Promising results for high risk
doctor program reported in UK journal
Promising results of decreased claims and complaints for high risk doctors as a result of attending the Institute’s Clinical Communication Program have been published in the British Journal of Hospital Medicine.
The Institute’s program is run by the Medical Protection Society in the United Kingdom who studied 80 members that had attended the program since 2001. In the UK, it is estimated that at any one time about 5% (6000) of UK doctors experience performance problems (General Medical Council, 2005).
International research reveals that impaired performance in doctors has as much to do with behaviour, attitudes and communication skills as clinical skills (Levinson et al, 1997; Bunting et al, 1998). However there are relatively few remedies available to referring organisations or the doctor concerned and even less evidence of effectiveness of the interventions.
It will be some years before the program methodology can be rigorously validated but the results over the first 2 years give cause for optimism.
Findings include:
- A notable reduction in complaints against participants since completing the program
(see table to the left)
- Patient satisfaction with participants has increased
- Participants experience improved relationships with their patients and colleagues.
| Reduction in complaints | ||
|---|---|---|
| . | BEFORE In the 5yrs before CCP attendance |
AFTER In the 2yrs after CCP attendance |
| Total number for all respondents |
66 | 7 |
| Average number of complaints per respondent |
3.9 | 0.4 |
Australian open disclosure pilot report released
The report on the Australian open disclosure pilot has just been released, providing a detailed evaluation of policies and education implemented by the 40 facilities that took part throughout Australia.
The Cognitive Institute was the largest provider of open disclosure education to the pilot sites, implementing its Clinical Incident Management (CIM) program across Queensland, South Australia, Victoria and the Australian Capital Territory.
New workshop: Mastering Supervision Challenges launched to support training programmes
This month the Cognitive Institute launched Mastering Supervision Challenges. The workshop explores the challenges supervisors and mentors may face with a doctor in training not performing at the standard required, important theoretical models to assist in determining the underlying cause and practical skills to maximise the opportunity of a successful intervention.
It was developed in response to demand and feedback from training programs and Royal Colleges to assist them meet the increasing challenges required by the Australian Medical Council (AMC) accreditation standards.
Mastering Supervision Challenges is an extension program recommended for supervisors and mentors who have already undertaken either the Cognitive Institute’s one day Mastering Clinical Supervision or half day Mastering Clinician Coaching and Feedback workshops.
For more information on how Cognitive Institute courses, including Mastering Supervision Challenges, can assist in the training and up skilling of supervisors and mentors, contact Alison Kay at Cognitive Institute on enquiries@cognitiveinstitute.org
Articles, news and developments
OPEN DISCLOSURE
- Disclosing Medical Errors: Best Practices from the “Leading Edge”
This recently released article by Eve Shapiro provides an in-depth review of successful open disclosure programs in North America.... Download
RISK MANAGEMENT
- New guidance on consent and decision making
The UK’s General Medical Council has issued new guidance for doctors on consent and decision-making, reflecting changes in the law and the shift in professional and public attitudes towards more patient-centred care.... Download
- Exam scores a key predictor of future complaints
Reform of licensure assessment in Canada has resulted in a national standardised assessment of patient-doctor communication skills. In this examination, doctors who scored more that 2-SD below the mean were significantly more likely to have been the subject of complaints to medical regulatory authorities.... Download
SUPERVISION AND COACHING
-
Remediation for struggling doctors in training is successful
This 25 year review of trainee ‘doctors in trouble’ reports that tailored remediation programs resulted in 90% of these doctors successfully graduating.... Download
COMMUNICATION SKILLS
- Clinician communication reduces healthcare use
Specific communication skills and behaviours by clinicians significantly enhanced patient perceptions of clinician performance and also reduced health care use.... Download
- Patient experience predicts doctor complaints
In this US 2008 study, the relationship between patient survey assessments of the quality of doctor patient interactions and care coordination was assessed. Patient assessment of the quality of the interaction with their doctor was inversely related to their likelihood of making a complaint.... Download
Cognitive's new faculty
view profiles
Seven new faculty presenters
Seven doctors from three countries have recently been accredited as faculty presenters for the Cognitive Institute.
The new faculty members are drawn from Singapore, New Zealand and Australia and bring a diverse range of experience to the organisation. Among them are three book authors, hospital managers, PhD students, a former Royal College president and a former pro vice-chancellor.
They also bring a broad range of medical expertise to the faculty, with fellowships in urology, psychiatry, paediatrics, obstetrics and gynaecology, and emergency medicine.
The faculty members are Dr Josephine Burnand, Dr Nicholas Chew, Dr Mohamed Khadra, Dr Anne Kolbe, Dr Kathryn Robertson, Dr Alan Sandford and Dr Mark Woodrow.
FROM LEFT: Ms Yong Mei Chin, Manager, Patients Relations Services, Tan Tock Seng Hospital; Dr Mark O’Brien, Medical Director, Cognitive Institute; Dr Sophia Ang, Assoc Chairman Medical Board, National University Hospital; Ms Mindy Ang, Assistant Manager, IMET, NHG College; Ms Nellie Yeo, Chief Quality Officer, NHG; Mr Matthew O’Brien, Managing Director, Cognitive Institute; Dr Tai Hwei Yee, Deputy Chief Quality Officer, NHG |
Singapore open disclosure delegation visits Cognitive Institute
The Cognitive Institute recently hosted a delegation to its Brisbane offices from its valued Singapore client, the National Healthcare Group (NHG).
NHG represents approximately half of Singapore’s public sector hospitals and its Tan Tock Seng Hospital was the second organisation to implement the Institute’s Clinical Incident Management open disclosure program.
The open disclosure movement is gaining momentum in Singapore and the visit to Australia was part of an international review of successful implementation programs including supporting legislation, policy frameworks and training initiatives.
The five person delegation was in Brisbane for three days to learn from the Institute’s public and private clients that conducted training in the Clinical Incident Management program. The delegation visited Queensland Health, Mater Health Services campus which includes public and private hospitals, and the private Wesley Hospital.
