Trainee Representative

Trainees at TSH ED are encouraged to participate in decision making.

Oppoutunities for participation include:

  • mid-term trainee meeting – open to all trainees
  • via the trainee representative
  • via the trainee feedback form each term

Trainee Representatives

2021 clinical year: Claudia Mische and DJ Taitz

Role of the trainee representative

  • Provide a voice for the trainees in all departmental issues and key decision processes
  • Provide communications between trainees and other stakeholders within the department
  • Active contributions in meetings on behalf of trainees:
    • Monthly Departmental Meeting
    • Mortality and Morbidity Meeting
    • Relevant Sub-committee meetings (eg covid response planning)
  • 2 trainees are invited to be trainee representatives. Invitation open to all trainees. Focus on the diversity of trainee backgrounds and stage of training.
  • Selection process to take place in December-January prior to the start of the next clinical year
  • Encourage autonomy and flexibility: Representatives are encouraged to review and refine their role as the clinical year progresses.
  • The trainee representative role can be used for development and assessment of the Leadership and Management domain in the Curriculum Framework
TSHED Trainee Policy – Participation in Decision MakingDownload

Quality Improvement

Trainees at TSH ED are encouraged to participate in quality assurance and improvement activities.

Checking of results

Mandatory review of investigation results at the beginning of each clinical shift

  • Trainees are required to check their eMR (electronic medical records) results inbox for all outstanding investigation results at the beginning of each clinical shift
  • Day shift – 0800; Evening Shift – 1400
  • FACEMs are available on the floor to consult and advise
  • Trainees are encouraged to propose an alternate management plan if missed abnormal results or incidental findings arise
  • Results to be checked during the first 15 minutes of each clinical shift

Participation in audits

  • Trainees are briefed of the active portfolios that require auditing at the start of each clinical year and clinical term
  • Trainees are strongly advised to be involved with at least ONE audit each clinical year as part of their ITA/Curriculum Framework development
  • Trainees who are seconded to TSHED for one term are encouraged to perform short term audits that are time appropriate
  • FACEMs are requested to invite trainees to be involved with audits of their non-clinical portfolio where appropriate

Process for review of trainee QI participation

  • Checking of results:
    • Mid term review and end of term feedback on trainees’ perception of support/input into result checking
    • eMR auditing of the number of outstanding results of trainees yet to be checked. (3 monthly)
  • Audits
    • 3 Monthly ITA
      • Assessment of the Leadership and Management and Scholarship and Teaching domains
      • Review trainee’s involvement/participation in audits
      • Reinforce the expected standard of at least ONE audit per clinical year for each trainee
    • Staff Specialist Meetings
      • FACEM perspective of trainee involvement in audits and research

FACEM on-call/recall guidelines

  • Cardiac arrest/Death in ED
  • If unexpected or complicated (eg toxicological/environmental cause)
  • If patient clearly at end-of-life then ED Consultant on-duty can be notified the following morning
  • Major Trauma
  • Patient requiring intubation – if unexpected or complicated or anticipated to be difficult
  • Category 1 Paediatric patient
  • Paediatric intubation
  • Patient requiring urgent complex/uncommon/unfamiliar procedure (eg pleural/ascitic tap, CVC) and team unable to facilitate overnight
  • ED overcrowding impacting on patient safety – especially if two or more critically ill patients requiring active resuscitation and beyond the resources / skill mix of the department
  • Medical staffing issue eg sickness or injury impacting on safe staffing levels or skill-mix eg down to 3 medical officers overnight or no Senior Decision Maker (Senior Registrar)
  • External disaster e.g. expecting mass casualty / influx of patients
  • Situations likely to generate media or ministerial interest
  • Situations generating conflict with inpatient team and unable to progress patient management / disposition further
  • Situation where a consultant from another specialty is required to physically attend the ED

Also consider calling for:

  • Clinical deterioration despite ED management and trainee needing advice / support
  • Complication/deterioration as a result of ED procedure or management
  • Senior nursing team concern
  • Any other time help or advice is required – our job is to support you!