Taking a practice-based approach to orientating new clinical staff to Mater

Blog written by Anne Jackson, Education Coordinator, Mater Education.

Mater Education has embedded the National Safety and Quality Health Standards (NSQHS) standard 2 (Engaging Consumers in Care) into an interprofessional model of clinical orientation in a new approach to preparing staff for working at Mater. The objective is to make the learning experience real and engaging in a simulated practice-based, patient centred approach. The aim is to enhance communication and team work, prioritise clinical safety and an optimal patient journey.

What do we do

The Mater Interprofessional Clinical Orientation Program (ICOP) engages staff from clinical professions including doctors, allied health professionals, mental health clinicians, nurses and midwives. With a focus on patient safety and interprofessional teamwork, participants undertake case based activities related to quality improvement, documentation, utilisation of interpreter services, infection control (including waste segregation and sustainability) and management of deteriorating patients. To bring the learning to life, the participants then translate their learning into practice by forming as an interprofessional team to plan and deliver care, to a simulated patient.

The newly formed interprofessional team then identify patient risk factors, escalation of care needs, and effective teamwork principles in order to collaboratively manage the patient. Additionally, there is a focus on clear team communication and leadership which have been shown to be key elements to safe and effective patient centred care. The simulated patient throughout their journey will also simulate deterioration in their condition, requiring early recognition and response by the clinical team.

Mater’s wonderful group of trained volunteers who act as patients (simulated patients) in a diverse range of clinical scenarios, are pivotal to engaging these clinicians in a holistic approach to assessment and care delivery. We try to enhance clinician capability and awareness in securing an optimal patient journey that is more than the physical act of delivering care. The feedback from the simulated patients on the clinical team’s performance has been well received by participants who don’t often have the opportunity to hear how their actions impact the patient on a personal level. 

Christine, one of our very willing and engaging volunteers, provides her perspective on the program.

“As a standardised patient I am able to assist the participants to practice and hone their skills in a safe and caring environment. I encourage those who are hesitant and soothe the nerves of those who are frightened of practicing on a simulated patient. It is important to me to be part of their learning journey and to portray the ailing patient so the clinicians attending me can learn without fear of reprisal or ridicule. During and after simulation sessions I feel the feedback most close to my heart is one of positive re-enforcement. I like to remind each and every participant that clear communication is foremost important in their roles as clinicians. I admire their willingness to hear my feedback and I am often personally thanked for my role in their learning experience.

I like to thank them for their care, consideration and participation. I admire their dedication to this chosen career. Having experienced first-hand the grief that lack of communication can cause, I like to tell the participants my story, reiterating that a few explanatory words of comfort could have saved me a lot of angst worry and self-doubt. 

Participants seem to enjoy their experience with simulation as part of their learning, and I note satisfaction, pride and good general banter as they leave the sessions.

The learning for me as a simulated patient has been incredible. I appreciate more the art of clear communication. I am learning and understanding more about the wonderful world of medicine. And above all, having the privilege to work with the new staff groups as they stand with pride knowing they have given their utmost to this training session. It is obvious that, although they started as strangers, they leave this training as part of a well-disciplined, well-oiled working team”.

What have we achieved since using this approach to staff orientation?

1. A better understanding and appreciation of the different scopes of practice within the multidisciplinary team and the priorities in care planning. As well as improved understanding, networking opportunities and team building across the different health disciplines.

2. Significant increase in staff’s confidence levels in before and after participation in ICOP with the junior medical officers showing the greatest increase in confidence across all areas.  This results in greater confidence to commence clinical practice. Some areas of greatest increase in confidence across the health disciplines include:

• Engaging an interpreter:  “Calling the interpreter was really helpful. I never knew how simple it was”. Increase in confidence across all groups by 57% (73% in the junior doctor’s). Subsequent data has identified an increase in interpreter use by 60% and a resultant reduction in  wait times in the Emergency Department, length of stay and readmission rates
• Documentation for optimal clinical coding and patient care: Increase in confidence across all groups by 39% (81% junior doctor’s) supporting revenue optimisation and healthcare data accuracy. Engaging patients in care planning: Increase in confidence across all groups by 12% (72% junior doctor’s)
• Care of the deteriorating patient: 13% (64% junior doctor’s) increase in confidence in communicating for safety and recognising and responding to deterioration, supporting an optimal patient journey.

3. There has also been a decrease in clinical waste across the Mater by 0.6kg per patient day and an identified improvement in confidence in participating in simulation across all participants of 14% (36% junior doctor’s).