1. MTI & Volunteering Committee
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
MTI & Volunteering Committee
RCOG

2. BEING A GOOD DOCTOR

3. COMMUNICATION Communication is an inherent part of social skills and enhances the other two

4. WHAT IS ALL THIS FUSS ABOUT COMMUNICATION SKILLS Now in undergraduate/Postgraduate curriculum, assessed in exams cornerstone of being a good doctor It is no longer a ‘nice to have’ IT IS ESSENTIAL

5. Good communications and engagement is at the heart of how the NHS engages with patients, public, communities and our staff

6. Bad Communications Loss of Life/ harm to patients Complaints- 30% complaints involve some aspect of poor communication NHS Resolution- 20% Complaints were due to staff attitudes and communication failures, medical negligence, dismissal and criminal convictions

7. COMMUNICATION STYLES UNETHICAL- when absent, delayed, misleading information intentionally given GMC advises effective communication with colleague is essential for good medical care GMC FTP may be called in to question Accusations 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

8. ESSENTIAL COMMUNICATION SKILLS LISTEN Non Verbal Communication Using patients own words Patient centred care Meeting patient expectations REQUIREMENTS OF APPRSISAL & REVALIDATION 360 degree feedback from colleagues and patients

9. CONSEQUENCES OF BAD COMMUNICATIONS Disciplinary actions Complaints and Claims Gross negligence manslaughter s and social networks Advise; 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

12. CHANGING WORKING PATTERNS IN MODERN MEDICAL CARE IN NHS

14. 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

15. – 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.

16. 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.

17. DOCUMENTATION Check- 1st confirm you have the correct records for the patient CLEAR AND ACCURATE Contemporaneous, write up soon as possible, retrospective date and time Identify yourself

18. Good practice in handover Who should be involved
Good practice in handover Who 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

19. IN SUMMERY GMC Good Medical Practice UK covers Communication, Documentation, handover Multidisciplinary Team working in obstetrics and gynaecology practice in UK Working 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