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DOCUMENTATION, COMMUNICATION & HAND OVER MTI Induction Programme – 2-3rd Sept 2019 MR.HIRAN SAMARAGE MS,FSLCOG,FRCOG(UK) CONSULTANT OBSTETRICIAN AND SPECIALIST IN FETAL MEDICINE LONDON NORTH WEST UNIVERSITY HEALTH CARE NHS TRUST & DEPUTY CLINICAL CHAIR- LMS NORTH WEST LONDON CHAIR
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DOCUMENTATION, COMMUNICATION & HAND OVER MTI Induction Programme – 2-3rd Sept 2019 MR.HIRAN SAMARAGE MS,FSLCOG,FRCOG(UK)CONSULTANT OBSTETRICIAN AND SPECIALIST IN FETAL MEDICINELONDON NORTH WEST UNIVERSITY HEALTH CARE NHS TRUST &DEPUTY CLINICAL CHAIR- LMS NORTH WEST LONDON CHAIR MTI & Volunteering Committee RCOG
COMMUNICATIONCommunication is an inherent part of social skills and enhances the other two
WHAT IS ALL THIS FUSS ABOUT COMMUNICATION SKILLSNow in undergraduate/Postgraduate curriculum, assessed in examscornerstone of being a good doctorIt is no longer a ‘nice to have’IT IS ESSENTIAL
Good communications and engagement is at the heart of how the NHS engages with patients, public, communities and our staff
Bad CommunicationsLoss of Life/ harm to patientsComplaints- 30% complaints involve some aspect of poor communicationNHS Resolution- 20% Complaints were due to staff attitudes and communication failures, medical negligence, dismissal and criminal convictions
COMMUNICATION STYLESUNETHICAL- when absent, delayed, misleading information intentionally givenGMC advises effective communication with colleague is essential for good medical careGMC FTP may be called in to questionAccusations of bullying and intimidation can be a feature of some disciplinary and GMC cases. Sometimes when communication breaks down between colleagues “ dysfunctional department” GMC guidance requires doctors to treat colleagues “fairly and with respect "and not to make malicious or unfounded criticisms of colleagues that could undermine patients trust in care
ESSENTIAL COMMUNICATION SKILLSLISTENNon Verbal CommunicationUsing patients own wordsPatient centred careMeeting patient expectationsREQUIREMENTS OF APPRSISAL & REVALIDATION360 degree feedback from colleagues and patients
CONSEQUENCES OF BAD COMMUNICATIONSDisciplinary actionsComplaints and ClaimsGross negligence manslaughter Emails and social networksAdvise; Honestly assess your communication style for approachability and openness 360 degree feedback Have a difficult or sensitive discussions with colleagues in private, especially away from patients Document instructions to colleagues and other members of the healthcare team clearly in the notes
With the move to shift patterns, which increase the number of individuals caring for patients,the need for comprehensive handover of clinical information is more important than ever.Good handover does not happen by chance
– shifts must coordinate– adequate time must be allowed– handover should have clear leadership– adequate information technology support must be provided. Sufficient and relevant information should be exchanged to ensure patient safety: – the clinically unstable patients are known to the senior and covering clinicians – junior members of the team are adequately briefed on concerns from previous shifts – tasks not yet completed are clearly understood by the incoming team.
Lastly, handover is of little value unless action is taken as a result:– tasks should be prioritised– plans for further care are put into place– unstable patients are reviewed.
DOCUMENTATIONCheck- 1st confirm you have the correct records for the patientCLEAR AND ACCURATEContemporaneous, write up soon as possible, retrospective date and timeIdentify yourself
Good practice in handoverWho should be involved? What should be handed over?When should handover take place? Where should handover take place? How should handover happen? Information management solutions
IN SUMMERY GMC Good Medical Practice UK covers Communication, Documentation, handoverMultidisciplinary Team working in obstetrics and gynaecology practice in UKWorking Time and Rota rules for Junior doctors, many handovers at Labour ward. 8am, 5pm/8pm Good Communications, good handovers, good documentations will improved patient care, reduced harm and death and increased patient satisfaction and cure