safety
Patient Flow SafetyPatient Flow Safety
Patient Flow Safety
 
Allied Health Future Directions
Allied Health Future DirectionsAllied Health Future Directions
Allied Health Future Directions
 
Cetiscape 7 Oct 2011
Cetiscape 7 Oct 2011Cetiscape 7 Oct 2011
Cetiscape 7 Oct 2011
 
Superguide (Medical)
Superguide  (Medical)Superguide  (Medical)
Superguide (Medical)
 
Ceti Team Health Future Directions
Ceti Team Health Future DirectionsCeti Team Health Future Directions
Ceti Team Health Future Directions
 
Building the evidence: developing the winning principles for children and you...
Building the evidence: developing the winning principles for children and you...Building the evidence: developing the winning principles for children and you...
Building the evidence: developing the winning principles for children and you...
 
Allied Health Superguide
Allied Health SuperguideAllied Health Superguide
Allied Health Superguide
 
Future of Healthcare - Crown Point - Interprofessional Teams
Future of Healthcare - Crown Point - Interprofessional TeamsFuture of Healthcare - Crown Point - Interprofessional Teams
Future of Healthcare - Crown Point - Interprofessional Teams
 
Mass HIway Implementation Grants Presentation - March 2013
Mass HIway Implementation Grants Presentation - March 2013Mass HIway Implementation Grants Presentation - March 2013
Mass HIway Implementation Grants Presentation - March 2013
 
Healthy Ageing, Chronic Disease Management, and Co-production of Health and C...
Healthy Ageing, Chronic Disease Management, and Co-production of Health and C...Healthy Ageing, Chronic Disease Management, and Co-production of Health and C...
Healthy Ageing, Chronic Disease Management, and Co-production of Health and C...
 
Intergrated public health care model ppp case study in kenya
Intergrated public health care model  ppp case study in kenyaIntergrated public health care model  ppp case study in kenya
Intergrated public health care model ppp case study in kenya
 
HMSC - A Health Management System Collaborative
HMSC - A Health Management System CollaborativeHMSC - A Health Management System Collaborative
HMSC - A Health Management System Collaborative
 
SDC @ HeN 12 - Prof Mick Reid
SDC @ HeN 12 - Prof Mick ReidSDC @ HeN 12 - Prof Mick Reid
SDC @ HeN 12 - Prof Mick Reid
 
07
0707
07
 
Strengthening health systems for equitable eye care
Strengthening health systems for equitable eye careStrengthening health systems for equitable eye care
Strengthening health systems for equitable eye care
 
R bleddyn v rees international opportunities for healthcare services, researc...
R bleddyn v rees international opportunities for healthcare services, researc...R bleddyn v rees international opportunities for healthcare services, researc...
R bleddyn v rees international opportunities for healthcare services, researc...
 

Más de Health Education & Training Institute

Más de Health Education & Training Institute (20)

CETI Annual Report 2011
CETI Annual Report 2011CETI Annual Report 2011
CETI Annual Report 2011
 
Independent Panel Garling Review Progress
Independent Panel Garling Review ProgressIndependent Panel Garling Review Progress
Independent Panel Garling Review Progress
 
White Ribbon Day 2011
White Ribbon Day 2011White Ribbon Day 2011
White Ribbon Day 2011
 
Criterion Based Assessment Forms
Criterion Based Assessment FormsCriterion Based Assessment Forms
Criterion Based Assessment Forms
 
Trainee Led Initiatives
Trainee Led InitiativesTrainee Led Initiatives
Trainee Led Initiatives
 
NSW Health and Medical Research Strategic Review
NSW Health and Medical Research Strategic ReviewNSW Health and Medical Research Strategic Review
NSW Health and Medical Research Strategic Review
 
Prevocational Medical Educational Forum
Prevocational Medical Educational ForumPrevocational Medical Educational Forum
Prevocational Medical Educational Forum
 
Associate Professor Peter Procopis presentation
Associate Professor Peter Procopis presentationAssociate Professor Peter Procopis presentation
Associate Professor Peter Procopis presentation
 
Accreditation Presentation
Accreditation PresentationAccreditation Presentation
Accreditation Presentation
 
Gaynor Heading Presentation
Gaynor Heading PresentationGaynor Heading Presentation
Gaynor Heading Presentation
 
Craig Bingham & Ros Crampton Presentation
Craig Bingham & Ros Crampton PresentationCraig Bingham & Ros Crampton Presentation
Craig Bingham & Ros Crampton Presentation
 
World Premier NSWHETI Media Repository
World Premier NSWHETI Media RepositoryWorld Premier NSWHETI Media Repository
World Premier NSWHETI Media Repository
 
HSP Orientation Manual 2011
HSP Orientation Manual 2011HSP Orientation Manual 2011
HSP Orientation Manual 2011
 
HSP Core Skills Module
HSP Core Skills ModuleHSP Core Skills Module
HSP Core Skills Module
 
HSP Emergency Department Module
HSP Emergency Department Module HSP Emergency Department Module
HSP Emergency Department Module
 
HSP Mental Health Module
HSP Mental Health ModuleHSP Mental Health Module
HSP Mental Health Module
 
Hospital Skills Program Aged Care Curriculum
Hospital Skills Program  Aged Care CurriculumHospital Skills Program  Aged Care Curriculum
Hospital Skills Program Aged Care Curriculum
 
Acute Psychiatric Management
Acute Psychiatric ManagementAcute Psychiatric Management
Acute Psychiatric Management
 
Team Health Consultation
Team Health Consultation Team Health Consultation
Team Health Consultation
 
CETI Psychiatry Review
CETI Psychiatry Review CETI Psychiatry Review
CETI Psychiatry Review
 

Último

SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdfSGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdfHongBiThi1
 
Role of Soap based and synthetic or syndets bar
Role of  Soap based and synthetic or syndets barRole of  Soap based and synthetic or syndets bar
Role of Soap based and synthetic or syndets barmohitRahangdale
 
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaMale Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaSujoy Dasgupta
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu Medical University
 
blood bank management system project report
blood bank management system project reportblood bank management system project report
blood bank management system project reportNARMADAPETROLEUMGAS
 
Adenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisAdenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisSujoy Dasgupta
 
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...Shubhanshu Gaurav
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .Mohamed Rizk Khodair
 
Basic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptxBasic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptxkomalt2001
 
AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectiondrhanifmohdali
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptPradnya Wadekar
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE Mamatha Lakka
 
Red Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfRed Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfMedicoseAcademics
 
Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Peter Embi
 
pA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologypA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologyDeepakDaniel9
 
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfCONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfDolisha Warbi
 
Generative AI in Health Care a scoping review and a persoanl experience.
Generative AI in Health Care a scoping review and a persoanl experience.Generative AI in Health Care a scoping review and a persoanl experience.
Generative AI in Health Care a scoping review and a persoanl experience.Vaikunthan Rajaratnam
 
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxBreast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxNaveenkumar267201
 

Último (20)

SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdfSGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
 
Role of Soap based and synthetic or syndets bar
Role of  Soap based and synthetic or syndets barRole of  Soap based and synthetic or syndets bar
Role of Soap based and synthetic or syndets bar
 
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaMale Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu
 
blood bank management system project report
blood bank management system project reportblood bank management system project report
blood bank management system project report
 
Adenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisAdenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosis
 
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .
 
Basic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptxBasic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptx
 
AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissection
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.ppt
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE
 
Red Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfRed Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdf
 
Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024
 
GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...
GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...
GOUT UPDATE AHMED YEHIA 2024, case based approach with application of the lat...
 
pA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologypA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacology
 
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfCONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
 
How to master Steroid (glucocorticoids) prescription, different scenarios, ca...
How to master Steroid (glucocorticoids) prescription, different scenarios, ca...How to master Steroid (glucocorticoids) prescription, different scenarios, ca...
How to master Steroid (glucocorticoids) prescription, different scenarios, ca...
 
Generative AI in Health Care a scoping review and a persoanl experience.
Generative AI in Health Care a scoping review and a persoanl experience.Generative AI in Health Care a scoping review and a persoanl experience.
Generative AI in Health Care a scoping review and a persoanl experience.
 
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxBreast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
 

Cetiscape 3 February 2011

  • 1. cetiscape CLINICAL EDUCATION & TRAINING INSTITUTE  Issue 3  February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 1  Intergenerational health systems: securing a sustainable future Thursday 10 February 2011, John Loewenthal Auditorium, Westmead Hospital “The world has changed; we are living longer and the burden of chronic illness is rising. A revolution in health systems Future thinkers at the forum technology and delivery may be our only hope for future  Centre for Health Innovation and Partnership (CHIP) generations.” — so read the banner at the Intergenerational  Clinical Education and Training Institute (CETI) Health Systems Forum, an unprecedented gathering of government, education, community and business groups in  Regional Development Australia-Sydney western Sydney.  NSW Government Education and Training The forum sought a common set of directions to address  Western Sydney Institute of Technical and Further some of the major issues affecting health and community Education care, focusing on the potential of digital technologies to  College of Health Sciences, University of Western better coordinate, integrate and improve services. Sydney In his opening remarks, Professor Glen Maberly, Director  Penrith Business Alliance of the Centre for Health Innovation and Partnership,  Western Sydney Community Forum reminded everyone that demographic change presented  Western Sydney Local Hospital Network huge challenges for public budgets, as health care costs  Nepean Blue Mountains Local Hospital Network (already 28% of the NSW state budget) threatened to grow unsustainably. Smarter health care was the alternative. digital devices like the iPhone — and what we need to do is “I will be happy when we stop talking about technology take relatively simple steps to connect health workers to the and start talking about smart systems,” Professor Steven information potentially available to them.” Boyages, CETI Chief Executive, said in his address to the forum. “The technical means for improved health care don’t Professor Branko Celler, Dean of the College of Health have to be invented — they are ubiquitous, on the internet, on Sciences at University of Western Sydney, described the In this issue  Safety with injectable medicines 6  Intergenerational health systems: securing a sustainable  Nursing grand rounds via videoconference 7 future 1  Emergency department demand increases 7  Postgraduate clinical placements 2  making a difference HSP 8  Above and beyond 3  Survey of General Practitioner Procedural Training  Scholarships for doctors in rural training 3 Program 8  Improving care for patients with osteoporosis 4  Diploma of Rehabilitation 9  Coming: 5th NSW Rural Allied Health Conference 5  Karma – a prevocational general practice placement  Coming: NSW Prevocational Medical Education Forum 5 experience 10  Sepsis kills 6 Building 12, Gladesville Hospital, Victoria Road, Gladesville NSW, 2111 Editor: Craig Bingham Locked Bag 5022, Gladesville NSW 1675 02 9844 6511 CLINICAL EDUCATION & TRAINING INSTITUTE p: (02) 9844 6551 f: (02) 9844 6544 e: info@ceti.nsw.gov.au cbingham@ceti.nsw.gov.au
  • 2. cetiscape  February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 2  CLINICAL EDUCATION  Issue 3 & TRAINING INSTITUTE potential of telehealth to empower patients to manage their the future as an opportunity for the development of a stronger, health from homes with the aid of clinicians connected by smarter health care industry in Sydney’s west. phone. He hopes to see a Cooperative Research Centre The forum initiated a wideranging discussion about the in Telehealth established at UWS to drive evidence-based possibilities for cooperative action to realise smarter health adoption of this aid to effective and efficient patient care. systems, which many participants saw as resting on “power Mr Paul Brennan of the Penrith Business Alliance drew to the people” — more information for health care consumers, attention to the health-care corridor that runs from Westmead and more engagement of consumers in managing their Hospital to Nepean Hospital, Penrith, taking in UWS and the health. The positive benefits and potential pitfalls of a patient western clinical school of Sydney University. This is Sydney’s controlled electronic health record were debated at length. demographic centre and an area populated with skilled workers A communiqué issued by the forum will be available soon. who need local employment. Mr Brennan saw the challenges of The destiny of our demography: from pyramid to ... coffin? A future with more elderly in the population, and a smaller proportion of workers: demographics cited by Glen Maberly from a Productivity Commission report. Postgraduate clinical placements When the NSW Health Care Advisory Council met on general practice, community settings, specialist and private Thursday 9 December 2010, CETI Chief Executive Professor practice and private hospitals. Steven Boyages and Dr Marie Louise Stokes presented a Several initiatives have already been implemented. Up to 50 report on the increasing numbers of medical graduates in prevocational general practice training places in NSW will be NSW requiring placement for clinical training as the new funded by the Commonwealth from 2011, based mainly in medical schools produce their first graduates. rural and regional areas. CETI has developed a streamlined Provided clinical training opportunities are expanded, there is accreditation process for general practices and regional training providers wishing to offer clinical placements for junior doctors. an opportunity for the increase in medical graduate numbers to address workforce shortages in rural and regional areas, and CETI’s Rural Division will centrally coordinate the NSW Rural in disciplines such as general practice, emergency medicine, General Practitioner Procedural Training Program to support psychiatry, geriatrics and palliative care. Strategies under the rural GP procedural workforce. consideration to increase postgraduate clinical placements The Health Care Advisory Council reiterated the importance include shift rostering, new models of service, increasing the of developing effective strategies to retain the medical number of facilities offering placements, and expanding the graduate workforce in rural areas, and to invest in paediatrics range of alternative training settings, which could include and general practice.
  • 3. cetiscape  February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 3  CLINICAL EDUCATION  Issue 3 & TRAINING INSTITUTE Above and beyond “I will go to any lengths looking for a cure More information about Cure Cancer Australia for cancer – I’m even prepared to climb can be found at <http://www.cure.org.au>. mountains!” says Associate Professor Michael is a longstanding member of Michael Agrez, a colorectal surgeon at John CETI’s Prevocational Training Council, Hunter Hospital, and one of Australia’s and has recently joined the Prevocational most dedicated Directors of Prevocational Accreditation Committee. At John Hunter Education and Training. Hospital, he was an early adopter of the In July, Michael is climbing Kilimanjaro Australian Curriculum Framework for Junior (Africa’s tallest mountain) to raise money for Doctors, piloting implementation of the the Cure Cancer Foundation. framework in new term descriptions and You can sponsor Michael by visiting reflective portfolios for trainees, and gathering <https://www.gofundraise.com.au/AgrezM>. new data about the experiences that trainees gain (or sometimes do not gain) in their core Cure Cancer Australia commenced in 1967 training terms. and is an independent Foundation for cancer research with its own Medical Grants Advisory Michael Agrez, shown here Michael’s ambitious climb to conquer cancer Committee to select projects with the greatest training for the assault on is typical of his energy and community spirit, potential that have been submitted by young Kilimanjaro in his mountain and CETI will be cheering him on all the way. post-doctoral researchers. climbing kit. Scholarships for doctors in rural training CETI :  you be working in two or more rural terms this year? Are you Will The Clinical Education in a CETI network training program? and Training Institute  you can answer yes to both questions then you may be entitled If (CETI)EDUCATION CLINICAL is a statutory health & TRAINING INSTITUTE to apply for a rural scholarship of up to $6,000, depending on corporation established your level of training. by the NSW government The Rural Scholarship Fund supports medical trainees committed to training to promote excellence and providing patient care in rural locations in NSW. in clinical education and training. Prevocational (PGY1 or 2), basic physician, paediatric physician, emergency medicine (new for 2011), pre-specialist surgical and psychiatry (basic and CETI collaborates with advanced) trainees can apply. universities, colleges, Applicants must complete a minimum number of regional and/or remote clinicalINSTITUTE leaders, hospitals, CLINICAL EDUCATION & TRAINING terms in NSW Health facilities in the 2011 clinical year as follows: health services and the  Prevocational trainees — 2 terms community to achieve better health through  Basic trainees — 2 3-month terms education, training and  Advanced trainees — a full clinical year. development of a clinical Trainees who will complete the minimum number of terms and are in a workforce that meets the CETI networked training program can apply for a rural scholarship. If their healthcare needs of the application is successful they will receive payments of: people of NSW.   $1500 for prevocational trainees CETI innovates to improve  $5000 for basic trainees communication, capacity  $6000 for advanced trainees. and competency in health CLINICAL EDUCATION & TRAINING INSTITUTE Applications for the Rural Scholarship Fund open at the end of February and care by promoting blended close on 15 April 2011. learning approaches, including face-to-face For more information, follow the links on the CETI website or contact Andrea teaching, simulation and Ross (02 9844 6530) or Kirsten Campbell (02 9844 6536) at CETI. e-learning.
  • 4. cetiscape  February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 4  CLINICAL EDUCATION  Issue 3 & TRAINING INSTITUTE Improving care for patients with osteoporosis CETI is working with the Agency for Clinical Innovation (ACI) to help bring potentially life-saving preventive care to elderly patients with brittle bone injuries or fractures. Although the risk increases with advancing age, the largest impact on the community is in relation to the relatively young old. This month ACI and its Musculoskeletal Network launched a new model of care to prevent the risk of repeat fractures in patients with osteoporosis. The bones of people with osteoporosis are fragile and brittle, with a significantly higher likelihood of fracture from even minimal impact or injury. It is estimated that 2.2 million Australians have osteoporosis, Pictured left to right: Professor Markus Seibel, Professor Lyn which affects half of all women aged over 60 and one in three March, Robyn Speerin (Network Manager of ACI’s Musculoskeletal older men. The economic cost was estimated in 2007 at Network), The Hon. Carmel Tebbutt BEc MP, Minister for Health $7 billion, including more than $1.5 billion in direct health costs. and Deputy Premier, and Professor John Eisman. Photo: ACI. About half of all patients who have one osteoporotic bone fracture will have another. support for junior doctors at the front line to identify, In NSW, 35% of patients who were admitted to hospital with investigate and treat patients with osteoporosis. a minimal trauma fracture between 2002 and 2008 were A working group has been convened to develop a curriculum subsequently admitted to the same hospital with a refracture. under the leadership of Orthopaedic Surgeon Dr Kerin This accounted for 16,225 admissions, with an average Fielding, with representation from endocrinology, rheumatology, length of stay of 22 days. These data do not include patients gerontology, falls prevention, curriculum development and admitted with a refracture to a different hospital. information technology. The web-based curriculum is close to Many people who have multiple osteoporotic fractures have completion and will be available to NSW Health staff online. ongoing pain and disability, reduced quality of life and die Users will be able to work their way through topics at their own prematurely. pace and at any time of the day or night. While the increased risk of refracture is well known and The Chief Executive of ACI, Dr Hunter Watt, said the new evidence-based guidelines highlight the need to intervene at model of care addressed one of the biggest health issues for the time of the first fracture, in far too many cases it is simply elderly people in NSW. not happening. “This is a huge issue. People who suffer osteoporotic fractures National audits have repeatedly shown that only 20%–30% often are faced with chronic pain, are less able to manage of female patients, and even fewer male patients, are being activities of daily living, and risk losing their independence and identified at first fracture for preventive care. This means developing other chronic conditions because of immobility. Their that more than four out of five people presenting at health risk of premature death also is very real.” services with an osteoporotic fracture are being denied the “ACI funded this model-of-care project and the health benefits of effective fracture prevention. Musculoskeletal Network worked with medical, nursing and The NSW Model of Care for Osteoporotic Refracture allied health clinicians and consumers from across the State, Prevention is an easy-to-use guide to best practice care for as well as stakeholder groups such as Arthritis NSW and doctors, nurses, other health professionals and managers Osteoporosis NSW, to make it happen.” across the NSW health system. It aims to ensure that all “The challenge now is implementation and we are delighted patients presenting with brittle bone fracture are assessed and that CETI is working so closely with us on the need to offered advice and treatment to prevent further fractures. This educate front-line clinicians.” may include bone density scanning, measurement of vitamin D levels, assessment of calcium intake and thyroid function, Professor Lyn March, a senior rheumatologist from Royal disease management advice and self management support. North Shore Hospital and one of the authors of the guide, said it was designed to address a very real area of High quality services already are in place at Concord, St underperformance in the health system. Vincent’s, Royal Prince Alfred, Royal Newcastle Centre and the Mid North Coast Local Health Network. “It is not acceptable that when the markers are so clear and so much can be done to prevent refracture, so many people CETI is working with ACI to address one of the keys to with osteoporosis continue to miss out.” implementation of the model of care — education and
  • 5. cetiscape  February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 5  CLINICAL EDUCATION  Issue 3 & TRAINING INSTITUTE “That is condemning many thousands of people to a future of families. Why wouldn’t you do it? I am delighted that we are pain, inability to perform normal activities of daily living, loss now at the implementation stage.” of independence, developing other chronic diseases and “Early identification of people in NSW who have osteoporosis dying prematurely.” is a critical component of the new model of care because it “It also means that Australians continue to pay billions of will enable early treatment, which can reduce further fractures dollars in health care costs and loss of productivity for issues by up to 50%.” that can be prevented.” “This model of care has been shown in many trials, including in Australia, to reduce medical complications, reduce readmissions to hospital and reduce the number of premature deaths. It also has been shown to improve quality of life of individuals and their Coming events îStrong foundations in shifting sands 5th NSW Rural Allied Health Conference The Glasshouse, Port Macquarie, 9–11 November 2011 î Principles and practice NSW Prevocational Medical Education Forum Proudly presented by CETI’s Rural Division Rural allied health services bring together a blend of 11–12 August 2011 multidisciplinary skills requiring a flexible approach to At this year’s prevocational forum, medical educators, cooperation, coordination and collaboration. Interdisciplinary directors of training and administrators will share their rural health partnerships have become strong foundations experience, workshop the issues that matter and hear which will continue to sustain quality care in shifting sands, practical advice from leaders in JMO education. the transitional period of the current national health reform. In 2010, CETI commissioned an external review of the This conference will provide an opportunity for all allied health prevocational training networks. In November, the review staff, managers and education team reported that it “found an extra-ordinary level of providers to demonstrate commitment of individuals and institutions at all levels to how collaborative health prevocational training across the NSW health system.” partnerships create models of care which achieve positive The team delivered inspiring recommendations for renovation patient journeys. of prevocational training that it hoped would multiply the This conference is designed effectiveness of this commitment. During 2011, CETI is working to attract rural and remote with its partners in the local health networks to unlock the allied health clinicians from new graduates to senior potential identified in the review. managers, and those who work in partnership with allied health services. On the agenda  learning model in prevocational training: who learns The Pre-conference workshops what, when, how. There will be a choice of pre-conference workshops to attend  Tuning the networks for smoother performance on Tuesday 8 and Wednesday 9 November. Come along,  Workable methods of assessing trainees and evaluating share experiences and take home some practical information programs: building better feedback to put straight into practice with your team.  Maximising the benefit of general practice training terms Call for abstracts in March  Innovations in training and education. In March authors will be invited to submit an abstract relevant For more information, please contact Craig Bingham to the theme Strong Foundations in Shifting Sands, using (02 9844 6511, cbingham@ceti.nsw.gov.au) or visit the examples of established rural collaborative partnerships website <www.ceti.nsw.gov.au/prevocational>. which achieve positive patient outcomes. First time presenters welcome. For more information please contact Jenny Preece (02 6692 7716, jenny.preece@ncahs.health.nsw.gov.au) or visit the website <www.ircst.health.nsw.gov.au>.
  • 6. cetiscape  February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 6  CLINICAL EDUCATION  Issue 3 & TRAINING INSTITUTE Sepsis kills ACI and CEC joint project to improve the recognition and management of severe infection and sepsis Appropriate and timely recognition and management of A pilot study using the draft patients with sepsis is a significant problem in healthcare. sepsis pathway and a staff Sepsis is associated with high morbidity and mortality; severe education program has been sepsis and septic shock have a mortality of around 25%.1 In undertaken in emergency another study, the mortality rate for patients with septic shock departments at John Hunter, increased by 7.6% for every hour of delay in commencing Liverpool, Concord and Prince antibiotic therapy.2 of Wales Hospitals. Preliminary audit results have been very encouraging, with a marked Sepsis has been identified by the NSW Root Cause Analysis reduction in time to administration of intravenous antibiotics Review Committee as a recurrent emerging problem. The and heightened staff awareness of sepsis and the need for Clinical Excellence Commission Clinical Focus Report on the prompt treatment. There has been wide consultation with Recognition and Management of Sepsis3 found significant rural clinical groups and the pilot study is being extended to a deficits in a range of clinical settings, with a higher proportion rural site. Staff feedback from the pilot study and audit results of problems being reported in the emergency department. are informing the finalisation of the draft sepsis pathway, Key clinicians and other experts have identified improving education resources and project support for the state-wide recognition and management of sepsis as a high priority implementation in May 2011. for local health networks. In response, the Agency for For more information please contact Dr Tony Burrell, Director Clinical Innovation and Clinical Excellence Commission Patient Safety (02 9269 5550, tony.burrell@cec.health.nsw. are collaborating with the newly-formed Emergency gov.au) or Mary Fullick, Project Manager (02 9269 5542, Care Institute on a joint initiative. The project will enable mary.fullick@cec.health.nsw.gov.au). a consensus approach to improving the recognition and management of sepsis at a state level. 1 The Australasian Resuscitation in Sepsis Evaluation (ARISE) Investigators and the Australian and New Zealand Intensive Care Society (ANZICS) Adult The goals for the project are to reduce preventable harm to Patient Database (APD) Management Committee. The outcome of patients with sepsis and septic shock presenting to emergency departments in patients through early recognition of sepsis, appropriate fluid Australia and New Zealand. Critical Care and Resuscitation 2007; 9: 8-18. resuscitation and reduced time to administration of antibiotics. 2 Kumar A, Roberts D, Wood KE, et al. Duration of hypotension before initiation Phase 1 of the project will focus on emergency departments of effective antimicrobial therapy is the critical determinant of survival in and Phase 2 will focus on improving the recognition and human septic shock. Critical Care Medicine 2006; 34: 1589-1596. management of sepsis for inpatients. Education for junior staff 3 Clinical Excellence Commission, 2009. will be a key component of the project. A generic adult sepsis pathway has been developed following wide clinical consultation. The pathway aims to support recognition of severe infection and sepsis in the emergency setting and to give clear guidelines for notification, escalation and initial management. The sepsis Safety with injectable medicines pathway promotes: New National Recommendations for User-applied Labelling  flagging of severe infection and sepsis at triage early of Injectable Medicines, Fluids and Lines propose standards  involvement of senior clinicians in diagnosis and for handling injectable medicines to ensure that patients management are never inadvertently injected with the wrong medicine or  appropriate and timely fluid resuscitation injected by the wrong route.  prompt administration of antibiotics (goal is within one The recommendations and support materials can be found hour of triage) at <http://www.health.gov.au/internet/safety/publishing.nsf/  serum lactate monitoring to assist diagnosis and ongoing Content/PriorityProgram-06_UaLIMFL> monitoring CETI supports this initiative and is consulting with its partners  referral of care to appropriate clinical teams, including in the NSW health system to ensure that clinical training has retrieval if appropriate. embraced the labelling standards.
  • 7. cetiscape  February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 7  CLINICAL EDUCATION  Issue 3 & TRAINING INSTITUTE Nursing grand rounds via videoconference Jenny Preece Rural and Remote Health Project Officer, CETI Rural Division, Dorrigo Multi-Purpose Service In 2008, NSW Health Nursing Office, in collaboration with Evaluation of NCAHS nursing grand rounds at 18 months has the NSW Institute of Rural Clinical Services and Teaching found that networking with peers, nurses educating nurses and (IRCST, now the CETI Rural Division) identified mentoring sharing experiences in the management of actual cases has and supervision of rural and remote nursing staff from been a very practical approach to focusing on best practice. smaller facilities across NSW as an area to be addressed, Reflection on team and individual clinical practice and identifying particularly where triaging and initial emergency management lessons learned from each episode of care has often influenced of patients is frequently undertaken in the absence of a change in clinical processes. The regular communication medical officer. between sites has created an accepted form of peer review. Isolated rural nurses feel more comfortable sharing and In 2009, IRCST introduced rural and remote nursing grand rounds via videoconference linking nurses from eight analysing experiences with professionally isolated colleagues isolated health facilities in North Coast Area Health Service and comment they now feel part of an extended team. (NCAHS) for generalist case presentations and discussion of Over time, the operational framework developed in NCAHS interesting or challenging patient journeys of relevance to the was consolidated into an implementation toolkit to enable the rural setting. Nurses are rostered monthly to present a patient spread of nursing grand rounds across NSW. journey for discussion, with guest speakers presenting a case-based inservice at regular intervals as an educational Rural and remote nursing grand rounds via videoconference component. Presentations can involve the use of PowerPoint have now expanded to include smaller sites across the or simply tell the patient story. Keeping the sessions case- former Greater Western Area Health and Greater Southern oriented — a rural patient’s story told by rural nurses — Area Health Services, with Hunter New England proposing to ensures that discussions are relevant and meaningful. implement the program in 2011. Emergency department demand increases The recent “Christmas rush” in NSW public hospital There is typically less elective surgery performed in public emergency departments was intense, with the number of hospitals towards the end of each year and this held true in patients seen eclipsing those treated at the height of the 2010. The proportion of patients receiving elective surgery 2009 swine flu pandemic. on time remained stable and there has been a decrease since last quarter in the time patients wait for non-urgent More than half a million patients attended NSW emergency surgery. Wait times for urgent and semi-urgent elective departments from October to December 2010, according to surgery have remained relatively unchanged. Hospital Quarterly, Issue 3, the most recent report from the Bureau of Health Information. This is nearly 30,000 more than The report and related materials, including performance profiles in the previous quarter, nearly 21,000 more than the same time for individual hospitals, are available at <www.bhi.nsw.gov.au>. last year, and nearly 18,000 more than in July to September 2009, when the swine flu pandemic was at its peak. Bureau Chief Executive Dr Diane Watson said attendances during the quarter were at a two-year high, with increased numbers generally seen across October and November UM Need the advice, support or creative FOR as well as a Christmas holiday spike. In the face of extra JMO thinking of a representative group pressure, emergency departments generally held their NEW SOUTH WALES of junior doctors? performance. Patients were seen within recommended time frames for all triage categories, except triage category 3 Contact the JMO Forum via CETI’s Prevocational (patients with a potentially life threatening condition). Program Coordinator: Craig Bingham (cbingham@ceti.nsw.gov.au, 9844 6511).
  • 8. cetiscape  February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 8  CLINICAL EDUCATION  Issue 3 & TRAINING INSTITUTE HSP making a difference Dr Simon Leslie, Medical Director at He now feels much Shellharbour Hospital and Chair of the less threatened and Hospital Skills Program State Training HOSPITAL SKILLS PROGRAM understands that he Council, reports. is being supported to Three hundred and fifteen medical One of our CMOs thanked me yesterday, improve and will not be officers are now enrolled in enthused about the Hospital Skills Program unfairly judged. He feels CETI’s Hospital Skills Program (HSP) and the benefits to him. He had just part of a group that is and are enjoying the benefits attended a half day in theatres re-skilling in learning and improving of more training opportunities, airway management and could not speak highly together. He has greater better recognition and an improved career pathway. For enough of the experience and the benefits to him. He was also enthusiasm for work and more information, speak to Acting full of praise for the education day last week at Wollongong continuing professional Program Coordinator Alpana University and also for the simulation course he was sent to development, he has Singh (02 9844 6551, asingh@ attend at Royal North Shore Hospital last year. His face was engaged with other ceti.nsw.gov.au) or visit <www. beaming and he was obviously very excited. team members and ceti.nsw.gov.au/hospitalskills>. This was a doctor who before the HSP had worked solely become willing to work on weekends, feeling isolated and even somewhat paranoid at any time of the week. because his only contact with “administration” in the past This is just one example of how the Hospital Skills Program is was with regard to complaints about him. His habit was to making a difference for our doctors. avoid any oversight or scrutiny and his resultant negative attitude affected his relationship with other staff. Survey of General Practitioner Procedural Training Program The GP Procedural Training Program is being evaluated Feedback gained from the survey will inform the future growth through a survey of participants. and development of the program, enhancing its contribution to a sustainable rural GP procedural workforce. The program, now coordinated through the CETI Rural Division, has had 285 participants since 2003. It provides Ms Linda Cutler is the Executive Director of the program GPs and GP registrars with experience in procedural general which was transferred to the Rural and Remote Division practice to equip them to practise in rural NSW. Participants of CETI in December 2010. Many will recall that Linda is the former Executive Director of the NSW Institute of Rural train on a full time, part-time or flexible basis in rural training Clinical Services & Teaching (IRCST), which has now been hospitals in one or more of the following five specialties: brought under the CETI umbrella.  Anaesthetics For more information about the survey or the GP Procedural  Emergency Medicine Training Program, contact: Margaret Starr, Program  Obstetrics Coordinator, CETI (02 9844 6548, mstarr@ceti.nsw.gov.au).  Surgery  Mental Health. The survey of participants who have completed their training will be conducted by the NSW Health Department’s trained telephone interviewers. The survey asks about:  trainee’s experience of the program and the extent to the which they are currently using the skills gained though the training  the program has contributed to the GP procedural how workforce in NSW  the program has contributed to participants’ career how 16th Australasian decisions Prevocational Medical Education Forum 6-9 November 2011 Auckland, New Zealand  suggestions for improving the program.
  • 9. cetiscape  February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 9  CLINICAL EDUCATION  Issue 3 & TRAINING INSTITUTE New Diploma of Rehabilitation Sue Steele-Smith Education Consultant and Manager, Royal Rehabilitation College Royal Rehabilitation Centre Sydney The Royal Rehabilitation College The diploma also provides an has developed a unique, nationally opportunity for specialised training of recognised Diploma of Rehabilitation. allied health assistants to meet the The diploma provides a practical, increasing demand for rehabilitation multidisciplinary, flexible, accessible services due to the ageing and and relevant program for those growing population. seeking an accredited qualification in The Royal Rehabilitation College rehabilitation. is a health-industry-based private The Royal Rehabilitation College was registered training organisation that able to gain national accreditation for is part of the Royal Rehabilitation this course because an equivalent Centre Sydney. The college multidisciplinary course did not exist specialises in the training and within Australia. assessment of the Certificate IV in Allied Health Assistance, with The diploma is a self-paced course over 200 participants nationally. offered by distance education, This experience with clinicians which provides the greatest flexibility throughout NSW and Australia has around participant needs. The highlighted the need for specific course content was developed by practical training in rehabilitation. experienced rehabilitation clinicians The concept, development and working at the Royal Rehabilitation accreditation of the Diploma of Centre Sydney. Core units provide Rehab in action. Rehabilitation is the result of this the foundation for working in a experience. rehabilitation environment, while there are elective options in spinal The Royal Rehabilitation Centre injury, neurology, cardiopulmonary, Sydney provides specialist orthopaedics, oncology, community, rehabilitation and disability services mental health and aged care. There for people with complex and long are also units on goal-directed care, term health care needs, traumatic health promotion and prevention and brain injury and spinal cord injury. research skills. Royal Rehab engages in extensive education and research to improve The diploma provides an opportunity the rehabilitation outcomes for its to refresh and enhance skills or clients and, as a teaching hospital, to retrain. It provides professional Royal Rehab has strong partnerships development with a practical with the University of Sydney’s rehabilitation focus and a chance academic units. to enhance skills and knowledge of new areas of rehabilitation within an Registrations for the Diploma of interdisciplinary learning environment. Rehabilitation are now open for Support for this distance course 2011. For further information on has come from clinicians working this fantastic learning opportunity in rehabilitation who are interested contact Royal Rehabilitation College in validating their skills or who are (02 9808 9626, enquiries@ returning to the workforce after royalrehab.com.au) or see extended leave, and from others <www.royalrehab.com.au/college/ interested in moving into rehabilitation courses.html>. from another speciality. Spinal rehabilitation.
  • 10. cetiscape  February 2011  Promoting excellence in clinical education  www.ceti.nsw.gov.au  page 10  CLINICAL EDUCATION  Issue 3 & TRAINING INSTITUTE Karma — a prevocational general practice placement experience Stella Tang was a Resident Medical complex care that demands medical prioritisation of their Officer at Westmead Hospital when chronic conditions. How can someone learn this without the she did a term in general practice. She exposure and the appropriate guidance? is now a general practice registrar in My time at TMC provided broad-based teaching and insight Westnet network. into how our health care system works. It encompassed more The first day of my PGPPP term I dedicated one-on-one teaching by passionate mentors on a found myself wondering if I had made vast range of medical subspecialties than any other medical a HUGE mistake in choosing a general terms I have experienced. This was surrounded by a familial practice rotation. The last two years of environment of comradeship and up-to-date medical practice in my hospital training had disciplined me weekly clinical “grand-round” meetings of case presentations, in into an efficient and effective discharging addition to access to quality nursing and allied health services machine moulded by the likings of on site (diabetic educator, podiatrist, psychotherapist, mental consultants and their specialities. The words “follow up with health nurse). This was a term that developed my confidence your GP”, “that’s something your GP can look into”, “discuss in patient management and also fine-tuned my clinical and that with your GP, it’s not an emergency problem”, “Your interpersonal skills in diagnosing, interpreting and managing GP can refer you”, flashed before my eyes, and I began to common medical problems. wonder if this was Karma. I found it rewarding to see the outcome of my decisions As inconceivable as it may be to some, I found myself being through continued and ongoing patient care, but my term drawn into the complexities and value of community-based in general practice also emphasised the importance of teaching in my placement at Toormina Medical Centre (TMC). establishing a good work and life balance. The freedom it Now I wonder why general practice isn’t a core rotation, as it is provided with organising my own patient load, having devoted the only “speciality” that treats the patient as a whole, not just lunch breaks and the regularity of working “normal” office in bits. General practice is the integral hub that interacts with all hours was a stupendous luxury after the last two years of these specialities (the ‘bits’). It’s the speciality that witnesses a unrostered overtimes. All in all, I cannot fault this rotation and patient’s journey from birth to death and the speciality that has regardless of what “specialist” training you are endeavouring the privilege to treat all the generations of a family at one time. to strive towards “holistic” patient care such as I was learning and practising at TMC is what good medicine is about, and Our core population in healthcare is ageing day by day as our good medicine is what good doctors practice. advances in medical intervention continue. This means that our patients not only have multiple morbidities, but require After all, there’s Karma … cetiscape is published monthly by email and online: The submission deadline for each issue is the middle of www.ceti.nsw.gov.au/cetiscape the month. Articles can be submitted as Word documents. Pictures and logos should be sent separately, using the best available file. For logos, this is often an EPS file. Contributions: cetiscape invites contributions on all Picture files should be sent at the highest resolution aspects of clinical education and training, in particular: available.  Short news stories: achievements, launches, events. Articles submitted to cetiscape are subject to editing (100 to 300 words, photos and illustrations desirable) (proofs are shown to the authors).  Reviews or editorials commenting upon issues related to health workforce education, training and development To subscribe or unsubscribe: (300 to 1000 words, photos and illustrations desirable). email cbingham@ceti.nsw.gov.au Building 12, Gladesville Hospital, Victoria Road, Gladesville NSW, 2111 Editor: Craig Bingham Locked Bag 5022, Gladesville NSW 1675 02 9844 6511 CLINICAL EDUCATION & TRAINING INSTITUTE p: (02) 9844 6551 f: (02) 9844 6544 e: info@ceti.nsw.gov.au cbingham@ceti.nsw.gov.au