Email Newsletter
August 2010
Please follow the link to our website:
http://www.rnzcgp.org.nz/division-of-rural-hospital-medicine/
For all Division enquires please email: [email protected] and your query will be forwarded to the appropriate person at the Royal NZ College of General
Pracitioners or phone: 04 496 5999.
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News from the Division
The Division now has 56 members, 39 of whom are Fellows and 15 of whom are dual Fellows of the Division and the RNZCGP.
Congratulations to the following doctors who were all awarded Fellowship of the Division of Rural Hospital Medicine (FDRHMNZ) at the recent DRHMNZ Board of Studies meeting:
Dr Patrick James McHugh Dr Hilary Rita Isobel Trouw Dr Stephen John Main Dr Thomas Barry Dr Stephen Withington
The recent DRHMNZ Board of Studies and Council meeting covered a number of issues including:
• The appointment of two interim clinical leaders Drs Garry Nixon and Kati Blattner
• An elective one year anaesthetic training programme at Waikato hospital • The possibility of reciprocity for FDRHMNZ with other countries
• How to improve health inequalities through training
• How the current proposed Integrated Family Health Centres impact on rural hospitals
• The Divisions’ involvement with Health Workforce New Zealand, the
RNZCGP, and the MCNZ on assessing GPEP and the DRHMNZ education programmes
• Changes to base hospital requirements for MOPs, details of which are below
Changes to the DRHM Maintenance of Professional Standards
Programme (MOPS)
The rural hospital medicine MOPS programme includes a requirement to spend 1 week per annum undertaking a clinical attachment in a base hospital. The principal
reason for this is the professional isolation that is so often a feature of rural hospital practice.
It is intended that the attachment will provide opportunities to: • Keep up to date with changes in practice
• Practice procedures that are required only occasionally in the rural hospital • Develop relationships with base hospital staff
• Become familiar with new technologies that may be of value in the rural hospital
It is recognised that arranging these attachments may be difficult especially for doctors working in very small rural hospitals. It is hoped that by making it a compulsory requirement rural hospital managers will take some responsibility for facilitating it including finding locums.
The issue was recently reconsidered by the Board of Studies in light of feedback from some fellows. It was decided that the reasons for introducing the requirement remain important. However in order to make is easier to meet the requirement the BOS approved the following changes:
• The requirement should be for 120 hours per triennium (or 40 hours per annum when the period being considered is less than a full triennium). • Other attachments that achieve the same goal of overcoming professional
isolation can be undertaken instead. This might include spending time at another rural hospital (preferably working alongside a colleague), time spent working in a visiting specialist’s outpatient clinic or time spent working on the surgical bus with the surgeon or anaesthetist.
• These alternatives to the base hospital requirement will need approval from the RNZCGP in the same way approval is sought for alternative CQI activities that contribute to MOPS.
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Modelling Robust Cultural Processes
Tim Phillips, Te Akaronga a Maui Representative NZ Council Rural Hospital Medicine:
I was chatting to Kati Blattner at the 2010 RNZCGP Educators Convention and she was describing the DRHMNZ registrar Marae immersion and how much everyone got from the experience. Crikey Kati, it gave me goose bumps just hearing about it!
Over the years I'm sometimes asked why Maori health access is emphasised when there are so many minority groups needing help to access health care. I reckon it’s a good question and find the following statistics are helpful for answering it; because they are pretty well straight up...like our back paddock.
DISPARITIES AND ACCESS ISSUES
In New Zealand, Maori have the poorest health status of all minority groups (table 1). Over half of the Maori population is represented in the most deprived deciles and this is when all cause hospitalization rates increase with increased socioeconomic deprivation. Between 2003 and 2005 Maori age standardised rates of
hospitalization were 30% higher than non-Maori. Maori, Pacific Peoples and low income groups have all been shown to access primary health services less when their poorer health outcomes signal a higher need for these services. It makes sense to investigate the up skilling and networking of GPs with hospital teams to improve access to health resource for Maori and other minority groups and ensuring that sufficient health resource is available to support this process [1,2).
PREVAILANCE (95% CI) UNMET NEEDS FOR GP SERVICES
BY ETHNIC GROUP CHILDREN ADULTS European/Other 3.8 (3-4.6) 5.6 (5.0-6.1) MAORI 6.7 (5.2-8.3) 12.1 (10.6-13.6) Pacific 4.0 (2.5-5.6) 11.2 (8.5-13.9) Asian 4.3 (2.4-.1) 7.4 (5.7-9.2)
Tab: New Zealand Health Survey 2006-2007; unmet needs for services by ethnicity [3]
[1] Te Rōpū Rangahau Hauora a Eru Pōmere Hauora Māori Standards of Health IV, School of Medicine and Health Sciences, University of Otago, Wellington November 2007
[2] Guidelines on Maori Cultural Competencies for Providers ACC July 2008 http://www.acc.co.nz/for-providers/resources
[3] A Portrait of health; key Results of the 2006/2007 New Zealand Health Survey. Wellington; Published by New Zealand Ministry of Health June 2008; http:/www.moh.govt.nz
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Role of the Clinical Leader for the DRHM Training Programme
Who is the Clinical Leader of the RHM training programme?Drs Kati Blattner and Garry Nixon have shared this role 50:50 since March 2010. They are doing this on an interim basis until a permanent Clinical Leader is appointed in early 2011.
In general Kati is responsible for registrars placed in the North Island, Garry for those in the South Island.
What is the role of the Clinical Leader?
• The Clinical Leaders main task is to help the operational staff in the College coordinate the Training Programme (on behalf of the DRHMNZ Board of Studies (BOS))
• The Clinical Leader acts as a conduit between the registrar representative and the Division.
• At this early stage of the training programme whilst registrar numbers are small and the Educational Facilitator system is still being developed, the Clinical Leaders can also provide advice and support for any individual registrar.
• Their other roles include liaison with Educational Facilitators; the Division and College staff; other specialties in planning placements e.g.: anaesthetics/ICU. • The Clinical Leaders are also responsible for recommendations to the BOS
on the accreditation on RHM clinical training posts and, for the academic side of the programme, relevant university papers
How does the role of the Clinical leader differ from the Educational Facilitator?
Each registrar is assigned an Education Facilitator (EF) when they enter the DRHM Training Programme. The role of the EF is to act as a mentor to that registrar throughout the training programme. It is the EF that helps the registrar identify their learning needs and thus develop their professional training plan and report. The EF should have an overview of the registrars plan with respect to both the clinical and
academic components of the training programme. The EF sends a written report for that registrar to the DRHM Board of Studies each year.
Both Kati and Garry are very happy for any registrar, Educational Facilitator or Rotational Supervisor to contact them with any issues/concerns.
Contact:
Garry Nixon Phone: 0211782662 Email: [email protected] Kati Blattner Phone: 09 4057 709 Email: [email protected] OR [email protected]
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CME
ADVANCED PAEDIATRIC LIFE SUPPORT APLS COURSE DATES & VENUES FOR 2010 27 – 29 October – Waikato
TBC – December – Middlemore
Come and take part in this very worthwhile and popular course. CANDIDATE NUMBERS ARE LIMITED FOR EACH COURSE SO REGISTER NOW!
For more information please contact:
Jo Jones Phone: 07 312 9574
Executive Officer Mobile: 027 287.9377
APLS email: [email protected]
PO Box 506
Whakatane 3158 Website: www.apls.org.nz
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Postgraduate Diploma in Community Emergency Medicine University of Auckland
Papers running second semester 2010 POPLPRAC 737 Acute Orthopaedics POPLPRAC 740 Acute Surgical
POPLPRAC 741 Practical Orthopaedics and Plastics (practical weekend) PAEDS 714 Emergency Paediatrics
POPLHLTH 701 Research Methods in Health For more information please contact:
Dale-Cormack Pearson Programme Administrator School of Population Health
Email: [email protected] Phone: +64 9 373 7599 x 84409
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University of Otago
The following papers will be offered in 2010. The structure of the diploma has changed and if you have already done some papers you should talk to the course administrator about exclusions.
Semester 2 2010
GENX726 Obstetrics and Paediatrics in Rural Hospitals, no restrictions (though there is considerable overlap with GENX 722 and some with GENX 721)
Paediatrics / Neonatal care / Obstetric and Gynaecological emergencies 15 points - fully subscribed - no more places available.
GENX727 Surgical Specialties in Rural Hospitals, restriction GENX 722
Preoperative and postoperative management / Abdominal pain / Urology / Ulcer management / Wound management / Ophthalmology / ENT / Vascular problems 15 points - fully subscribed - no more places available.
Postgraduate Certificate in Clinician-Performed Ultrasound (PGCertCPU) Designed for rural doctors who wish to pick up ultrasound and ECHO skills.
GENX 717 Generalist Medical Echocardiography
30 points (full year) - fully subscribed - no more places available.
GENX 718 Generalist Medical Ultrasound
30 points (full year) - fully subscribed - no more places available.
For more information please contact: Raelene Abernethy
Rural Postgraduate Administrator
Otago University (Wed, Thurs and Fridays) Department of General Practice
PO Box 913 Dunedin
Phone: 03 479 9186 or Mobile: 021 263 2635 Email: [email protected]
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Rural Health Courses and Conferences
For information about International Rural Health courses and conferences we suggest you visit the ACRRM website:
https://www.rrmeo.com/rrmeo/dls_rrmeo.pl?a=eduinv_type_list
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CHANGE CHAMPION EVENTS
2nd Improving the Delivery of Emergency Care
Where: Radisson Resort Gold Coast, Palm Meadows Drive, Carrara, Queensland 4211
Seminar Aims:
• Highlight strategies, systems, structures and redesigns that have resulted in improvements in the safe a timely delivery of emergency care
• Showcase models of care/service delivery/clinical practice improvement and other innovations projects with demonstrated outcomes that have improved patient flows
• Showcase patient centred approaches to the design, management, co-ordination and delivery of improved services for outpatients
Audience: All health team members with an interest in improving service delivery of emergency care
In the Spotlight: Patient Centred Care
When: 2-3 September 2010
Where: Novotel Brisbane, 200 Creek St, Brisbane, Queensland Seminar Aims:
• Highlight strategic directions and policy initiatives that focus on the patient at the centre of care
• Showcase development programmes that focus on patient empowerment and patients as leaders of quality improvement initiatives
• Showcase innovations programmes where learning from the patient experience has improved service delivery and practice
• Share information on approaches to measuring the impact and outcomes of patient involvement in service delivery and practice.
Please visit http://www.changechampions.com.au for registration and updates.
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Job Vacancies
We are happy to advertise job vacancies. If you wish to place an advertisement in the DRHMNZ newsletter please contact Linda Hartstonge: [email protected]
