Palliative Care/Palliative Medicine Registrar
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- Valentine Spencer
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1 Monash Doctors Workforce Monash Medical Centre 246 Clayton Road Clayton Victoria 3168 Australia Palliative Care/Palliative Medicine Registrar Role Information: Postal address: Locked Bag 29 Clayton South Vic 3169 Australia Tel (03) Fax (03) Full time post Palliative Care Inpatient Unit Registrar Sites: McCulloch House and Monash Medical Centre, Clayton Note: This position would be suitable for advanced trainees towards the FRACP or FAChPM or other trainees wishing to gain experience in palliative medicine as part of training in another specialty or general practice (as an elective year). Applicants intending to do the Diploma of Palliative Medicine will also be considered. Applications are invited from qualified medical practitioners, registered by or eligible for the Australian Health Practitioner Regulation Agency, for the position of Palliative Care/Palliative Medicine Registrar Full time post Palliative Care Consult Service Registrar (not currently funded) Sites: McCulloch House and Monash Medical Centre Clayton, and Dandenong Hospital Note: This job is designed for a senior trainee or fellow. This position would be suitable for advanced trainees towards the FRACP or FAChPM or applicants aiming for the Diploma of Palliative Medicine. Prior experience in Palliative Care is highly desirable. Applications are invited from qualified medical practitioners, registered by or eligible for the Australian Health Practitioner Regulation Agency, for the position of Palliative Care/Palliative Medicine Registrar. For further information please refer to the position description below and contact Kate Jackson, Leeroy William, Michael Franco or Peter Poon for further discussion. Applications open: Sunday 15 th June 2014 Applications close: Friday 15 th August 2014 Interviews held: Week beginning 19 th August th August 2014 These positions begin on 2 nd February 2015 for 12 months to 31 st January 2016, for 6 month terms (ie. Inpatient x2 6-month terms, Consult x2 6-month terms). Enquiry Contact Details: A/Prof Kate Jackson, Director, Supportive and Palliative Care Unit, Monash Health and Monash University Ph: (03) pallcare@monashhealth.org Dr Leeroy William, Palliative Medicine Specialist Ph: (03) or Mobile leeroy.william@monashhealth.org Monash Medical Centre, Clayton 246 Clayton Road Clayton Tel: Monash Medical Centre, Moorabbin Centre Road East Bentleigh Tel: Kingston Centre Warrigal Road Cheltenham Tel: Dandenong Hospital David Street Dandenong Tel: Casey Hospital Kangan Drive Berwick Tel: Community-based services across the South East ABN
2 Monash Doctors Workforce Monash Medical Centre 246 Clayton Road Clayton Victoria 3168 Australia Postal address: Locked Bag 29 Clayton South Vic 3169 Australia Tel (03) Fax (03) Dr Michael Franco, Palliative Medicine and Oncology Specialist Ph: (03) or via Monash Health switchboard , and ask to be put through to mobile Dr Peter Poon, Palliative Medicine Specialist, Monash Health and Eastern Palliative Care Ph: (03) Application details These positions are part of the statewide Victorian Palliative Medicine Training Program (VPMTP) and application will need to be made to the Medical Training Coordinator for the Victorian Palliative Medicine Training Program via (select the VPMTP link and follow the prompts under 'Education' to the application process. Please or ring if you would like further details regarding these positions prior to completing your VPMTP application. Monash Medical Centre, Clayton 246 Clayton Road Clayton Tel: Monash Medical Centre, Moorabbin Centre Road East Bentleigh Tel: Kingston Centre Warrigal Road Cheltenham Tel: Dandenong Hospital David Street Dandenong Tel: Casey Hospital Kangan Drive Berwick Tel: Community-based services across the South East ABN
3 Monash Health Position Description Palliative Care Registrars Last Updated: April, 2014 Position Title: Classification: Reports to: Department: Palliative Care Registrars Inpatient Unit or Consult Service HM25-HM30 Clinical Unit Head Unit specific to Allocation/Appointment About Monash Health Monash Health provides health care across south eastern Melbourne, uniquely integrating in one organisation all primary, secondary and tertiary health services, as well as world-renowned research and teaching facilities. We serve a core population of over 942,000 people or 17% of the city's population, who depend on us for all aspects of their public health care needs, with our services drawn upon by a greater population of over 1.32 million or 32% of Melbourne. Monash Health also has a wider official specialist role for greater Melbourne, regional Victoria and interstate in such specialties as paediatrics, cardiology, transplants and neonatal intensive care with extensive university affiliations. Over 13,400 staff work at more than 40 sites across south eastern metropolitan Melbourne, including the major hospital facilities of Monash Medical Centre Clayton and Moorabbin, Dandenong Hospital, Casey Hospital, the Kingston Centre and Cranbourne Integrated Community Care Centre, and extensive community health facilities throughout the region. In the last financial year our hospitals treated more than 201,000 inpatients, triaged more than 179,000 emergency presentations, performed over 39,000 operations, and assisted with the delivery of over 8,600 new Victorians. Supportive and Palliative Care Unit The Supportive and Palliative Care Units responsibilities include: Inpatient/Hospice beds at McCulloch House (McCH). McCulloch House is a purpose built 16-bed palliative care unit located on the Clayton campus of Monash Medical Centre. The vision is to provide optimal clinical care to patients and their families within an academic multidisciplinary unit, which has a substantial education and research focus. Patients are admitted to McCulloch House under one of the following goals of care: - Symptom control - End of Life care - Psychosocial support - Assessment - Respite (pre-arranged for a designated duration usually 1-2 weeks) The McCulloch House monthly averaged statistics show: Admissions Discharges Length of stay Number of deaths A bi-disciplinary (medical and nursing) Palliative Care Consult Service with designated teams at: (a) Clayton campus (b) Moorabbin (Oncology) campus 1
4 (c) Dandenong campus, and on an as needed basis to other campuses, eg Kingston. The service sees over 1,500 patients per year. The 2009 figures showed a 70% / 30% malignant / non-malignant split, and 40% CALD. Teaching and Research as part of the Faculty of Medicine, Nursing and Health Sciences, Monash University. Representation on relevant hospital and university committees. Informal co-operation with the three local domiciliary palliative care services viz: - South East Palliative Care, - Eastern Palliative Care (EPC) and - Bethlehem Community Palliative Care Service (BPCS) Memorandum of Understanding with Gippsland Regional Palliative Care Consortium for support and education. The current medical staffing of the unit is: Professor/Director/Unit Head Names of consultant/supervisors (each of whom takes responsibility for one of the consult services, as well as sharing McCulloch House ward service on a fortnightly basis and has outside attachments as indicated) Junior Medical Staff A/Professor Kate Jackson Dr Leeroy William (Monash Health) Dr Peter Poon (Monash Health and Eastern Palliative Care Domiciliary Service) Dr Michael Franco (Monash Health Palliative Care and Oncology) It is anticipated that a Fellow in Pain Medicine will be appointed in 2014 and this position will have significant palliative care involvement. Registrar x2 (1 inpatient unit, 1 Palliative Care Consult Service) Intern Nature and Scope of the Position Description There will be two accredited training positions in 2015, but at this stage only the inpatient position is funded. i) Registrar to McCulloch House, the inpatient (hospice) unit with some general hospital consult work. This would be suitable as a 1 st, 2 nd or 3 rd year position for FRACP or FAChPM (RACP) candidates or for a general practice or other specialty elective. ii) Registrar in the Monash Health Palliative Care Consult Service. This job is designed for a senior trainee or fellow. i) Palliative Care Inpatient Unit Registrar Day to day medical matters in the unit during normal working house Supervision of the Palliative Care Intern To liaise at least daily with the NUM/ANUM In association with NUM/ANUM, fielding and when necessary prioritising admission requests Updating relatives including taking a leadership role at the formal routine family meetings Providing telephone advice to eg GPs, domiciliary care services, about past or potential patients Review of consult service patients as requested with subsequent handover/consultation with the relevant staff specialist/consultant Review of patients in A&E if requested, for advice and/or admission Supervising discharge planning Updating the ward service consultant in a timely fashion. This should occur promptly for any of the following: o Uncertainty as to patient management o Unexpected deterioration/death o Other major untoward events o Significant family anger/dissatisfaction o Any potential medico-legal or coronial matters 2
5 Involvement in the units teaching (predominately undergraduate medical students) and any ongoing research projects Organising, as required, consultant opinions from other SH units/consultants, eg Neurosurgery, Oncology, Liaison Psychiatry, Acute Pain Service Participation, after a period of acclimatisation and with backup consultant cover, in the out of hours weekend and weekdays roster (see below). NB Currently (April 2011) there is no cross cover with other units/specialties. As a corollary there is no Registrar cover to Palliative Care when the Palliative Care Registrar is off duty. Timetable of Monash Health Formal Inpatient Registrar Commitments Monday 1315 Supportive and Palliative Care Unit Journal Club (alternate weeks) 1400 Consultant Ward round meeting (all consultants encouraged to attend) followed by patient bedside review by ward service consultant. Tuesday Formal family meetings Registrar/Social Worker Currently Intern afternoon off Wednesday 12:30-1:30 Professorial Grand Round (Clayton) PM Supervision from Unit Head/Staff Specialists initially monthly Alternate Victorian Palliative Medicine Training Program Trainee Education Session Weds, PM Thursday 0830 Consult Service patient reviews and McCulloch House death review 0915 Consultant Ward round meeting (all consultants encouraged to attend) followed by patient bedside review by ward service consultant. Currently Registrar afternoon off. Friday Formal family meetings Registrar and Social Worker Reflective Practice 1630 Registrar Handover to W/E on call consultant Saturday AM Oncall Registrar or Consult review of problem McCulloch House patients or overnight admission PM On-call Registrar or Consultant Sunday AM On-call Registrar or Consultant PM On-call Registrar or Consultant ii) Palliative Care Consult Service Registrar To work with the SPCU clinical nurse consultants and palliative medicine and other medical consultants. Review of patients referred to Monash Health consult service: o Symptom issues o Parent unit asking for help re setting goals of care o Medical liaison other units and GP s o Combined medical/nursing assessment as required Review potential McCulloch House admissions particularly from ED, ICU and MAU. Attend strategic other unit meetings eg. General Medicine and ICU, at least once weekly. 1.5 days at McCulloch House, SPCU for the ward service consult formal ward rounds and cover McCulloch House s registrar s afternoon off. Participate in the rolling out of PICD across the network. Involvement in the units teaching of medical and nursing trainees and graduates Involvement in the units ongoing research. After a period of acclimatisation and with back up consult cover participate in the McCulloch House/Monash Health out of hours weekend and weekday rosters. 3
6 Draft Timetable of Palliative Care Consult Service Registrar Commitments Monday AM Gen Med handover meeting, then Clayton consult patients 1315 Supportive and Palliative Care Unit Journal Club (1 st and 3 rd Monday of each month) 1400 Consultant Ward round meeting (all consultants encouraged to attend) followed by patient bedside review by ward service consultant. Tuesday AM Dandenong consult patients PM Afternoon off Wednesday 12:30-1:30 Professorial Grand Round (Clayton) AM ICU ward round?potential palliative care referrals, then Clayton consult patients PM Supervision from Unit Head/Staff Specialists initially monthly Alternate Victorian Palliative Medicine Training Program Trainee Education Session Weds, PM Thursday 0830 Consult Service patient reviews and McCulloch House death review 0915 Consultant Ward round meeting (all consultants encouraged to attend) followed by patient bedside review by ward service consultant. PM Cover McCulloch House Registrar afternoon off and oncall overnight. Friday AM Dandenong consult patients PM Dandenong Palliative Care Consultant Ward Round 1630 Registrar Handover to W/E on call consultant Saturday AM On-call Registrar or Consultant review of complex McCulloch House patients or overnight admission PM On-call Registrar or Consultant Sunday AM On-call Registrar or Consultant PM On-call Registrar or Consultant Job Summary (Purpose /Key Result areas/scope) Purpose Work as part of a multidisciplinary team to provide safe and effective person centred care, provide teaching and supervision of resident medical staff and students and undertake training towards attaining Fellowship of the relevant college. Key result Areas As Registrar of the Unit you will have a significant responsibility and a complex role. You will be required to undertake: Patient assessment and management in consultation with the treating consultant Patient care coordination Intern/HMO support, supervision, feedback and teaching Student interaction and teaching Family member communication, feedback and liaison Extensive interaction with the other health professionals, especially, the nursing and allied health staff Self-management (including time management, accessing education and training and completing college requirements) Provide clinical leadership to the multidisciplinary treating team Demonstrate commitment towards key organisational initiatives Demonstrate compliance with all relevant Monash Health Policies and Procedures 4
7 Scope Dimensions Budget Equivalent Full Time Staff Direct reports Not Applicable Not Applicable Resident Medical Staff of the Unit Key relationships Internal External Responsibilities/Accountabilities Unit Head Senior Medical Staff Other Registrars and HMOs Nurse Unit Manager and Nursing staff Allied Health Staff Monash Doctors Workforce Monash Doctors Education Directors of Vocational Training Monash Innovation and Quality Director Medical Services Junior Medical Staff Advisory Committee Relevant Medical College The Postgraduate Medical Council of Victoria Other public health services Operational / Clinical As the registrar you are accountable to your Unit Head/consultant for the care all the patients in the unit. It is your responsibility to Provide safe and high quality person-centred care for patients under your care Ensure coordination of care for patients in your unit Ensure timely and clear clinical communication including clinical handover with regards to patients under your care Ensure timely escalation of care related issues to your consultant when required In your clinical practice demonstrate commitment to quality and safety and Monash Health s Patient first initiative. In your clinical practice demonstrate commitment towards Monash Health s Four hours will be ours initiative Financial Management As a registrar you do not have financial or budgetary responsibility but you are required to demonstrate an understanding of how your clinical practice affects the financial performance of the organisation In your clinical practice you should a commitment to ethical and appropriate use of resources You must demonstrate a commitment towards Monash Health s Living within our means initiative Human Resources As a registrar you are required to demonstrate a commitment towards Occupational Health and Safety. You are required to Participate and co-operate in consultative processes to improve health and safety Observe safe working practices and protect your own and others health and safety You are also required to participate in the professional development of resident medical staff Provide leadership and support for resident medical staff, appraise their performance in consultation with your Unit Head and ensure that staff receive appropriate performance management, professional training and development opportunities 5
8 Self-Management Maintain clinical knowledge, skills and attributes appropriate to your practice Seek regular feedback on your progress with your clinical supervisor and other members of your team formally and informally. Ensure timely mid and end of term performance appraisals Maintain your health and understand its impact on your performance in the role. Seek help early in case of health related concerns. Person Specification Qualifications/ Registrations/ Licenses A medical qualification (MBBS or equivalent) which is recognised for registration by the Australian Health Practitioner Regulation Agency Trainee of relevant Medical college Technical Skills/ Knowledge / Experience Has the appropriate level of clinical knowledge and skills to undertake the role of Registrar Has the appropriate level of relevant clinical experience to undertake the specific role Capabilities Professionalism Demonstrates all the attributes that accord with the Monash Heath values icare (Integrity, Compassion, Accountability, Respect and Excellence) Demonstrates a high level commitment to ethical practice Understands medico-legal issues associated with clinical care Demonstrates a commitment to profession-led regulation Demonstrates ability to effectively manage matters of patient safety and quality of care Understand the role of the relevant College and the associated expectations of the Registrar role Scholar/ Teacher Demonstrates ability to contribute to the development, dissemination, application, and translation of new medical knowledge and practice Facilitates the medical education of patients, families, trainees and other health professionals and the community Provides the necessary training and commitment to the supervision, mentoring and assessment of junior medical trainees and students Supports basic laboratory, translational, and clinical research, as appropriate to the Department Health Advocacy Demonstrates ability to advocate for improvements in health care through involvement in relevant professional bodies and forum Able to respond to individual patient health and educational needs Promotes the maintenance of good health in colleagues and junior medical staff Looks after his or her own health and well being Advocates for improvements in health care Leadership & Management Demonstrates clinical Leadership with proven ability to exercise sound judgment and provide leadership in professional standards, ethics and a commitment to research and innovation Teamwork Demonstrated ability to work in collaboration with members of interdisciplinary teams and committees Capacity to be an effective member of the relevant Department/Program, stimulate constructive debate 6
9 and support colleagues in the achievement of Department/Program objectives Communication Able to communicate effectively with team members and colleagues Able to communicate effectively and appropriately with patients and families, including those of diverse cultural backgrounds Maintains clinical and administrative documents accurately Facilitates continuity of patient care through effective communication and handover of relevant information Monash Health Values Integrity Compassion Accountability Respect Excellence Honesty, open and transparent, admit mistakes, maintains confidentiality, fairness, builds trust. Empathy, sensitivity, concern for others, interacts with dignity, tolerance, anticipates needs Understands roles, uses resources wisely, delivers on time, timely decision making, achieves stretch goals, takes responsibility for performance Builds relationships, courteous, listens and understands, gives & receives feedback, sensitivity & understanding, values difference & individual worth Supports creativity & innovation, proactive & solution focused, seeks out opportunities, embraces quality improvement, professionalism Other Position Requirements May be required to travel between Monash Health sites May be required to cover relevant and appropriate positions at other sites Is required to comply with all relevant Monash Health policies and procedures Approved : Director of Medical Services Date: April
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