Date: Job Title : Senior Medical Officer Anaesthetist Department : Department of Anaesthesiology and Peri-Operative Medicine Location : Waitemata District Health Board Reporting To : Clinical Director Anaesthesia Direct Reports : Supervision of junior medical staff Functional Relationships with : Internal Medical Staff Management Staff Nursing Staff Technical Staff Support Services External Patients and their families Medial Council General Practitioners Other Secondary and Tertiary Service Units Health and Disability Commission Purpose : Provide a high standard of clinical practice in the management and delivery of anaesthesiology care for the people of the Waitemata District Health Board (WDHB) region. Assist with the continual development of secondary anaesthesiology services for WDHB which is recognised nationally and internationally as a centre of excellence KEY TASKS Delivery of clinical care to patients requiring Anaesthesiology services EXPECTED OUTCOMES Takes professional care of and undertakes delegated clinical responsibilities for patients under his/her care Conducts theatre, clinics and ward rounds, and other duties, using the allocated time efficiently and effectively as per agreed contract Oversees Registrar s activity to ensure patient care is delivered in accordance with standards and policy Manages workload to ensure clinical time is reallocated where cancellations of one aspect of clinical care occur, e.g. theatre cancellations Sees and advises promptly on patients referred for a specialist opinion Is responsible for acute theatre sessions as Waitemata District Health Board -JOB DESCRIPTION - SMO Anaesthesiology Page 1
KEY TASKS Proposed Clinical Schedule Elective sessions at North Shore, Waitakere and ESC Acute sessions are North Shore and Waitakere Obstetric sessions at North Shore and Waitakere Pre-operative assessment of patients Pain Rounds Clinical and non-clinical administration EXPECTED OUTCOMES per the after hours agreed requirements Theatre and clinics organised to ensure optimal productivity and utilisation of resources. See detailed work plan Provision of acute specialist care for Anaesthesiology Participates in the provision of after hours on call and acute services as per the Anaesthesiology Agreement When on call is available to respond within 5 minutes to requests for telephone advice, and to attend to patients requiring care within 15-20 minutes Leave arrangements are requested with a minimum of six weeks notice and approved by the Clinical Director and Leave Manager Takes professional care of, and assumes clinical responsibility for, patients admitted or transferred under his/her care Patient information and informed consent Gives patients and their families a full explanation of all procedures and treatments Obtains informed consent for all patients in accordance with the organisation s policy for undertaking any operation or test of procedure Staff and patient relations Acts in a manner consistent with a senior member of staff Maintains effective interpersonal relationships with multidisciplinary staff, patients and relatives/whanau Handles problems and complaints sensitively Education and Teaching of Junior medical staff and other professional groups Provides clinical supervision and teaching for House Officers and Registrars Ensures the orientation, guidance, performance management and objective setting process and feedback to junior surgical staff is consistent with good employer relations and Council standards Is available to junior medical staff for advice, supervision of procedures and urgent acute problems when on call and during normal business hours as appropriate Provides teaching or educational presentations for nurses, resource nurse and other health professionals or groups with a general anaesthesiology interest as Waitemata District Health Board -JOB DESCRIPTION - SMO Anaesthesiology Page 2
KEY TASKS EXPECTED OUTCOMES appropriate Maintenance of adequate record and reports to referring doctors Comprehensive, accurate and up-to-date medical records are maintained for all patients under the Senior Medical Office care Medical records and discharge letters on inpatients as well as outpatient letters on patients seen by the Senior Medical Officer are completed and dispatched within organisational timeframes Professional Development Knowledge and practice updated and maintained Demonstrates evidence of continuing selfeducation through, for example, attendance at relevant courses/seminars/conferences; reading relevant literature Utilises appropriately annual entitlement of Continuing Medical Education Leave Attends and actively participates in local postgraduate medical education activities Participates in service credentialing and recommendations Participates in quality assurance programmes Attends and participates in regular departmental audit/peer review activities, including morbidity/mortality reports Attends and participates in Quality Assurance activities Quality of written records meets specified standards Patient satisfaction is positive Actively contribute to Continuous Quality Improvement activities within the service Management and Administration of the Anaesthesiology and Peri- Opeartive service Peer review is favourable Meets with colleagues to discuss and record performance issues and professional/personal development, at least annually Identifies improvement opportunities and notifies the Clinical Director of these Participates in the service s quality and risk improvement and minimisation activities Provides good patient/client service and is responsive to patient/client requests or complaints Complies with standards and works to improve patient/ client satisfaction. Identifies risks and notifies the Clinical Director of these Complies with WDHB Reportable Events policy and other policies and procedures Participates in audits Attends the business meeting unless on planned and approved leave Attends regular meetings of the Service to collaborate with his/her colleagues and, as requested, with the Clinical Director, Utilises staff, technological, pharmaceutical and other publicly funded resources prudently and efficiently for cost effective patient care Waitemata District Health Board -JOB DESCRIPTION - SMO Anaesthesiology Page 3
KEY TASKS EXPECTED OUTCOMES Participates in monitoring resource allocation and decision making within the service Provides reports and information as required by the Clinical Director on behalf of the General Manager Surgical & Ambulatory Services Participates in the development and updating of clinical management guidelines, including integrated clinical pathway Clinical Leadership Responsibilities Teach postgraduate students as required Supervise/teach junior medical and nursing staff Treaty of Waitangi Demonstrates an understanding of the Principles of Te Tiriti o Waitangi and how these relate to the development and application of service specific initiatives for Maori Understands the holistic approach to Maori health Develops and plans strategies that are responsive to the health needs or Maori Recognises and seeks counsel on the cultural requirements when dealing with Maori To recognise Individual Responsibility for Workplace Health and Safety under the Health and Safety in Employment Act 1992 Company health and safety policies are read and understood and relevant procedures applied to their own work activities Workplace hazards are identified and reported, including self-management of hazards where appropriate Can identify health and safety representative for area Waitemata District Health Board -JOB DESCRIPTION - SMO Anaesthesiology Page 4
Competencies Vision and Strategic Capability Able to articulate the aspiration for the direction of the future of WDHB Understands trends in health, relevant policy and operational areas and the external environment Able to think strategically and convert strategy to actions Has courage and is willing to challenge the status quo Understands the role of information management in decision making and forecasting Patient Care and Clinical Practice Able to deliver contemporary anaesthesiology practice to a high standard and in accordance with agreed anaesthesiology principles Demonstrates competence in all aspects of care and service delivery Access to care for patients is maximised through the maintenance of productivity and efficient and effective services Leadership Role models and communicates WDHB vision and values Inspires and motivates others to commit to and work towards goals Shows respect for people, focuses on employee involvement and allows others to take ownership Buildings confidence and resilience in the team Holds staff accountable for the delivery of outcomes and acts promptly to rectify performance issues Leads the team within theatre to ensure delays are eliminates, turnaround times are minimised and maximum use is made of the session time allocated Makes timely decisions Can chair a meeting and is skilled at leading discussions and providing clear direction, ensuring meetings are run in a positive and cooperative manner with respect for all members of the multidisciplinary team Management Organises tasks to make best use of time and resources and focuses attention on key objectives and priorities Makes sound decisions based on robust analysis and evidence Delegates activities and projects to others and positively influences their progress towards successful results Takes ownership of the need to be financially astute and optimises the use of resources by continually reviewing the effectiveness of current resource utilisation, minimising waste and always ensuring the decisions made are both clinically and fiscally appropriate Flexibility Willing to consider alternative viewpoints and new ideas Develops new and/or more effective work processes and systems through lateral thinking and creativity in work and process design Teamwork Assists colleagues and shares relevant information Manages the internal negotiation process regarding the allocation of resources Create a productive team environment by setting clear Waitemata District Health Board -JOB DESCRIPTION - SMO Anaesthesiology Page 5
goals, implementing sound work processes and giving and receiving constructive feedback Communication Is confident and appropriate assertive in dealing with others Perseveres with a task, and displays the required energy to achieve the objectives despite obstacles Deals effectively with conflict Is articulate and able to influence and persuade Expresses ideas spontaneously, logically and convincingly in simple, clear language Listens with a preparedness to understand Facilitates groups to a shared or an agreed way Behavioural Competencies Adheres to Waitemata District Health Boards 4 Organisational Values of: Every single person matters, whether a patient / client, family member or a staff member We see our work in health as a vocation and more than a job, We are aware of the suffering of these entrusted to our care. We are driven by a desire to relieve that suffering. This philosophy drives our caring approach and means we will strive to do everything we can to relieve suffering and promote wellness. We need to be connected with our community. We need to be connected within our organisation across disciplines and teams. This is to ensure care is seamless and integrated to achieve the best possible health outcomes for our patients/clients and their families. We seek continuous improvement in everything we do. We will become the national leader in health care delivery. Behavioural Competencies Behaviour Demonstrated Communicates and Works Co-operatively Actively looks for ways to collaborate with and assist others to improve the experience of the healthcare workforce, patients & their families and the community & Iwi. Is Committed to Learning Proactively follows up development needs and learning opportunities for oneself and direct reports. Is Transparent Communicates openly and engages widely across the organisation. Enacts agreed decisions with integrity. Is Customer Focused Responds to people s needs appropriately and with effective results Identifies opportunities for innovation and improvement Works in Partnership to Works in a way that: Reduce Inequality in Outcomes Demonstrates awareness of partnership obligations under the Treaty of Waitangi. Shows sensitivity to cultural complexity in the workforce and Waitemata District Health Board -JOB DESCRIPTION - SMO Anaesthesiology Page 6
Behavioural Competencies Behaviour Demonstrated patient population. Ensures service provision that does not vary because of peoples personal characteristics. Improves health Work practices show a concern for the promotion of health and well-being for self and others. Prevents Harm Follows policies and guidelines designed to prevent harm. Acts to ensure the safety of themselves and others. VERIFICATION: Employee: Manager: Date: Review Date: Note: This job description forms part of an individual s contract of employment with WDHB and must be attached to that contract. Waitemata District Health Board -JOB DESCRIPTION - SMO Anaesthesiology Page 7
PERSON SPECIFICATION POSITION TITLE: SMO Anaesthetist Minimum Preferred Qualification Medical Qualification Post Graduate qualification in Anaesthesiology FRACS or equivalent Experience Broad understanding of the New Zealand health sector reform and purchasing structure. Recognises the critical and key success factors in working in health Skills/Knowledge/Behaviour Builds relationships and engenders trust. Strong Networker. Change Orientated Ability to influence and inspire others. Empathetic Excellent written and verbal communication Open honest communicator Strategist Commercial awareness Waitemata District Health Board -JOB DESCRIPTION - SMO Anaesthesiology Page 8
DETAILED WORK PLAN 1. ROUTINE DAYTIME ACTIVITIES Daytime routine services include the following: 1.0 Provision of anaesthesia, in accordance with the schedule of routine planned sessions (inclusive of planned acute session), within North Shore Hospital operating theatre suite Waitakere day stay theatre suite Waitakere obstetric theatre Elective Surgical Center operating theatre suite Other sites as may from time to time be agreed to by the Department for the following services: General Surgery Orthopaedic Surgery Obstetric Anaesthesia and Analgesia Urology Gynaecology ENT Paediatric Surgery Psychiatry Cardiology Intensive Care Radiology 1.1 The Anaesthetist will have a schedule that is agreed with the Clinical Director. The Anaesthetist will have assigned responsibility for a session and is required to attend as detailed in the department roster. Changes to the anaesthetist s current days of the week worked (and type of work during those days) will be made in agreement with the Clinical Director and Anaesthetist. 1.2 Each morning and afternoon session is deemed to average five hours inclusive of all associated activities (as listed below), when averaged over a roster cycle. For anaesthesia, this includes: pre-operative assessment and pre medication of patients. administration of anaesthesia for elective lists which (on average) will take between 3.5 and 4 hours. supervision of patients in the recovery room and participation in their postoperative management (in consultation with other health professionals as required) postoperative review of patients in the ward where appropriate. any associated written work Waitemata District Health Board -JOB DESCRIPTION - SMO Anaesthesiology Page 9
1.3 All day elective anaesthetic lists at North Shore and Elective Surgical Centre. These lists equate to two sessions and include the associated activities detailed in 1.2. 1.3.1 Waitakere obstetric day. This includes: anaesthesia for elective and acute caesarean sections. pre anaesthetic assessment epidural analgesia assessment and management of unwell women (in consultation with other health professionals as required) The total duration is 0700 1900 1.4 Rostered daytime acute services (0730 1730) Acute anaesthetic work services include the following: general surgical acutes at North Shore Hospital operating suite gynaecological acutes at North Shore Hospital operating suite Orthopaedic acutes at North Shore operating suite supervision of anaesthetic related problems in post operative patients assistance in daily pain round obstetrics analgesia and anaesthetic services co-ordination and assistance of anaesthetic services in the operating suite assistance with transporting critically ill North Shore Hospital ICU patients e.g. to DCCM The anaesthetist allocated to a morning (0730 1230) and /or afternoon (1230 1730) session, is responsible for prioritising the acute work load, and at his/her discretion, may call a second anaesthetist if required. 2. CANCELLATION OF ROUTINE ACTIVITIES In the event of a scheduled session being cancelled, the anaesthetist will discuss with the Coordinator and Clinical Director 3. ALLOCATION OF ROUTINE WORK Six weeks application for all leave in writing to allow appropriate allocation of scheduled work. The application form will be given to the Leave Officer, who will check with the roster writer that the leave can be covered. Any substitutions for routine work will require the agreement of the Chairman of Department. The substitution must be arranged by the person rostered for that session and must be undertaken by another employed specialist. 4. SHORT NOTICE LEAVE (For Example, illness or bereavement) Waitemata District Health Board -JOB DESCRIPTION - SMO Anaesthesiology Page 10
A specialist can at short notice advice that they will not be available for a scheduled session. Short notice leave needs to be notified by calling the coordinator on.. and a message left on the department secretaries phone on The Clinical Director will be notified and the no show will not be counted towards the session total and will need to be made up at some other time except for those related to illness or bereavement. 5. PAIN SERVICE Provision of acute pain service, consultation, assessment, management (including pain rounds), education of perioperative pain. 6. PREOPERATIVE ASSESSMENT CLINICS Triage assessment and management of patients presenting for surgery. 7. CONTINUING MEDICAL EDUCATION Anaesthetists are required to regularly participate in the following activities: attendance at the department business meeting departmental weekly meetings (morbidity mortality reviews, journal reviews, literature reviews) city-wide clinical meetings (morbidity/mortality, peer review and clinical audit programs (MOPS via ANZCA) personal literature review attendance of workshops and simulator sessions where appropriate attendance at NZ/Australian CME meeting at least once every two years attendance at regional/world meetings at least once every five years Waitemata Health courses BLS, ACLS, computer courses North Shore Hospital Grand rounds 8. EDUCATIONAL ROLE Participate in professional education activity for registrars, technicians and other supervision of trainees college assessment activities 9. ADMINISTRATIVE TASKS REQUIRED WITHIN THE ANASESTHETIC DEPARTMENT AS ASSIGNED BY THE CLINICAL DIRECTOR OF THE DEPARTMENT: refer to the department document in relation to these activities. 10. IN-HOSPITAL SERVICES PROVIDED OTHER THAN ANAESTHESIA IN OPERATING SUITES Waitemata District Health Board -JOB DESCRIPTION - SMO Anaesthesiology Page 11
Provision of analgesia expertise outside of the operating room. In hospital emergencies: - Cardiac arrests - Emergency Department assistance Central Line Insertion Interhospital transfer 11. ROSTERED AFTER HOURS DUTIES all are expected to participate in acute service rosters. refer to the department document in relation to these activities. While on call the anaesthetist is required to be immediately available and to return to the hospital as soon as possible after being called (except when delayed by exceptional circumstances beyond their control).t Waitemata District Health Board -JOB DESCRIPTION - SMO Anaesthesiology Page 12