POSITION DESCRIPTION/RUN DESCRIPTION POSITION TITLE: HOUSE OFFICER/SENIOR HOUSE OFFICER DEPARTMENT/SERVICE: WHANGANUI HOSPITAL REPORTS TO: HEAD OF DEPARTMENT RESIDENT MEDICAL OFFICERS SPECIALIST CONSULTANT OF ASSIGNED AREA APPROVED: Manager Date ACCEPTED: Employee Date ROLE SUMMARY This position works principally within the department or service specified above, however all employees at Whanganui District Health Board may be required to undertake duties in other areas of the organisation which promote the efficient and effective operation of Whanganui District Health Board which reasonably fall within the general parameters of this position PURPOSE OF THE POSITION Each run is of three months duration at Wanganui Hospital rotating through: Medical Services Surgical & Orthopaedic Services Paediatric Services / Obstetrics & Gynaecology Services Emergency Department Mental Health DIRECT REPORTS Nil DELEGATED AUTHORITIES Financial Nil Staff Nil 1
FUNCTIONAL RELATIONSHIPS Key Contacts (internal): Nature or purpose of contact: Clinical Director/Head Professional Responsibility / Accountability of Department Delivery of strategy and advice on clinical related issues Other doctors within Facilitation of Patient Care the Hospital The multi disciplinary Referral to Specialist care health care team Clinical advice Support Services Facilitation of Patient Care Key Contacts (external): Nature or purpose of contact: Patients/clients and families/whanau To develop effective relationships in providing management of patient care External agencies Referral of patients to other health service providers REGISTRATION/SCOPE OF PRACTICE You must be able to demonstrate that you are registered with the Medical Council of New Zealand and that your scope of practice enables you to undertake the duties of this position RECOGNITION BY ROYAL COLLEGES Whanganui Hospital is recognised by: The Royal Australasian College of Surgeons for the purposes of surgical training in General Surgery (Part I); and in advanced trainee Orthopaedic Surgery The Royal Australasian College of Physicians for basic training It is also recognised in Paediatrics for the Diploma in Child Health (Otago) and the Diploma of Obstetrics & Gynaecology (Otago)
KEY PERFORMANCE INDICATORS Key Accountabilities (Key areas of focus) Tasks (How it is achieved) Emergency All House Officers when rostered on duty shall attend the Department Emergency Department at 8am to receive handover from the night House Officers and attend a supervised Emergency Department handover session, if they were on evening duty the previous day (4pm-10pm). Ward duties The House Officer shall attend all ward rounds conducted by the consultant(s) in rostered hours, unless there is a medical emergency. Each patient is to be seen and examined at least on a daily basis on week days, and as clinically indicated outside of working hours / weekends. Instruction from consultants re investigations/ treatments are to be carried out as soon as is practicable. Consultants or Registrars, where applicable, shall be notified of admissions, significant changes in patients' condition and deaths as soon as practicable. Review and action investigation results as appropriate. Key Performance Indicators (How it will be measured) 3
Acute admissions Responsible for assessment and management of general practitioner and emergency admissions, and for clerking patients of the appropriate consultant. Consultants or Registrars, where applicable, must be informed of all acute admissions to the ward and emergency monitoring unit as soon as practicable. Outpatient clinic Attendance at these clinics is recommended (if Pre-admission clinics (Surgical / Orthopaedics / O&G runs) Theatre (Surgical / Orthopaedic / O&G runs) Minor operations (Surgical / Orthopaedic runs) possible). Attendance at pre-admission clinic of assigned consultant, assessing and clerking pre-operative patients. House Officers have the responsibility for organising appropriate investigations and liaising with anaesthetic staff. Assisting in Theatre as requested by Consultant. Encouraged to attend Theatre when ward duties permit. General Surgical House Officers may assist Registrar with day case list once a week. Where minor operations are performed by the House Officer the House Officer is responsible for organising follow-up including GP letter. Documentation Clinical records must be updated as often as indicated by the patient s condition; the minimum requirement is daily during week days. Investigations, changes of treatment, including prescriptions and procedures, are to be documented in the clinical records. Discharge summaries must be completed prior to discharge. Written referrals are to contain adequate clinical information, degree of urgency and a legible signature. Specialist referrals must be discussed with the consultant or the appropriate Registrar first. 4
All documentation must be dated, with time of entry recorded, and signed by the House Officer making the entry. Medical practice Must be conducted in accordance with legislative requirements and normal professional standards. Speciality cover On rostered evenings and weekends, House Officers cover the specialty area where rostered for both admissions and inpatients. House Officers rostered on night duty will be expected to cover both the wards and the Emergency Department alternatively with the other House Officer on duty. Out of regular hours, (ie 4:00 pm to 10:00 pm, 9.30 pm to 8.30 am and weekend and statutory holidays) House Officers are expected to assist with the caseload in the Emergency Department as ward workload allows. House Officers may be expected to cover departments to which they are not attached at that point in their current run. This should be the exception rather than Health and Safety in Employment the rule. Comply with all safe work procedures, policies and instructions. Report all incidents hazards and injuries to supervisors in a timely manner. Actively participate in the ongoing development of safe workplace practices in Whanganui District Health Board. Completed the WDHB Health and Safety Orientation Course and updates Attendance at workplace safety meetings (indicated by minutes) Demonstrated by signed training records Active Involvement in, and completion of, rehabilitation programmes as required Timely, full and accurate completion of accident and hazard forms if and when required. 5
TRAINING AND DEVELOPMENT Professional development of a House Officer's skills and knowledge should occur during the run Wanganui Hospital provides the following tutorials and all House Officers must attend their departmental meetings. The other training and development sessions are available for attendance if their clinical commitments allow Monday 0800 to 0900 hours Emergency Dept / O&G RMO X-ray meeting Tuesday 0800 hours Surgical X-ray tutorial 130 hours Post graduate lecture topics published in advance Wednesday 0800 hours Orthopaedic meeting 130 hours Multidisciplinary lecture Thursday 130 hours House Officer tutorial Friday 0830 to 0930 hours Medical X-ray meeting 1130 hours Paediatric tutorial 130 hours Medical meeting alternate weeks IDEAL PERSON PROFILE QUALIFICATIONS, SKILLS AND EXPERIENCE Essential Registered with the Medical Council of New Zealand Hold a current Annual Practising Certificate Have a medical indemnity insurance (which complies with New Zealand requirements) Desirable Ability to communicate fluently in English, both verbally and in writing Ability to work effectively as part of a multi-disciplinary team Sensitivity to the needs of other cultures High professional standards Commitment to professional development PHYSICAL ATTRIBUTES Under the Human Rights Act 1993 discrimination based on disability is unlawful. AD. MA 8 July 010 6
Whanganui District Health Board will make all reasonable efforts to provide a safe and healthy work place for all, including persons with disability. Every effort has been made to outline requirements clearly. If a potential applicant has uncertainties about their ability to fulfill these physical requirements, enquiry should be made whether it would be possible to accommodate a particular issue by obtaining advice from Occupational Health Unit/Infection control team. Must be able to function in rapidly changing and demanding conditions when required Hearing and speech sufficient to communicate clearly with patients and co-workers, monitor patient status and equipment, recognise impending emergencies relating to patients and equipment and hear emergency alarm Ability to wear face masks and rubber gloves for protection against infectious disease. Absence of a health condition which could increase appointee's susceptibility if exposed to infections more frequently than usual Skin condition should allow frequent contact with water, soap/disinfectant soap, chemicals and latex rubber Skin should not be fissured, scaly, cracked on hands, forearms, face or neck The appointee must not have infection or colonisation with MRSA The appointee must not have a health condition that will put others at risk Manual dexterity sufficient to operate a variety of specialised equipment used within wards/departments at Wanganui Hospital as required, including syringes and intravenous pumps together with safe administration of drugs and use of clerical items including personal computers A high degree of physical capacity is required as the work is physically demanding, involving standing, walking, sitting, stretching, twisting bending and lifting/moving weights up to and above 15 kilogram s frequently. (Stature extremes may increase hazard of shared activities). A high degree of mental concentration is required BEHAVIOURAL COMPETENCIES Whanganui District Health Board has a Competency Framework that describes the behavioural competency levels required for each role within the organisation. One = high level of competency required to perform this role five = low level of competency required. AD. MA 8 July 010 7
Competency Communication Time Management Responsibility/ Accountability Teamwork and Cooperation Problem Solving Customer Responsiveness Leadership Cultural Awareness Description All communication has a clear purpose, is well structured, uses appropriate language and grammar and conveys the information in a clear and concise manner. Asks questions and summarises key points to ensure understanding Is able to set goals and realistic timeframes to meet those goals. Understands the significance of their time management skills from an organisational perspective. Accepts responsibility for implementation and completion of a task/action. Learns from mistakes to ensure improvement in future performance. Accepts accountability for outcomes and seeks to improve future performance. Invites all members of a group to contribute to a process. Understanding and appreciative of different and opposing perspectives on an issue. Actively promotes a friendly climate, good morale and co-operation within the team. Accepts responsibility for the effectiveness of the team. Takes a logical approach to problem solving by eliminating irrelevant information and analysing relevant information to reach a workable and appropriate solution. Suggests alternative approaches based on consideration of the issues involved, in a consistently positive and constructive way. Anticipates current and future customer needs by seeking information about the underlying needs of the client, beyond those initially expressed. Regularly introduces work practices designed to improve service quality Sets a good example by providing a clear sense of purpose. Actively seeks to improve others skills and talents through coaching, training opportunities and feedback. Uses strategies to promote team morale, quality service etc, e.g., team projects, multi-skilling. Has an understanding of the Articles and Principles of Te Tiriti O Waitangi / the Treaty of Waitangi. Is aware of the Maori Model of Health Te Whare Tapa Wha. Attempts to pronounce Maori words correctly. Is aware of Kaupapa/Tikanga Maori. Demonstrates some understanding of health gains. Level Required 3 HOURS OF WORK All House Officers will be rostered four "Night / Weekend" duties per quarter; no more than two of these will be night duties. However, in order to fill the roster requirements, every House Officer will be required to work an extra weekend, but this will usually happen only once in any 1 months. These duties will not exceed Category C hours. AD. MA 8 July 010 8
Rostered basic 40 hours 0800 to 1600 hours Monday to Friday Rostered weekday evening duty 1600 to 30 hours long day Rostered weekend duty 0800 to 00 hours long day Rostered night duty 7 nights 130 to 0830 hours Unrostered hours hours per week On call requirement Approximately 1 in 7 MEDICAL/GERIATRIC RUN DESCRIPTION RUN DESCRIPTION The run is categorised A for the purposes of registration with the New Zealand Medical Council. It is expected that the Medical and Geriatric/ATR House Officers will cover each other within the department during times of House Officer vacancies i.e. night duty, sick, study leave etc. This team approach means the department will have continued cover and the House Officer will continue to be supported by an assigned Consultant for their training. PAEDIATRIC / OBSTETRICS & GYNAECOLOGY RUN DESCRIPTION GENERAL SURGERY / ORTHOPAEDIC RUN DESCRIPTION Medical Staff Numbers 6 Consultant Physicians 5 House Officers 1 Geriatrician 1 Geriatric/ATR House Officer The run is recognised for the Diploma of Paediatrics and recognised for the Diploma of O&G. Paediatrics / Obstetrics & Gynaecology are Category A (Paeds) & C (O&G) runs for the purposes of registration with the New Zealand Medical Council. The House Officer covers both Paediatrics and Obstetrics & Gynaecology after hours, ie, evening and weekend duties. Medical Staff Numbers 4 Consultant Paediatricians Paediatric House Officers 4 Obstetrician & Gynaecologists O&G House Officers or 1x Registrar and 1 x House Officer Both Surgery and Orthopaedics are Category A runs for the purposes of registration with the New Zealand Medical Council. House Officer covers both general surgery and orthopaedics after hours, ie, evening and weekend duties. Medical Staff Numbers 4 Consultant General Surgeons General Surgical Registrars 3 General Surgical House Officers or General Surgical House Officers and 1 SHO/Junior Registrar 4 Consultant Orthopaedic Surgeons 3 Orthopaedic Registrars Orthopaedic House Officers AD. MA 8 July 010 9
EMERGENCY DEPARTMENT Emergency Department run is a Category B run for the purposes of registration with the New Zealand Medical Council. Medical Staff Numbers Senior Emergency Physicians 4 Medical Officers 6 House Officers RELIEF RUN DESCRIPTION Clinical Responsibilities The Emergency Department House Officer is rostered for duties between 0800 and 1600 hours with a 30-minute lunch break to be arranged with the Head of Department or senior doctor on duty, while gathering emergency medicine experience. At a point mutually agreed by the Emergency Department Director and doctor, a component of shift work may be required. This position involves working in a variety of specialities; covering Emergency Department after hours Monday to Friday, Annual Leave / Night Duty / Sick Leave, etc, to meet the needs of the hospital. The House Officer is responsible to the Consultant for whom he/she will be working for clinical practice. AD. MA 8 July 010 10
POSITION DESCRIPTION POSITION TITLE: HOUSE OFFICER / SENIOR HOUSE OFFICER DEPARTMENT/SERVICE: MENTAL HEALTH SERVICES REPORTS TO: CLINICAL DIRECTOR MENTAL HEALTH SERVICE MANAGER MENTAL HEALTH APPROVED: ACCEPTED: Manager Employee Date Date ROLE SUMMARY This position works principally within the department or service specified above, however all employees at Whanganui District Health Board may be required to undertake duties in other areas of the organisation which promote the efficient and effective operation of Whanganui District Health Board which reasonably fall within the general parameters of this position. PURPOSE OF THE POSITION To provide a high standard of clinical practice and clinical expertise, contributing to the provision of efficient and effective mental health services to the Inpatient Units, community services and the region served by Whanganui District Health Board under the direction and supervision of an appointed Psychiatrist. To participate as an active member of the mental health team promoting effective management of the mental health community and inpatient Service Users. DIRECT REPORTS Nil DELEGATED AUTHORITIES Financial Nil Staff Nil AD. MA 8 July 010 11
Key Contacts (internal): Service users/patients/ family and carers Senior medical staff and other health professionals Mental Health Clinical Director Mental Health Service Manager Services within Mental Health Continuum Other services within the general hospital Nature or purpose of contact: To develop effective relationships in providing management of patient care Management of patient care MDT Professional responsibility / accountability Medical / operational management and service provision within the service Communication of clinical matters, advice, consultation, professional support, related to provision of patient care. Administrative Staff Organisation of clinical work, typing, etc Key Contacts (external): Primary Health Organisation (PHO) General Practitioners Community agencies and statutory organisations, Maori Mental Health staff, IWI and Maori Health agencies External referrers to service Family/whanau of patient Family Court NZ Police Nature or purpose of contact: Consultation and liaison To develop effective relationships in providing management of clinical care, within the legislation and standards for mental health services Referral of service users to other providers Liaison with and supporting networks / community local and regional residential providers Advice and education as required REGISTRATION/SCOPE OF PRACTICE You must be able to demonstrate that you are registered with the Medical Council of New Zealand and that your scope of practice enables you to undertake the duties of this position. AD. MA 8 July 010 1
Key Accountabilities (Key areas of focus) Clinical Care KEY PERFORMANCE INDICATORS Tasks Key Performance Indicators (How it will be measured) (How it is achieved) Clinical Responsibility for the clinical A high standard of clinical care, including assessment, investigation, diagnosis assessment, investigation, and treatment is provided for patients. diagnosis and treatment of Clinical competence, especially in emergency situations, meets WDHB patients admitted to the requirements. Patient treatment is accurately charted and progress notes are kept up to Mental Health Service under date, ensuring discharge summaries are completed in a timely manner in the direction and supervision accordance with service requirements. of an appointed Pyschiatrist. Actively participate in the Mental Health Service quality assurance programme. Report significant patient events to the Specialist Psychiatrist under whom the patient has been admitted. Ensure clinical wellbeing of patients is assured at all times and care is delivered in a sensitive fashion, taking into account ethnic and other interest and recognition of patient rights. Actively promote early, effective and appropriate discharge of patients. Ensure appropriate documentation is sent to the patients GP at the time of discharge. Supervision, instruction and support is provided to junior medical staff as required. Informed patient consent is obtained for particular procedures or courses of treatment. (If consent is refused appropriate steps are taken to explain the possible consequences of refusal to of procedures or treatment). All patient information and informed consents are consistent with the Mental Health Compulsory Assessment & Treatment Act 199, and the amendment Act 199. Effective interpersonal relationships are maintained with members of the multi-professional team, patients and relatives/whanau. Provide cover as required to other Mental Health Service units when rostered on evening duties is provided as per the duty roster. Provide cover as required to other Mental Health Service units when rostered on weekend duties is provided as per the duty roster AD. MA 8 July 010 13
Management and Administration Responsibility for maintaining adequate records and reports to referring Doctors. Teaching Assist specialist staff in ensuring appropriate patient education and teaching of nursing and other related professionals. Communication Communications are delivered at appropriate levels across the service. Locator Response Response to pager messages. Health and Safety in Employment Comply with all safe work procedures, policies and instructions. Report all incidents hazards and injuries to supervisors in a timely manner. Actively participate in the ongoing development of Non-Clinical Ensure comprehensive, legible, accurate and up to date medical records are maintained for each patient being cared for. Ensure discharge letters and other communications are completed in a timely manner. Ensure clinically related work is completed within specified timeframes. Develop and provide clinical teaching sessions for nursing and other related health professionals. Participate in regular clinical meetings with medical staff eg: peer review and contribute to those reviews. Ensure patients and relatives/whanau/close friends receive timely and full information in layman s terms about the patients condition, proposed courses of treatment and ay associated risks as a result of such treatments and the likely outcome. Provide evidence of continuing self education including appropriate use of CME leave. Maintain an up to date record of CME. Ensure continuity of care by handing over to the next Doctor on duty prior to going off duty. Ensure relevant information/instructions are given to nursing staff and other members of the multidisciplinary team in patient care/treatment. Ensure the Emergency Department is informed of GP referrals coming into the department. Ensure the Medical Records Department is notified of any patients being transferred to Whanganui Hospital. When rostered on-call, an immediate response is expected in emergency situations. The personal pager allocated to this position is carried when rostered on-call and page messages are responded to. Complete the WDHB Health and Safety, Orientation Course and updates. Demonstrated by signed training records Attend workplace safety meetings (indicated by minutes) Active Involvement in, and completion of, rehabilitation programmes as required. Timely, full and accurate completion of accident and hazard forms if and when required. AD. MA 8 July 010 14
safe workplace practices in Whanganui District Health Board. TRAINING AND DEVELOPMENT Professional development of a House Officer's skills and knowledge should occur during the employment period. Wanganui Hospital provides the following tutorials and all General Hospital House Officers must attend their departmental meetings. The training and development sessions are available for attendance by the Psychiatric Senior House Officer if their clinical commitments allow Monday 0800 to 0900 hours Emergency Dept / O&G RMO X-ray meeting Tuesday 0800 hours Surgical X-ray tutorial 130 hours Post graduate lecture topics published in advance Wednesday 0800 hours Orthopaedic meeting 130 hours Multidisciplinary lecture Thursday 130 hours House Officer tutorial Friday 0830 to 0930 hours Medical X-ray meeting 1130 hours Paediatric tutorial 130 hours Medical meeting alternate weeks Psychiatry You are required to attend and participate in clinical teaching sessions, and in particular clinical supervision sessions and team meetings. Structured Education/Training Sessions and Medical Team Meetings are scheduled on a rotation basis and are held weekly on Wednesdays between 1.30 and 1.30 in the CMHT meeting room: - Peer Support sessions - Journal Club presentations - Teaching sessions - Team meetings - Networking with neighboring DHB s - Undertake audits as defined by department AD. MA 8 July 010 15
IDEAL PERSON PROFILE QUALIFICATIONS, SKILLS AND EXPERIENCE Essential Registered with the Medical Council of New Zealand Hold a current Annual Practising Certificate Have a medical indemnity insurance (which complies with New Zealand requirements) Verbal and written fluency in English Commitment to personal development. Desirable Ability to work effectively as part of a multi-disciplinary team Commitment to professional development Knowledge of Mental Health Act and the related New Zealand Legislation Knowledge and interest in psychiatry and psychotropic medications. PHYSICAL ATTRIBUTES Under the Human Rights Act 1993 discrimination based on disability is unlawful. Whanganui District Health Board will make all reasonable efforts to provide a safe and healthy work place for all, including persons with disability. Every effort has been made to outline requirements clearly. If a potential applicant has uncertainties about their ability to fulfill these physical requirements, enquiry should be made whether it would be possible to accommodate a particular issue by obtaining advice from Occupational Health Unit/Infection control team. Must be able to function in rapidly changing and demanding conditions when required Hearing and speech sufficient to communicate clearly with patients and co-workers, monitor patient status and equipment, recognise impending emergencies relating to patients and equipment and hear emergency alarm Ability to wear face masks and rubber gloves for protection against infectious disease. Absence of a health condition which could increase appointee's susceptibility if exposed to infections more frequently than usual Skin condition should allow frequent contact with water, soap/disinfectant soap, chemicals and latex rubber Skin should not be fissured, scaly, cracked on hands, forearms, face or neck The appointee must not have infection or colonisation with MRSA The appointee must not have a health condition that will put others at risk Manual dexterity sufficient to operate a variety of specialised equipment used within wards/departments at Wanganui Hospital as required, including syringes and intravenous pumps together with safe administration of drugs and use of clerical items including personal computers A high degree of physical capacity is required as the work is physically demanding, involving standing, walking, sitting, stretching, twisting bending and lifting/moving weights up to and above 15 kilogram s frequently. (Stature extremes may increase hazard of shared activities). A high degree of mental concentration is required AD. MA 8 July 010 16
BEHAVIOURAL COMPETENCIES Whanganui District Health Board has a Competency Framework that describes the behavioural competency levels required for each role within the organisation. One = high level of competency required to perform this role five = low level of competency required. Competency Communication Time Management Responsibility/ Accountability Teamwork and Cooperation Problem Solving Customer Responsiveness Leadership Cultural Awareness Description All communication has a clear purpose, is well structured, uses appropriate language and grammar and conveys the information in a clear and concise manner. Asks questions and summarises key points to ensure understanding Is able to set goals and realistic timeframes to meet those goals. Understands the significance of their time management skills from an organisational perspective. Accepts responsibility for implementation and completion of a task/action. Learns from mistakes to ensure improvement in future performance. Accepts accountability for outcomes and seeks to improve future performance. Invites all members of a group to contribute to a process. Understanding and appreciative of different and opposing perspectives on an issue. Actively promotes a friendly climate, good morale and co-operation within the team. Accepts responsibility for the effectiveness of the team. Takes a logical approach to problem solving by eliminating irrelevant information and analysing relevant information to reach a workable and appropriate solution. Suggests alternative approaches based on consideration of the issues involved, in a consistently positive and constructive way. Anticipates current and future customer needs by seeking information about the underlying needs of the client, beyond those initially expressed. Regularly introduces work practices designed to improve service quality Sets a good example by providing a clear sense of purpose. Actively seeks to improve others skills and talents through coaching, training opportunities and feedback. Uses strategies to promote team morale, quality service etc, e.g., team projects, multi-skilling. Has an understanding of the Articles and Principles of Te Tiriti O Waitangi / the Treaty of Waitangi. Is aware of the Maori Model of Health Te Whare Tapa Wha. Attempts to pronounce Maori words correctly. Is aware of Kaupapa/Tikanga Maori. Demonstrates some understanding of health gains. Level Required 3 AD. MA 8 July 010 17
Run Description - Psych Category D, year?, Senior House Officer (Non Rotational) Hours of work A Basic Hours AM duty 0800 1630hrs Monday to Friday normal days 0800 00hrs on long days including Saturday & Sunday 1 bed Acute Adult Inpatient Unit (Te Awhina ) 15 bed Extended Secure Regional Forensic Inpatient Unit (Stanford House) B. Rostered long weekday evening duty x 1 per week general hospital C. Rostered after hours weekday First on Call duty X 1 per week 5pm till 8am D Rostered First On Call & ward round weekend duty: 1 x 4 The weekend rostered and First on call covers from Friday 5pm through to Monday 8am. The on call Registrar will carry out an Inpatient ward round on Saturday and Sunday between the hours of 8am and 11am when covering the weekend. A consultant Psychiatrist is rostered Second on call over this period of time. On Call Ward Round On Call Ward Round On Call 5.00pm Friday to 8.00am Saturday plus Saturday 8.00am 11.30 plus 11.am Saturday to 8.00am Sunday plus Sunday 8.00am 11.30 plus 11.00am Sunday to 8.00am Monday The after hours roster duties and on call will include Psychiatric and Physical assessments, Crisis Intervention and Mental Health Act Assessments, inpatient areas, and includes seclusion requirements. K:\RMO & SMO Coordinators\RMO & SMO Coordinators\Starter packs\rmo ( Locum) Orientation Folder\RMOs\HO- SHO position description with Psych.doc AD. MA 8 July 010 18