Blacktown Hospital

1 JMO ORIENTATION MANUAL FOR BLACKTOWN HOSPITAL 2 TABLE OF CONTENTS 1. GENERAL DESCRIPTION AND PHILOSOPHY 2. GOALS & OBJECTIVES OF TERM 3. SENIOR STAFFING 4. BLACKTOWN EMERGENCY FLOOR AREA 5. SUPERVISION 6. ROSTER 7. SICK CALLS 8. SHIFTS 9. COMMUNICATION 10. ADMISSIONS 11. DISCHARGES 12. CASE PRESENTATION 13. HANDOVER 1 Handover Information 14. TRIAGE 15. BED AND AREA ALLOCATIONS 16. BAT CALLS TO RESUSCITATION AREA 17. ROLES AND SERVICES WITHIN THE DEPARTMENT 18. TEACHING AND EDUCATION RESOURCES 19. MEDICO-LEGAL ISSUES .1 Police Statements .2 Child Abuse .3 Needle Stick Injuries .4 Abnormal Radiology Results .5 Test Results .6 Media Inquiries .7 Police Requests .8 Blood Alcohol Sampling .9 Rectal and Vaginal Examinations in Females .10 Duty of Care .11 Work Cover .12 Re-Presentations of Patients 20. GENERAL HOUSEKEEPING 21. COMPLAINTS AND DISPUTES 22. DISASTERS 23. ANCILLIARY SERVICES .1 Pharmacy .2 Pathology .3 Radiology .4 Interpreter Service 24. FORMS AND DOCUMENTATION 25. MANAGEMENT POLICY AND PROCEDURE 26. CONCLUSIONS 3 APPENDIX 1 URGENT REVIEW CLINIC BUSINESS RULES APPENDIX 2 EARLY PREGNANCY ASSESSMENT CLINIC APPENDIX 3 AGED CARE SERVICES EMERGENCY TEAM APPENDIX 4 MEDICAL EMERGENCY TEAM (M.E.T) APPENDIX 5 CASE PRESENTATION TEMPLATE APPENDIX 6 ADVANCED MEDICAL PLANNING FORM APPENDIX 7 SAMPLE OF DAILY FLOOR ROSTER APPENDIX 8 SOCIAL WORK REFERRALS APPENDIX 9 TRANSITIONAL NURSE PRACTITIONER SCOPE OF PRACTICE APPENDIX 10 SENSIBLE ORDERING PATHOLOGY APPENDIX 11 EMERGENCY DEPARTMENT SENIOR ASSESSMENT AND STREAMING 4 1. GENERAL DESCRIPTION AND PHILOSOPHY The Emergency Department at Blacktown Hospital offers emergency care for patients of all ages, 24 hours a day 7 days a week. The main purpose of the Department is the provision of initial assessment, stabilisation and acute management for patients presenting to the Department. Relevant subspecialty or the patient’s general practitioner carries out ongoing management. The Emergency Department has a major role as a liaison between Blacktown Hospital and the community. To many, it symbolises the whole hospital, as it may be their first or only view of the hospital. The department needs to be seen to be delivering a service to the community to help promote and maintain the hospital’s reputation. The Department is a major area in the hospital that may witness patient frustration. It may present a stressful, confusing, or apparently hostile environment to patients and relatives and may therefore be a source of complaints and litigation. Staff members are requested to recognise the need for privacy apart from being supportive and understanding of the patients and carers situation/anxiety/frustration and to offer clear, polite communicate/explanation in a timely manner and offer counselling services, when appropriate. The Emergency Department is a level 5 department, (with the hospital being a Level 2 trauma unit) providing treatment for major and minor trauma and medical emergencies. It provides a service that ensures the timely, skilled and appropriate management of all patients. Approximately 60,000 patients attend the department each year (about 170 patients per day). The number of admissions to inpatient beds averages 30%. The Emergency Department also provides a focus for teaching and research into the acute emergency care of patients apart from the health and well-being of the community as a whole. The teaching is primarily for Hospital staff but also provides a service to others in the community. An important role of the Emergency Department is its involvement in local and regional retrieval systems. Blacktown Campus sends half a disaster team (one doctor and two nurses) to the scene of a disaster as requested by the area response team. 2. GOALS AND OBJECTIVES To gain broad experience in the management of adult and paediatric emergencies. To develop and enhance resuscitation skills and procedural skills. You are encouraged to keep your on log book. To further the ability to work in a multidisciplinary team. To develop a high standard of documentation in clinical recording. To participate in continuing education. To enhance communication skills with colleagues, patients and relatives. To develop skills in the efficient and appropriate use of investigations. 5 3. SENIOR STAFFING Director Emergency Medicine Blacktown and Mt Druitt Hospitals: A/Prof Reza Ali Deputy Director Emergency Medicine Blacktown and Mt Druitt Hospitals: Dr David Melvin Emergency Medicine Consultants: Commented [RA1]: needs updating Dr Chamila De-Alwis Dr Harry Elizaga Dr Michael Hession Dr Karina Hochholzer (Co-DEMT BMDH) Dr Shaila Islam Dr Dushan Jayaweera Dr Daya Jeganathan Dr Ponnuthurai Jeyaruban (Co-DEMT MDH) Dr Gopi Mann Dr Richard McNulty Dr Satish Mitter Dr Jannatun Nayim (Co-DEMT BDH) Dr Fernando Pisani Dr Peter Preisz Dr Greg Robinson Dr Liaquat Sheriff Dr Kenny Yee Emergency Medicine VMOs : Dr Richard Lennon Dr Vijay Manivel Dr John Shirley Executive Assistant: Ms. Joan Brown Nursing Unit Manager: Ms. Camille Dooley Clinical Nurse Educator: Ms Zoe Clarkin Clinical Nurse Consultant: Ms Helen Zaouk 6 4. BLACKTOWN EMERGENCY DEPARTMENT FLOOR AREA Commented [RA2]: needs updating and mentioning the new ED is a major component The department is divided into different areas based on the model of care provided. floor area based on MoC There is Acute, Fast Track, PIT (Early Senior Assessment) and Treatment Commence Area (TCA). There are 2 resus beds and 18 monitored acute bed. There are 8 recliner chairs in the fast track area and 10 in TCA (2 beds & 8 recliner.) There are two consultation rooms plus an eye/suture room and plaster room, which may be used whenever appropriate. There is also a Short Stay ward in the department which comprises of 4 recliner chairs. We will be moving to the new Emergency department in July 2019. 5. SUPERVISION All JMO’s are supervised by the EDSS/Registrar/CMO. All JMOs are expected to discuss ALL their cases with a senior medical officer in the Emergency Department as soon as possible, preferably even before starting to write their notes and definitely before all the results are back. This allows the department to reach the ETP criteria by allowing early senior decision-making with regards to patient management and disposition. JMO’s are not expected to make admission or discharge decisions without the direct supervision of a senior physician. The Consultant on the floor will be in charge of the shift and decide on patient management plans and deal with any administrative or policy issues that might arise during the shift. In the absence of the consultant, the CMO or Registrar will fulfil this role. When there is no ED Physician on the floor, there is An ED Physician rostered on call. Any complex issues that the CMO/Registrar have difficulty with, needs to be discussed with the on-call ED Consultant. All Speciality Consultant on-call roster is published weekly and is clearly marked on the daily floor roster. If an emergency physician is available, management of all emergencies including cardiac arrests are handled by the ED staff. At other times, call a code BLUE on 2222 for the hospital MET call team. The ED senior doctor will remain the team leader for all MET calls in ED. You are expected to assist with the resuscitation. You are expected to alert Commented [RA3]: update the ED senior doctor of any critically ill patient for immediate review in order to prevent also need to add 1. when to call edss oncall further deterioration. Commented [DJ(SL4R3]: JMOs should notify ED senior immediately. The hospital’s surgical Team should be called to assist in the management of any multi- Reg/CMO orientation manual should have info on when to call ED trauma cases. See the guidelines in Appendix 5. SS 7 6. ROSTER Blacktown and Mount-Druitt ED have their independent REG/CMO and JMO roster. The Executive Assistant of the Department is in charge of the JMO roster. Dr David Melvin is in charge of the REG/CMO roster. The roster is arranged at least four weeks in advance. Thus any special requests must be made before this time. The Department has a rotating roster and it is expected that everyone would do their shares of day, evening and night shifts. Once the roster is finalised and published, JMO’s/REG/CMO must arrange their own swap/relief, if there is a specific shift they cannot work. The JMO/REG/CMO concerned in the swap must complete a “Shift Change Form” and inform the Executive Assistant. The shift change must be authorised by A/Prof Ali or his delegate when he is absent. All swaps must be within the same pay period. The change will also be noted on the master floor roster in the ED for pay purpose. The number of hours worked per fortnight depends on the number of staff available for the shifts. The number of hours may range from 80 to 90 hrs per fortnight. JMO/REG/CMO willing to work more shifts than usual should contact the Executive Assistant as early as possible for allocation to extra shifts. Meal breaks are paid for after hours, and there is no need to claim for these. If you work an in-hours shift (Day Shift), and do not receive a meal break, you must write next to the shift “NMB”. The ED Director or staff specialist must countersign this. If you are leaving the ED floor to go to a different part of the hospital, please notify Staff Specialist or Registrar of your whereabouts, so that you may be contacted if required. You will be rostered to a team in ED. Team A and Team B consists mostly of 2 or 3 JMOs attached to an ED senior (ED SS and /or reg). You are expected to see patients in the acute area.

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