Plan an operating list | Best Practice, Better Practitioners

At the early registrar level it is expected that a prevocational doctor will have acquired the skills, knowledge and behaviours to competently plan an operating list.

This task describes a number of activities, as below, where proficiency should be achievable by the end of PGY3. The doctor is encouraged to download the key clinical task guidelines and seek the support of his/her supervisor for feedback on performance. A mobile version of this Task is available as part of the JDocs subscription and directly records results into your JDocs Portfolio.

Plan, allowing for elective and ward patients
Note medical and strategic issues, e.g. diabetes, day case vs. inpatient
Work out (provisional) appropriate order

Review with consultant, e.g. discuss with operation theatre, anaesthetic team, make sure ward nurse is informed and attend to patient issues

Related Competencies:

Collaboration and teamwork

Establish respectful good working relationships with team members and other healthcare professionals

Communication

Provide updates to the current health team, e.g. new critical issues or changes in a patient’s condition

Health advocacy

Demonstrate awareness of the cultural diversity and requirements of patients

Medical expertise

Identify and provide relevant and succinct information when ordering investigations. Ensure tests and results are documented

Medical expertise

Know and work within hospital, state and government policies and legislation relating to prescribing. Make use of guidelines and standard documents, e.g. National Inpatient Medication Chart

Accurately and safely prescribe (common) medications and recognise (potential) administration errors
Know the types, causes and risks of medication errors and adverse drug reactions
Use standard reporting mechanisms to report medication errors and adverse drug reactions

Medical expertise

Understand the key features of antibiotic prophylaxis and appropriate therapeutic use, noting local protocols and the Therapeutic Guidelines (Antibiotics)

Collaboration and teamwork

Recognise expertise and roles of other health team members and staff

Communication

Communicate effectively within multidisciplinary teams, reflecting an understanding of, and respect for, different health professional perspectives

Health advocacy

Identify key issues on which to advocate for the patient to ensure their immediate clinical care and requirements are achieved

Judgement and clinical decision making

Select appropriate procedures, with involvement of senior clinicians and the patient

Judgement and clinical decision making

Able to succinctly present the patient scenario and discuss management plan

Leadership and management

Able to ensure that ward patients are ready for theatre on time

Medical expertise

Work within unit-based protocols with regard to pre-operative assessment and care, operative procedures and post-operative care:

apply medical knowledge to clinical practice
implement and evaluate a management plan relevant to the patient following discussion with a senior clinician
identify when patient transfer is required, and manage risks prior to and during patient transfer
recognise indications for, and risks of, fluid and electrolyte therapy and blood products
provide appropriate aftercare and arrange follow up for common procedures
safely manage anti-coagulant therapy and manage diabetes
recognise acute cardiac events and use relevant resuscitation/drug protocols
initiate resuscitation of the unwell patient. Recognise indicators for sepsis and implement clinically relevant plan
maintain a clinically relevant patient management plan of fluid, electrolyte and blood product use
recognise and manage fluid and electrolyte imbalances in a patient
effectively use semi-automatic and automatic defibrillators
provide appropriate aftercare and arrange follow up for more complex procedures
recognise when patients are ready for discharge and arrange referral to relevant members of the healthcare team to promote planning for safe discharge

Medical expertise

Follow-up and interpret investigation results appropriately to guide patient management

Professionalism

Mindful of potential impact of resource constraint on patient care

Collaboration and teamwork

Collaborate effectively with other specialist teams involved in the patient’s care

Communication

Collect and collate relevant information from other team members or specialist teams pertinent to decision making or patient management

Health advocacy

Identify any gaps between management plan and patient wishes

Judgement and clinical decision making

Plan the order of an operating list and discuss with consultant

Leadership and management

Remain calm under pressure

Medical expertise

Present complex cases effectively to senior medical staff and other health professionals