Past SSRS Projects
Importance of communication
Previous projects conducted by the Support Scheme for Rural Specialists
include:
- Laparoscopy Audit
- Colposcopy Audit
- AROMA Risk Managment & Audit Project
- Communicating for Better Outcomes
- Perinatal Mortality & Morbibity
- Practice Visits
Laparoscopy Audit
This project was funded by the Support Scheme for Rural Specialists,
an initiative of the Committee of Presidents of Medical Colleges
and the Australian Government Department of Health and Ageing.
This project was championed by the RANZCOG Provincial Fellows Committee
through their experience working in rural practice where Fellows
may encounter difficulties in completing audit and discussing outcomes
in a collegial, supportive environment.
A retrospective claims study carried out by RANZCOG and United
Medical Protection identified a significant number of claims related
to laparoscopy.While some of these issues may go unnoticed and not
affect patients, some will potentially result in suffering for patients
and require further surgery or treatment.
By designing a laparoscopy audit framework for use amongst rural
and remote Australian anaesthetists, gynaecologists and general
surgeons, this project successfully met its aims, which were to:
- Provide education about laparoscopy error and adverse events
- Use collected data to profile laparoscopy practice in rural
and regional Australia and identify opportunities to improve clinical
practice
- Encourage completion of the quality cycle, action planning and
implementation of change to improve laparoscopy practice
- Provide a supported, multidisciplinary CPD opportunity for rural
and remote specialists
- Scope the future application of the laparoscopy audit tool
and evaluate whether this type of audit tool is practical for
rural and remote specialists
Key stages of the project included:
- Introductory multidisciplinary risk management videoconferences
- Using the tailor made audit tool to prospectively collect data
on consecutive laparoscopy cases in collaboration with colleagues
- Follow-up multidisciplinary videoconferences to discuss the
data, implications for practice, conducting ongoing audit and
implementing change at a local level
- Individualised and aggregate results structured to encourage
self reflection and identify opportunities to improve practice
- Support resources to encourage action planning, local review
and ongoing audit
Colposcopy Audit
The Colposcopic Audit Project was funded in round seven of the
Support Scheme for Rural Specialists (SSRS).
The objective of this audit was to provide specialists with a view
to better identify and accurately manage risks relating to Colposcopic
assessment.
The Colposcopy Audit Project provided specialists with opportunities
and resources to undertake a multidisciplinary clinical Audit and
peer review in relation to Colposcopy and cervical abnormalities.
AROMA
The AROMA Risk Management and Audit Project was a collaboration
between the Royal Australian and New Zealand College of Obstetricians
and Gynaecologists (RANZCOG) and the Australian and New Zealand
College of Anaesthetists (ANZCA).
The Project aimed to provide an audit support and practice improvement
program for rural specialist obstetricians and anaesthetists.
It was designed to provide rural specialists with an opportunity
to gain skills in risk management, develop and implement clinical
audits, evaluate objectively adverse obstetric and anaesthetic outcomes
within a safety and quality framework, and to provide them with
collegiate support when managing these difficult events More
Communicating for Better Outcomes
This project was a collaboration between the Royal Australian and
New Zealand College of Obstetricians and Gynaecologists (RANZCOG),
the Australian and New Zealand College of Anaesthetists (ANZCA),
and the Royal Australasian College of Medical Administrators (RACMA).
The aim of the Communicating for Better Outcomes project was to
improve specialists' competencies in communication, personal management,
insight and patient advocacy. These skills are set within the context
of risk management and gaining informed consent More
Perinatal Mortality & Morbibity
2004 Pilot
In 2004 the Perinatal Mortality and Morbidity (PM&M) Audit was piloted in different regions in Victoria, South Australia and northern Tasmania. Six visits were carried out with over 50 perinatal deaths reviewed. The pilot project was a success in terms of creating an objective forum for peer audit, with sites benefiting from external review.
2005 Project
PM&M continued in 2005 following the success of the 2004 pilot project. This project reviewed the perinatal mortality and morbidity at nine regional hospitals in Queensland and the Northern Territory . The aim was to provide a transparent audit of perinatal deaths and unexpected transfers to neonatal intensive care or nursery after caesarean section. Outcomes of the visit included reducing the isolation of rural and regional practitioners by providing peer review and connection with colleagues. Providing audit facilitators who have shared a common background of rural practice gave the audit and visitors' credibility and frankness in discussions about quality and safety. In addition, the audits raised awareness of the PSANZ Perinatal Morality Audit Guidelines.
2006/2007 Project
Further funding was obtained to continue the PNM&M Project
in Round 6 of the SSRS funding following the 2005 project. The project
was conducted in rural NSW involving 8 site visits and 14 O&G
and 4 Paediatricians. Approximately 85 other regional practitioners
were interviewed in the visits, including obstetricians, paediatricians,
medical administrators, anaesthetists, midwives, registrars, trainees,
GP obstetricians and pathologists.
2008 Project
The PNM&M Project was run again in 2008, this time involving
seven rural sites throughtout SA and WA. Rural O&G’s and
Paediatricians throughout Australia were invited to act as audit
facilitators. Fifteen specialists agreed to participate in this
project.
Practice Visits
2005 Pilot Project
In 2005 /06 funding was received to run a pilot of practice visits
in regional New South Wales and selected Victorian sites. Practice
visits are designed to provide Fellows with a review of many aspects
of their practice by two peers in a collegial and supportive manner.
The process also includes interviews with the multidisciplinary
team the Fellow works with and a review of the clinical work load,
case mix and record keeping.
The 2005/06 project involved review of 16 Fellows' practices, over
10 rural sites throughout Victoria and New South Wales.
The Practice visits project is a resource intensive but a practically
relevant project, creating outcomes which have had the greatest
impact of any SSRS so far conducted. Benefits to Fellows participating
in the project included reducing professional isolation, providing
feedback of performance and highlighting areas of vulnerability
in practice. Based on this pilot, RANZCOG recommended a national
roll out of this project to a wider audience of provincial and metropolitan
Fellows.
© RANZCOG
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