Download PDF: FL Communiqué January 2023
Case: An Obstruction in an Unfamiliar Place
Expert Commentary: Technological solutions: A remedy for human error?
Expert Commentary: Ready, Set, Go: safe orientation of locum doctors
Comments From Our Peers
Welcome to the January 2023 edition of the Future Leaders Communiqué. In this edition we present a thought-provoking summary of the events leading to the tragic death of JL, a 69-year-old woman recovering from an elective neurosurgical operation. We reflect on the challenges faced by junior doctors engaging in locum work and the chain of communication in medical imaging reports.
Our guest editor for this edition is Dr Tony Pham. Tony is a Basic Physician Trainee at Mackay Base Hospital, Queensland. He is passionate about regional health and specifically patient safety within the confines of under-resourced environments. The case Tony has chosen to present will no doubt resonate with many of us. Attempting to navigate the care of an unwell patient within an unfamiliar work environment would provoke anxiety in any doctor. I can all too easily recall the fear and bewilderment I felt in the first few shifts of a new hospital rotation; getting lost on a daily basis through unfamiliar wards and corridors, surreptitiously peeking at a name badge as I asked yet another stranger for assistance with seemingly simple tasks, collapsing at the end of each shift, exhausted from having to consciously concentrate on every moment across the day. Reading through this case summary, I was starkly brought back to my own experiences of trying to find my way on the ward after an ’informal orientation’.
It has caused me to reflect on some of the current challenges faced within healthcare, and specifically the increasing reliance that hospitals and General Practice clinics now have on locum doctors to maintain safe patient care when faced with staffing shortfalls. Locum work is a perfect stress-test on a number of key healthcare systems: orientation programs, assessment and management protocols; escalation pathways for the deteriorating patient; the communication systems for clinical data. Without robust systems in place, essential clinical practices will inevitably falter when faced with a rapid turnover of staff. As healthcare’s reliance on locum work increases, so should its focus on strong, safe, systems. We must ensure that any new clinical staff can quickly and easily access the assistance and support they require to deliver safe patient care at all times. In this edition, I have provided a commentary focusing on orientation programs for new junior doctors, and the obstacles that locum doctors may encounter in being orientated to a new role.
Our other expert commentary for this edition is provided by Ms Nicole Mair who is the Director of Clinical Information Services at Sunshine Coast Hospital. Ms Mair reflects on common pitfalls in clinical care in the hospital environment, and how health information systems can assist and support the clinician in avoiding errors and promoting a standardized approach to safe patient care.
There is much to discuss with this case, and plenty of lessons to learn. We hope that you find it useful in reflecting upon and evolving your own clinical practice. The podcast version of this edition will be released in the future. Please remember, a podcast catalogue of previous editions for the Future Leaders Communiqué along with our sister publications, the Clinical Communiqué and the Residential Aged Care Communiqué, is available and free to download through our website or via Spotify, Apple and Stitcher.