VICTORIAN PUBLIC HOSPITALS NEONATAL FELLOW POSITIONS REFEREE ASSESSMENT FORM

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1 VICTORIAN PUBLIC HOSPITALS NEONATAL FELLOW POSITIONS REFEREE ASSESSMENT FORM INSTRUCTIONS TO APPLICANT: 1. Three (3) Referee Assessments are required. At least two (2) should be from Consultants. Registrars possible for one (1) only. 2. Complete the below details in full, prior to forwarding to your Referee, to ensure that this assessment is successfully matched to your application/s at the Hospitals. 3. Please fax referee form to: Department of Paediatrics, Mercy Hospital for Women, This form is NOT for COMPUTER MATCHING POSITIONS. APPLICANT S DETAILS SURNAME:... FIRST NAME:... POSITION/S APPLIED FOR:... (List actual position, i.e. HMO3 or Registrar, and Specialty) APPLICATION CLOSING DATE:... REFEREE S DETAILS REFEREE NAME:... Position Held:... Hospital:... Phone: INSTRUCTIONS TO REFEREE: 1. Complete the details below, rating the applicant according to the criteria by ticking the appropriate box, mindful of the applicant s ability expected at his/her particular level of training. 2. Retain the original Assessment until the end of the year (in the event of miss faxing or additional requests). 3. Fax a copy to Department of Paediatrics, Mercy Hospital for Women, In what capacity did this person work with you? (Eg surgical resident, medical registrar)... When? (year)... For how long? (Eg. 6 months)... Would you be prepared to have the applicant work with you again? Yes No N/A Please comment: Please tick the appropriate areas. CLINICAL COMPETENCY Requires substantial assistance (5% of population) Requires further development Performance just adequate Consistent with level of appointment Performance better than expected Performance exceptional (5% of population) N/A Unable to assess Knowledge base. Demonstrates adequate knowledge of basic and clinical sciences. Clinical skills. Elicits and records accurate, complete history and clinical examination findings Clinical judgement / Decision making Organises, synthesises and acts appropriately on information; applies sound knowledge base. Self-awareness. Recognises limits of own skills & knowledge, and actively seeks feedback & assistance to continuously improve. Procedural skills. Performs procedures competently VERBAL & WRITTEN COMMUNICATION SKILLS Patient and family. Interacts effectively and sensitively with patients and families / care givers. Medical records / Clinical documentation. Provides clear, comprehensive and accurate records. PERSONAL AND PROFESSIONAL CONDUCT Professional responsibility. Demonstrates punctuality, reliability, honesty and self-care. Teaching. Proactive in teaching other healthcare professionals, patients and/or care providers. Time management skills. Organises and prioritises tasks in an effective manner. Teamwork and colleagues. Works with and contributes effectively Within a team. SIGNATURE OF REFEREE:... DATE:...

2 MERCY HOSPITALS VICTORIA LTD POSITION DESCRIPTION Core Mercy Values: Compassion, Hospitality, Respect, Innovation, Stewardship, Teamwork Position title: Employee name: Entity/Group: Business Unit/Department: Mercy Hospital for Women Paediatric Department Date: Position reports to: Clinical Director - Neonatology (Medical) Positions reporting to this one: None Position Purpose: The position is rostered with periods of primarily clinical (NICU / SCN, Wards, Emergency Department, Clinics, etc) responsibility and primarily research and administrative responsibility, giving protected time for research This position will be responsible for the supervision of Clinical Care provided by Registrar staff under supervision of Consultant Medical Staff and to undertake administrative duties, teaching and research tasks as appropriate. Qualifications: Resource management: Medical practitioner registered in the State of Victoria with experience in neonatal paediatrics. The position is accredited for higher specialist training in Perinatal Medicine by the Royal Australasian College of Physicians. Total staff management (FTE): Annual Operating Expenditure: Annual Capital Expenditure:

3 Mandatory Organisational Competencies Personal Competencies Job Competencies Orientation (on commencement) Commitment to the Mercy values. Comply with the requirements of the annual organisational mandatory and role related competencies policy and procedure. Equity & Inclusion (annual) Demonstrated ability to build relationships with people at all levels. Competence in all routine NICU practical procedures Emergency Procedures (annual) Ability to manage and work as part of Ability to work effectively in multidisciplinary Work Health & Safety (annual) Infection Control (annual) Generic Requirements a team. Capacity for constructive selfreflection and learning from actions and feedback. Highly developed leadership skills. High level communication skills High level clinical skill and judgment in Neonatology Teaching ability Act professionally and in accordance with the Mercy Health Code of Conduct Maintain clinical registration (where applicable) Participate in annual performance development review (PDR) process team Ability to communicate effectively with families under stress Key Result Areas Key Activities Standard Measures Ensure the values of Mercy Health are incorporated into daily work practices for all staff. Demonstrates and upholds the Values and Mission of Mercy Health. Shows compassion and provides support to staff and customers. Consistently shows respect and values each person s dignity. Seeks opportunities to be innovative for improvement. Communicates openly and honestly as an effective member of the leadership team.

4 Key Result Areas Key Activities Standard Measures Maintain a safe environment for patients/self/colleagues and members of the public. Escalate concerns regarding safety, quality & risk if unable to rectify yourself. Lead, develop, implement and participate in evaluation and continuous improvement and clinical indicator processes. Demonstrate and champion the principles of Demonstrates leadership in the area of safety, quality & risk and contributes to organisational quality and safety initiatives Clinical Administrative Person Centred Care: o Respect & Dignity o o o Information Sharing Participation Collaboration Clinical supervision and support of registrar staff, under ultimate supervision of consultant medical staff. Provide clinical care in NICU/SCN, Postnatal Wards, Delivery Suites, Emergency and Outpatient Department settings. Backup support from senior consultant provided Includes some night hospital in-house shifts. Be available to assist registrars with clinical problems and practical procedures. Attend Developmental Follow Up Outpatient Clinic. Provide monthly audit of SCN for the Clinical Director - Neonatology (Medical) and for presentation at the Mortality and Morbidity Meeting. Organise Neonatal Journal Club Meetings each fortnight. Perform other administrative duties when called upon. On a monthly basis check discharge summaries are completed. Supervise and support registrars in data Risk assessments completed and controls implemented. Incident/s reported as soon as practicable. Undertake incident investigations. Injured employees are managed within Guidelines. Orientation records. Training records. Accreditation outcomes. Patient satisfaction and experience survey results. Develop and action annual quality plan and business plan. Satisfactory clinical performance Demonstrated ability to work in a team effectively Good risk management and WH&S performance Care of families and staff in NICU Complete administrative tasks as directed Staff feedback Relevant meeting participation. Fellows are expected to share such duties.

5 Key Result Areas Key Activities Standard Measures entry. Organise Monthly Unit Neonatal Morbidity and Mortality Meeting. Represent Paediatric Trainee Medical staff at Division of Paediatric meetings and other relevant forums. Teaching and further education Research Meetings Undertake teaching of registrars. Undertake teaching of medical students. Undertake teaching of nursing staff. Others as required by the Clinical Director - Neonatology (Medical). Attend Melbourne ship Teaching Program To take part in, perform and analyse results and publish articles. Hospital Clinical Meeting - weekly o Preparation and presentation of Paediatric follow-up of infants born to mothers with interesting or difficult obstetric problems. Presentation of infants with interesting paediatric problems which are judged by the Clinical Director - Neonatology (Medical) to be of educational value to obstetric staff Includes Perinatal Clinic. Neonatal Journal Club o Selection of journal articles for presentation. Organisation of roster for registrars presenting articles and coordination of distribution of articles in the fortnight proceeding Journal Club. (See individual document). Neonatal Morbidity and Mortality Meeting - Monthly o Co-ordinate agenda. Chair meeting. Prepare and present statistics. (See individual document). Perinatal Mortality Meeting Monthly Involvement in teaching Feedback from trainees and nursing staff Publish at least one article per year. Attendance at and involvement in meetings.

6 Key Result Areas Key Activities Standard Measures o Prepare and present neonatal paediatric cases. Special Care Nursery Meeting - second monthly o Participation. Committees Medical Records Committee SPI database Committee Development of data fields for neonatal paediatric information input, participation in training programme and subsequent training of other paediatric medical staff in system use. Attendance at and involvement in committees. Employee s Signature: Date: Print Name: Manager Signature: Date: Print Name:

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