A Practical Peer Oriented Approach to Intern Orientation
Hornsby Ku-ring-gai Health Service
Summary
Hornsby Ku-ring-gai Health Service (HKHS) introduced a new Junior Medical Officer (JMO) orientation program, Code Red, to meet these needs in 2007. The Code Red program is peer-led, practical, interactive, relevant, social, confidence building and critically appraised.
The program was developed from the Box Hill Hospital Amazing Race. The Code Red race is a team exercise in completing tasks around the hospital. At each station, new JMOs face clinical scenarios and, under the supervision of a current JMO, practise the clerical and clinical skills required. Written resources are provided for future reference. Education sessions, taught by registrars, are included and consultants supervise credentialing sessions.
JMOs were surveyed regarding their participation in Code Red. Before orientation, most participants were not confident in clinical, clerical and procedural skills. Orientation improved confidence: clinical 58% vs 34%, procedural 95% vs 54%, clerical 52% vs 97%.
JMOs report improved confidence in starting work and appreciate sessions on emergency and after-hours clinical problems.
View the presentation (
Powerpoint - 1.5 MB) given at the 2009 NSW Health Expo by Dr Jessica Sylvester and Dr Alison Parker.
Listen to this presentation (
Mp3 - 11.5 MB).
Code Red Program
Stations
Pre-admissions clinic, emergency admission, after-hours problems, ward duties, death certification.
Education sessions
Discharge summaries, medical handover.
Content
- Forms – pathology, blood bank and radiology requests, pre-admission and emergency admission forms.
- Prescribing – medication and fluid charts, hospital protocols, therapeutic drug monitoring.
- Computer access – pathology results, imaging, intranet, clinical resources.
- Communication – paging, switchboard, handover, case presentation, discharge summaries.
- Medico-legal – death certification, coroners case identification, incident reporting (IIMS), medical documentation.
- Clinical skills – prioritising clinical tasks, requesting senior support.
- Orientation to hospital facilities.
The Allied Health Expo features stalls set up by allied health services to promote the role of their service and referral systems.
A USB stick containing the Medical Officers Handbook, hospital policies and protocols is provided to each JMO as a tree-friendly alternative to published material. This allows easy access to information on the job.
Outcomes and evaluation
JMOs are surveyed (pre-orientation, post-orientation and at 3 months) to assess confidence in clerical, clinical and procedural skills.
2008 results
Percentage of JMOs moderately or very confident:
| Pre-orientation | Post-orientation | 3 months | |
|---|---|---|---|
| Clerical | 52% | 97% | |
| Clinical | 34% | 54% | 72% |
| Procedural | 54% | 95% |
- Most interesting: Death certification, pre-admission clinic and emergency admission.
- Least interesting: Infection control, OH&S and breaking bad news.
- Most useful: Handover, salary packaging and CPR.
- Least useful: OH&S, fire drill and infection control.
The impact of the new program at Hornsby Hospital has been instrumental at in building a healthy workforce, boosting JMO morale and promoting good peer networks.
Project Team
- Dr Auriel Jameson, Director of Prevocational Education and Training
- Judy Muller, JMO Manager
- JMOs 2007 - 2010
- 2010 - Drs Tristan Rappo, Alice Cottee, Rachel Choit, Hayley Berry and Hamish Dunn
- 2009 - Drs Joshua Steadson, Alison Parker, Alison Ritchie, Emma Culverston and Zorak Avakian
- 2008 - Drs Jessica Sylvester, Rebecca Kozor, Anna Chay, Catherine Meller, and Robert Page
- 2007 - Dr Peter Chung
Contact
JMO Manager, Hornsby Ku-ring-gai Health Service
Northern Sydney Central Coast Area Health Service
Phone: 02 9477 9249
