Document ID: Obtain from Objective Version: 1.0 Department: ORL Last Updated: 21/05/2015 Document Owner: Service Manager ORL Next Review Date: 21/05/2018 Approved by: Name of Approval Group/Committee Date First Issued: dd/mm/yyyy Counties Manukau Health POSITION DESCRIPTION Senior Medical Officer for OTORHINOLARYNGOLOGY General ORL with special interest Otology This role is considered a non-core children’s worker and will be subject to safety checking as part of the Vulnerable Children Act 2014 Position Holder's Name: ........................................................................ Position Holder's Signature: .................................................................. Manager/Supervisor's Name: ............................................................... Manager/Supervisor's Signature: ..........................................................
Transcript
Document ID: Obtain from Objective Version: 1.0
Department: ORL Last Updated: 21/05/2015
Document Owner: Service Manager ORL Next Review Date: 21/05/2018
Approved by: Name of Approval Group/Committee Date First Issued: dd/mm/yyyy
Counties Manukau Health
POSITION DESCRIPTION
Senior Medical Officer for OTORHINOLARYNGOLOGY General ORL with special interest Otology
This role is considered a non-core children’s worker and will be subject to safety checking as part of the Vulnerable Children Act 2014
Position Holder's Name: ........................................................................ Position Holder's Signature: .................................................................. Manager/Supervisor's Name: ............................................................... Manager/Supervisor's Signature: ..........................................................
Position description: Counties Manukau Health 2
Position description: Counties Manukau Health 3
PURPOSE OF THE POSITION
To provide specialist Otorhinolaryngology care with a specialist interest in Otology and support to the population of Counties Manukau. To provide clinical consultation with those patients identified as requiring specialist assessment and management. To provide continuity and service to the existing ORL and Otology sub specialty. Participate in the local and regional multidisciplinary team process for Head & Neck services as required. To promote best practice management of Otorhinolaryngology by providing safe and efficient Otorhinolaryngology services. To review, develop and implement professional medical standards of Otorhinolaryngology practice and competence in the inpatient and outpatient settings at CMDHB. To deliver on the service’s required outcomes through the active engagement in the clinical partnership model with the Clinical Head. To ensure that care is provided to patients through a coordinated continuum of care.
Position description: Counties Manukau Health 4
NATURE AND SCOPE OF RESPONSIBILITIES
ROUTINE ACTIVITIES
A session is defined as an aggregated total of approximately five hours, being a combination of scheduled activities (theatre operating sessions, clinics, etc.), together with all associated service and support work. Sessions are expected to average five hours inclusive of all activities, when averaged over time. 1.0 FTE equates to 8 x 5 sessions per week.
THEATRE SESSIONS Activities as part of theatre activities include;
- Teaching where required - Pre-operative visit - Consultation with colleagues and Registrars - Obtaining/checking informed consent - Following policies and procedures for wait listing patients - Inter-operative clinical management of patients notifying special requirements such as
special equipment and implants - Post-operative visit - Correspondence, reports, and other administrative activities.
During these sessions the Senior Medical Officer (SMO) is primarily responsible for the provision of effective, clinically appropriate, and safe intervention in accordance with clinical practice protocols and guidelines. The SMO is accountable for the safe management of patients under their care, obtaining informed consent, optimum utilisation of available theatre time, direction of nursing staff assigned to assist, and effective communication and liaison with ORL and other relevant staff. The SMO may also be accountable for effective supervision and teaching of assigned medical staff in training. The SMO with assigned responsibility for the provision of Otorhinolaryngology (ORL) services for a session is required to attend as detailed below and will be accountable for clinical sessions commencing at the agreed time. Morning Session 0800 – 12 00 hours (with the aim of 08.30am cutting time). Finishing at 1230 (when patient is in recovery) Afternoon Session 1300 – 1700 (with the aim of 1.30am cutting time). Finishing at 1700 hours (when patient is in recovery) WARD ROUNDS
Routine post-operative ward rounds are required: the frequency is dependent on the number of inpatients on the day (in accordance with clinical policy). Generally these are expected to be with the surgical team. Ward rounds will be evidenced by the assessment recorded in the patient notes.
Position description: Counties Manukau Health 5
These ward rounds include pre-operative assessments, supervision of investigations and management of in-patients, post-operative assessments, and consultation between team members (and other medical staff as appropriate) concerning all patients for whom the team is responsible. Major team ward rounds will vary in length depending upon the number of patients to be seen, their acuity, and other factors. For job sizing purposes, these will be combined with the associated activities set out below, and with other ward visits and post-acute ward rounds.
It is expected that the SMO will see all major cases within 24 hours of surgery whenever
medical input is indicated for reasons of clinical safety (e.g. due to relative inexperience of Registrars). However, occasionally other higher priority commitments (e.g. acute cases) will prevent the employee from seeing such patients within 24 hours.
While these post-operative assessments may usually take place within the context of a
team ward round, where the surgeon has performed surgery for acute cases, a post-acute ward round may be required in addition to the formal ward round to meet the above expectation.
Additional ward visits are required on an as-required basis, where specific problems arise
and where follow-up action is required. Activities included/associated with ward round sessions include;
Teaching of resident medical staff (Registrars, House Surgeons) and medical students
Direction of resident medical staff members of the surgical team Pre-operative planning and preparation of operating lists X-ray conferences/review Clinical-pathological conferences Peer review Consults between and within departments Ward meetings, care planning and discharge planning Associated administrative tasks Acute cover as required
The SMO is primarily responsible for the safe management of their patients care through the activities associated with these sessions.
The SMO is accountable for seeing all designated patients to assess and evaluate their care,
review and plan the management of their care, and plan discharge. The SMO is also accountable for effective and sensitive communication and liaison with the patients and/or their next of kin, and with nursing and other clinical care staff. The SMO may also be accountable for effective supervision and teaching of assigned medical staff in training.
CLINICS
Activities included as part of these clinics include; Teaching Consultation with colleagues and Registrars Undertaking pre-admission assessments (of patients seen and screened by resident
medical staff)
Position description: Counties Manukau Health 6
Discussing diagnoses, treatment options, and disease/condition management with patients and/or their next of kin
Obtaining/checking informed consent Correspondence, reports, and other administrative activities. Acute cover as required
During these sessions the SMO is primarily responsible for the assessment and evaluation of patients’ health status in order to diagnose, formulate opinions, and/or plan treatment regimes.
The SMO is accountable for the sensitive communication with the patients presenting in
clinics, obtaining informed consent, optimum utilisation of available time, and effective communication and liaison with relevant staff. The SMO may also be accountable for effective supervision and teaching of assigned medical staff in training.
ROSTERED ACUTE DUTIES The ORL SMO is required to be involved in the management of acute presentations Monday to Friday. This will be in conjunction with routine sessional requirement. Note: The minimum requirement for the ORL Surgery Clinical Group is for at least one consultant and one Registrar to be available in the hospital for acute cover during the hours 0800 to 1700, Monday to Friday inclusive. The group is collectively responsible for ensuring that such cover is provided on the Manukau SuperClinic site. The Monday to Friday component of Acute cover involves:
Ensuring appropriate assessment and management of all acute ORL surgery cases presenting during the rostered period (0800 hours through to 1700 hours or as otherwise allocated within the ORL Surgery clinical group). This will be rostered
The SMO is responsible for the general oversight of all such cases, undertaking surgery and reviewing in-patient calls and Emergency Care transfers in conjunction with the Acute on call consultant.
Being available on site from 0800 hours -1700 hours throughout the day, and until the pattern of work is organised and prioritised, and the employee is satisfied that all acute cases presenting are safely delegated to appropriate staff.
Acute cases may present at Middlemore Hospital and in the event that these patients are unstable and therefore unable to transfer to Manukau then the SMO is required to attend Emergency Care to assess the patient and arrange appropriate management.
Evening, night and weekend cover is provided by a regional roster. Participation in the regional roster is additional to the routine work and covered within the employment contract.
Position description: Counties Manukau Health 7
GRADING OF REFERRALS All referrals received require grading (prioritisation). This activity is shared between SMOs and is part of the clinical workload. CLINICAL RESEARCH The SMO will be encouraged to conduct clinical audit and research projects, and will be encouraged to submit a manuscript for publication. NON-CLINICAL DUTIES The following duties, which are not directly associated with patient care events, are included in the routine work requirements: Regular participation in continuing medical education activities on a week-by-week basis, by:
o attendance at scheduled clinical meetings o personal literature review - including participation in in-house journal review meetings
(attendance of at least 50% of planned meetings is required) o participation in national and local organisations dedicated to education and
maintenance of standards within general surgery
Administrative tasks not directly associated with clinics, ward rounds, theatre sessions. o Preparation of materials for and provision of formal teaching to junior medical staff,
nursing staff and other clinical support staff. o Case preparation and research (planning for major cases). o Business meetings
Note: The following activities are also required, and are specifically covered by other remuneration and leave provisions:
Participation in the departmental peer review, credentialing and clinical audit programs. (Note the provision of two weeks paid time per annum for quality assurance activities)
Attendance at CME activities to be negotiated with the Clinical HOD and Clinical Supervisor ((Note the provision of CME leave and financial support for CME activities)
PROFESSIONAL RESPONSIBILITIES CLINICAL SUPERVISION Clinical supervision is defined in the broadest sense as general oversight of clinical activities which may include but may not be limited to:
oversight of clinical activities
direct supervision of clinical care
participation in case review and referral meetings
availability for consultation with other staff
allocation and review of referrals
consulting with other specialists
supervision of follow-up programmes.
Position description: Counties Manukau Health 8
The SMO will be accountable for clinical decisions relating to treatment programmes, oversight and review of clinical activities, effective liaison with other treatment staff, use of resources within agreed protocols and guidelines, decisions concerning transfer, ensuring that an appropriate care programme is in place. The SMO will be accountable for ensuring that clinical sessions start on time. ORL has a GPwSI programme for the assessment of suitably triaged patients. The SMO may be involved in the training, supervision or oversight and support for this programme. There will be a contribution to the general and ongoing professional development of all clinical staff within service-based activities. SERVICE DEVELOPMENT The SMO will contribute (with the Clinical Head) to the development of the range and quality of services provided, in accord with best practice models and evidence regarding effectiveness. Key activities include:
Recruitment and orientation of clinical staff within the service, in partnership with the Clinical Head/Service Manager and the Recruitment Centre.
Developing clinical audit process and procedures.
Providing clear focus and expectations for performance of clinical staff through development of objectives and goals that reflect best ORL practice and enable the service to meet Business Plan standards and legislative requirements.
Planning future clinical staff human resource needs with the Clinical Head, General Manager and Service Manager (and Professional Leaders where appropriate),
Consultation and advice will be provided in all matters relating to service development and standards of practice. CLINICAL LEADERSHIP The SMO plays a central role in the function of the team. A lead role is expected in regard to developing, implementing and reviewing systems for assessment and for the delivery of care, with a focus on outcomes in the following areas:
providing a model of good practice clinically
promoting discussion and review of clinical assessments and plans
encouraging comprehensive clinical formulations and action plans based upon these
encouraging and modelling use of best practice, problem solving, and communication ensuring professional delivery of quality care.
reporting cases/incidents which, in his/her opinion, may warrant the attention of the Clinical Head..
There is the opportunity for Honorary University Senior Lecturer status.
Position description: Counties Manukau Health 9
SCOPE FOR ACTION
The ORL SMO is encouraged to use initiative and problem solving skills to develop innovative approaches to issues. Discretion is required to be exercised in releasing confidential information to the appropriate parties.
STATUTORY OBLIGATIONS The ORL SMO is responsible to ensure that procedures involving patients meet statutory requirements and are ethical and clinically appropriate.
GENERAL Support Services ORL equipment will be supplied by the DHB to standards agreed by the Clinical Board (and taking into account appropriate guidelines from the Royal Australian and New Zealand College of Oophthalmologists), and will be maintained to that standard. Support Staff Staffing levels for support staff will be planned and determined by the General Manager in consultation with the Clinical Head and Group Clinical Director, (and taking into account appropriate guidelines from the Australian and New Zealand College of Otorhinolaryngology) and in accordance with standards and safety levels agreed by the Clinical Board. This is with particular reference to:
Junior medical staff coverage to ensure safe practices support and assistance with clinical tasks, and with maintenance of ORL equipment appropriate administrative and secretarial support
PERFORMANCE ASSESSMENT The ORL SMO is accountable for his/her own professional development annually through ongoing participation in activities to maintain and enhance standards of practice (including peer review, attendance at CME meetings, academic activities, and individual review and appraisal of evidence in regard to service provision and patient care). Attendance at particular activities supported by the organisation will be in accord with service direction and requirements, and will be agreed with the Clinical Head and Service Manager. The undertaking of clinical audit and research projects including the documentation and publication will be in accord with service direction and agreed with the Clinical Head.
Position description: Counties Manukau Health 10
Key Accountabilities
Standards / Achievements
Cultural Safety & Diversity
Commitment to the principles of Treaty of Waitangi
Honouring Diversity
Respect, sensitivity, cultural awareness is evident in interpersonal relationships.
Our differences are acknowledged by respecting spiritual beliefs, cultural practices and lifestyle choices.
Utilise Information Technology
Demonstrate an ability to access and use available clinical information systems.
Is conversant with applications required for specific discipline/role. For example, i.PM, Concerto, Outlook, etc.
Maintains own professional development by attending relevant IT educational programmes.
Position description: Counties Manukau Health 11
COMMUNICATION AND INTERPERSONAL SKILLS
The Otorhinolaryngology SMO will be required to develop and maintain effective relationships with a range of CMDHB staff members and external contacts including clinical and administrative staff, managers, patients and their family/whanau. Situations may often call for tact, diplomacy and will require information to be handled in a discreet and sensitive manner. In conflict situations will be required to exercise sound judgement, negotiation and persuasiveness skills, toward facilitating a workable outcome.
PROBLEM COMPLEXITY
The ORL SMO will be regularly challenged by a wide range of clinical situations. There will be a requirement to be able to prioritise issues and negotiate time frames, while still providing a quality patient service. The range of problems will be diverse and require solutions customised to meet the circumstances of the patient. Therefore opportunities will arise to provide innovative options to the patient based on proven outcomes. Will refer to the Clinical Head of ORL or other senior colleagues for advice or second opinion.
There will be demands to meet deadlines, maintain accuracy and quality of information. Failure to do so could impact on the organisation in terms of the ability to meet contracted outcomes and provide quality standards.
DIMENSION OF THE POSITION
The ORL SMO will be responsible to the Clinical Head and/or Service Manager for the achievement of agreed objectives and operate within the confines of Counties Manukau District Health Board.
POSITIONS REPORTING IN THIS ROLE (numbers)
Directly (numbers): nil Indirectly (numbers): All clinical and support staff Relationships:
External Internal Committees/Groups
Relevant College Regional Services GPs GPwSI Specialists in other DHBs & in private practice Staff & services of other DHBs
Clinical Head of Otorhinolaryngology Service Manager Service Co-ordinator Clinical Nurse Co-ordinator Clinical Nurse Manager Nursing staff Audiology staff Admin/clerical staff CMDHB specialities/services Other CMDHB staff
Department meetings Meetings/ CME sessions MDM local and regional meetings Clinical, radiology and pathology meetings
Position description: Counties Manukau Health 12
PERSON SPECIFICATIONS (requirements for the role)
ESSENTIAL
Skills/Knowledge/
Medical Officer with NZMC registration as a specialist
Recognised ORL training programme
Leadership Proven ability to initiate and manage change.
Proven ability to lead a group of people to meet agreed goals.
Proven ability to manage conflict.
Proven ability to meet timeframes.
Proven ability to communicate effectively through both written and oral communication, including formal presentations.
Proven ability to give constructive criticism to other medical staff in relation to performance when needed.
Proven ability to develop the potential of others.
Personal Qualities Ability to operate in a team environment.
Personal sincerity and integrity.
Demonstrable commitment to the service values.
High levels of initiative and motivation, and a willingness to generate quality outputs.
Speaks and write effectively getting the message across, according to the needs of different people.
Listens actively to others and responds appropriately
A high standard of personal work ethic; time management skills; the ability to work autonomously.
Evidence of previous successful research activity.
Clinical competence & quality of care
Competent practitioner in Otorhinolaryngology care
Completion of a recognised Otology Fellowship or equivalent experience
Commitment to, & demonstrable involvement in, auditing, accreditation, credentialing, peer review.
Patient Focus
Orientation towards serving patients first
Position description: Counties Manukau Health 13
Teamwork
Collaborates with team members from all disciplines & professional groupings
Committed to development of Otorhinolaryngology Service
Communication & Interpersonal skills
Actively listens, drawing out information and checking understanding.
Expresses information effectively, both orally and in writing, adjusts language and style to the recipients and considers their frame of reference.
Empathises with others and considers their needs and feelings.
Able to negotiate and resolve disputes amicably.
Effective at building relationships both internally and externally.
Organisational skills
Establishes a plan of action and achieves priority goals.
Manages workload/flow, recognises and addresses barriers, and takes account of changing priorities.
Self-Management
Sets high standards and strives to achieve stretching goals, displays drive and energy and persists in overcoming obstacles.
Copes with stress, is resilient to change and understands personal limitations.
Is proactive and displays initiative.
Innovation
Actively questions old ways of doing things, thinks outside the square and develops creative, effective solutions to improve outcomes.
Intermediate Computing
Ability to use standard software application.
Position description: Counties Manukau Health 14
HEALTH AND SAFETY ACCOUNTABILITIES (non-management roles) Health and Safety (H&S) is a key accountability of all Counties Manukau Health (CM Health) staff. All CM Health Employees are responsible to:
Zero Harm Engage in safe workplace practices and take care of the health and safety of themselves, other employees and people in the workplace
Risk Management Identify, evaluate and report all hazards and incidents they are aware of in the workplace
Adhere to apply risk controls, identified in risk assessments, such as ‘Safe Operating Procedures’
Follow safety instructions
Stop work when there is an immediate risk of serious harm and notify the appropriate manager
Ensure nothing they do or don’t do will cause harm to themselves or others
Safety Management System Requirements
Understand and follow CM Health’s Occupational Health and Safety policies, Health and Safety regulations, and personal responsibilities as outlined by these policies
Follow all Occupational Health and Safety policies and procedures
Work Safely Report for duty in a fit state, free from the influence of alcohol or other drugs
Participate in consultation activities regarding matters affecting your health, safety and wellbeing
Wear the required Personal Protective Equipment when undertaking specific activities, or when in nominated areas
Operate clinical or plant equipment safely
Participate in relevant safety training, and maintain safety related competencies
If relevant to your position, be in possession of required and current Certificates of Competency
