ANZCA Bulletin December 2013

100 Pages·2013·7.12 MB·English

DECEMBER 2013
ANZCA BULLETIN
ANZCA research: Talking workforce:
What ANZCA is doing
How we have
Advancing CPD:
distributed
A fi rst look at the new
portfolio system
$1.2 million
National Anaesthesia Day:
Strongly embraced
ADVERTISEMENT
A
C
ZSetting the
standard
in CPD
.
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Training tomorrow’s anaesthetists • Setting the standards in quality and safety
• Providing the best in medical education • Representing you in the wider
community • Leaders in anaesthesia and pain medicine research
Fellowship of ANZCA and the Faculty of Pain Medicine are immediately
recognised hallmarks of specialists of the highest professional standing.
www.anzca.edu.au
A
24 Research funding allocated
The Anaesthesia and Pain Medicine
Foundation will distribute nearly
42 The “beach chair” position $A1.2 million for research in 2014.
Some guidelines for shoulder surgery in the
“beach chair” position have been developed.
54 FPM’s early years
Dr David Jones outlines the early
years of the Faculty of Pain Medicine.
46 Anaesthesia and the environment
Dr Forbes McGain is a leading proponent
of “greening” the healthcare industry.
ANZCA Bulletin
Medical editor: Dr Michelle Mulligan Contacts
Editor: Clea Hincks ANZCA
630 St Kilda Road, Melbourne
Art direction and design: Christian Langstone
Victoria 3004, Australia
Production editor: Liane Reynolds Telephone [phone]
Sub editor: Kylie Miller Facsimile [phone]
[email protected]
Submitting letters and other material
www.anzca.edu.au
We encourage the submission of letters, news and
The Australian and New Zealand College of feature stories. Please contact ANZCA Bulletin Editor, Faculty of Pain Medicine
Anaesthetists (ANZCA) is the professional medical Clea Hincks at [email protected] if you would Telephone [phone]
body in Australia and New Zealand that conducts like to contribute. Letters should be no more that [email protected]
education, training and continuing professional 300 words and must contain your full name, address www.fpm.anzca.edu.au
development of anaesthetists and specialist pain and a daytime telephone number. They may be Copyright: Copyright © 2013 by the Australian
medicine physicians. ANZCA comprises about edited for clarity and length. and New Zealand College of Anaesthetists, all rights
5000 Fellows and 2000 trainees across Australia Advertising inquiries reserved. None of the contents of this publication
and New Zealand and serves the community by To advertise in the ANZCA Bulletin please contact may be reproduced, stored in a retrieval system or
upholding the highest standards of patient safety. [email protected]. transmitted in any form, by any means without
the prior written permission of the publisher.
Please note that any views or opinions expressed
in this publication are solely those of the author and
do not necessarily represent those of ANZCA.
2 ANZCA Bulletin December 2013
18 A ddressing workforce issues
How ANZCA is collecting data and
contributing to government debate
about workforce.
9 Our new CPD portfolio system
The new user-friendly CPD portfolio system
is being fi netuned in time for launching on
January 20.
12 N ational Anaesthesia Day embraced
Fellows and the media responded well to
National Anaesthesia Day on October 16.
Contents
4 President’s message 32 A naesthesia and Pain Medicine 61 O ur overseas work: Kenyan
Foundation anaesthetist settles into scholarship
6 Chief executive offi cer’s message
in Sydney
34 ANZCA Trials Group
7 Blue Book available now
63 P rofi le: Lieutenant Commander
36 P rovisional fellowship training
7 Awards Peter Smith
and the 2013 curriculum
7 Letter to the editor 64 T he merger of the Medical Education
37 A NZCA Curriculum 2013 shapes up
8 Y our ANZCA: Continuing Professional well on the international stage and the Simulation SIGs
Development (CPD) Committee 65 R eturning to work after extended
38 R ay Hader Award: Helping others
9 N ew CPD system will simplify “just part of the job” leave – the CRASH course in
recording process anaesthesia
39 Successful candidates
10 W hat would you do?: Should you 67 T he very modern art of 140
advise smokers to quit? 42 Q uality and safety: Surgery characters
in the “beach chair” position
11 ANZCA and FPM in the news 68 New Zealand news
43 Quality and safety: Alerts
11 Professional documents – update 72 Australian news
44 Quality and safety: webAIRS news
12 C elebrating one of the greatest 78 Special interest group events
46 Greening your gases
discoveries of modern medicine 81 A naesthetic history: Dr William
– anaesthesia 50 Faculty of Pain Medicine Russ Pugh
16 A NZCA and government: building 52 FPM: Spring Meeting 82 Bullying and harassment
relationships
54 F PM: Faculty celebrates its early years 84 Library update
18 Talking workforce
58 Profi le: Dr Annette Turley 86 Obituaries
23 M aking a difference: Pain relief
59 O ur overseas work: Indonesian 91 Future meetings
medication and breast milk
registrars visit Ballarat
– is it safe for babies? 93 l ife&leisure: Singapore sparkles
60 O ur overseas work: Essential Pain with a feast of entertainment
24 A NZCA awards $A1.2 million for
Management continues to grow
research to improve patient care
3
President’s message
The College conducted its fi rst graduate ANZCA CPD standard which applies to
outcome survey on the work situation for all anaesthetists and pain specialists in
new Fellows in 2013. We recognise that Australia and New Zealand, and page 9
the large number of different stakeholders about the new electronic portfolio.
requires a collaborative approach and Compliance with the new ANZCA CPD
many meetings are being held with Program automatically meets the standard.
workforce decision makers – Health
College activities in 2013
Workforce Australia, Health Workforce
New Zealand, Australian state and territory Advancing standards (ANZCA strategic
health departments, and the New Zealand priority no. 1)
• Successful launch of the new ANZCA
health ministry. For more information,
curriculum at more than 170 training
see page 18.
sites, the biggest College project ever
Revalidation, the ANZCA CPD standard undertaken – thanks to all involved
and program for your hard work!
The 2012-2013 Australian Health
• Our fi rst electronic training portfolio
Practitioner Regulation Authority
system (TPS), progressively enhanced
(AHPRA) annual report Regulating Health
throughout the year in response to
Practitioners in the Public Interest makes it
your feedback.
clear that the Medical Board of Australia is
• The new integrated primary examination
considering revalidation closely and will
and upgraded examination management
be informed by international developments
system.
(for example, the UK and north American
revalidation programs). • Workplace-based assessment (WBA)
It’s been an extremely busy year for the It wants to work with the professions, rollout supported by WBA champions.
College, its Fellows, trainees and dedicated including the Colleges, and the community • More podcasts and webinars (see
staff. My article this quarter highlights 2013 on this issue. At the same time, the www.anzca.edu.au/resources/learning).
activites and projects planned for 2014 in Medical Council of New Zealand has
• The handbook and regulation for training
accordance with our goal of improving indicated its interest in strengthening
in Hong Kong, Malaysia and Singapore.
the quality and safety of anaesthesia, systems for identifying and dealing
perioperative medicine and pain medicine. with poorly performing doctors and • Ongoing work on the FPM Curriculum
Our focus is on high quality services, questioned what the role of medical Redesign.
both directly to support your day to day colleges might be in this. Professor Ron • Successful events: the Melbourne ASM,
practice, and also to address wider health Patterson has been an infl uential voice in attracting more than 2000 delegates and
system issues affecting our patients and New Zealand and Australia, and his book widespread media coverage (increasing
professions. The Good Doctor: What Patients Want the profi le of anaesthesia and pain
I acknowledge the work of many Fellows, elaborates on community expectations medicine); 17 regional combined ANZCA/
trainees and staff who have contributed to of doctors, especially that we remain Australian Society of Anaesthetists
the College this year and and welcome up-to-date. We have already seen RACS continuing medical education meetings
your feedback at [email protected]. implement compulsory audit; in some in Australia; New Zealand Anaesthesia
I wish you and your families a restful respects anaesthesia has some catching ASM, Dunedin; six special interest group
holiday season and the very best for 2014. up to do and the new ANZCA continuing meetings and the FPM spring meeting.
professional development (CPD) standard
Pressing issues • Nearly $A1.2 million for research
starts to address this.
(see page 24).
Workforce The introduction of revalidation in
To recognise signifi cant workforce issues, • The Electronic Persistent Pain
some form seems inevitable, although the
the College’s workforce action plan focuses Outcomes Collaboration pilot.
timeframe is unclear. There also seems
on three key areas:
clear benefi t in being actively engaged • Australasian Anaesthesia 2013
• Ensuring the College has an effective in the development of a revalidation (the “Blue Book”, page 7).
voice in decisions by policy makers. framework. Overseas, we have witnessed • Quality and safety: New and revised
• Collecting high quality data to inform regulatory authorities take the lead with professional documents, safety alerts,
workforce planning. recertifi cation processes. Our professions Bulletin articles, and support for
• Communicating with Fellows and have an opportunity, and a challenge, WebAIRS.
to ensure that anaesthetists and pain
trainees to understand their views and
specialists remain actively involved in Building engagement, ownership and
discuss the College’s workforce activities.
any future changes, ensuring that they unity (strategic priority no. 2): Supporting
remain relevant to our clinical practice. It Fellows and trainees
may be that strengthening CPD programs • The inaugural graduate outcome
will be suffi cient to meet regulatory and survey on the work situation for new
community expectations. See the ANZCA Fellows to guide further action.
website for more information on the revised
4 ANZCA Bulletin December 2013
• Introduction of the web-based • Professional document PS59 Statement Key services and projects for 2014
My ANZCA portal that includes on roles in anaesthesia and perioperative In addition to existing services, new
simple-to-use online event registration medicine developed (www.anzca.edu.au/ initiatives include:
and payment. resources/professional-documents).
• A workforce action plan (see page 18).
• Customer service training and charters • Continued expansion of the essential
• The revised CPD standard and program,
for staff to improve service to Fellows pain management (EPM) program, now
with streamlined entry on mobile devices,
and trainees. in 15 countries globally – a web presence,
automatically linked to online conference
EPM Subcommittee, newsletter and
• Fourteen hospital visits by Linda Sorrell, registration (My ANZCA Portal) and
successful funding of $150,000 over
CEO and regional/national committee the training portfolio system (TPS) to
three years from Perpetual Trustees
chairs. provide automatic recording, supporting
(see page 58).
• The ANZCA CPD survey, seeking your handbook with templates and tools, and
views on CPD. • Initiatives to “close the gap” for seamless transition for existing CPD
indigenous communities, including nine participants (see page 9) and the website.
• The online library project, improving
podcasts and medical student mentoring
library services for Fellows and trainees. (see September 2013 Bulletin). • A new learning management system
(LMS) with better facilities for online
• Online “fl ipbook” style access to • Collaboration with the Royal Australasian education and collaboration for Fellows
the ANZCA Bulletin, and the College College of Surgeons (RACS) Rural Health and trainees (for example, podcasts,
Conversations CD. Continuing Education (RHCE) indigenous webinars, document sharing and editing,
• A New Zealand Anaesthesia Education health portal project. committee meetings).
Committee (NZAEC) website, • Support for the National Pain Strategy • A fellowship satisfaction survey to ensure
NZAEC visiting lectureship visits to and the International Association for the the College is on the right track with
smaller centres and the BWT Ritchie Study of Pain (IASP) Global Year Against services for Fellows.
Scholarships. Pain.
• The “mega” Singapore ASM with RACS.
• FFPMANZCA logo for Fellows’ • Patient information sheets developed.
professional use on business cards, • Further enhancement of the TPS to
• More than 60 submissions to Australian
letterhead and other material. support supervisors and trainees.
and New Zealand governments and other
• New Bulletin article series – “Making authorities. • Continued implementation of service
a difference” about ANZCA-funded charters across ANZCA for improved
research (page 23) and “Your ANZCA” Ensuring ANZCA is sustainable (strategic focus on Fellow and trainee needs.
about what ANZCA committees do priority no. 4): Wise use of our resources • Finalisation of the FPM curriculum for
(see page 8 about the CPD Committee). • A framework for recognising Fellow delivery in 2015.
and trainee contributions.
• FPM New Zealand National Committee • Orientation resources for trainees,
• Prudent stewardship of resources to
established. supervisors of training, rotational
ensure maximum value in supporting
• The Geoffrey Kaye Symposium of supervisors and education offi cers.
Fellows and trainees in providing the
Anaesthetic history, History and Heritage • An online training accreditation system
highest standards of anaesthesia and
Expert Reference Panel and three (advancing accreditation).
pain medicine.
more web-based “Anaesthesia Stories”
• Improved business processes to ensure • Expanded fundraising for research by
(www.anzca.edu.au/about-anzca/
effi ciency and effectiveness – project further recruitment to the Anaesthesia
anaesthesia-stories).
management, fi nancial reporting to and Pain Medicine Foundation Board
Stronger external relationships ANZCA Council, performance appraisal of Governors.
(strategic priority no. 3) processes, Lean Six Sigma managerial • The online FPM education program for
• New Zealand function attended by health training, information management/ allied health practitioners, funded by
leaders, including the Minister of Health. information technogy roadmap, greater the Australian Medical Local Alliance
• Relaunch of National Anaesthesia Day trans-Tasman collaboration, Work (AMLA).
Health Safety management and the re-
with an eye-catching poster, strong • Investigation of a pain device implant
establishment of the Green Committee.
support from many Fellows and hospitals, registry.
and very positive news stories (see report • A staff recognition program, with 29 staff • Development of a cultural hub in
on page 12). acknowledged for services to the College Ulimaroa, including relocation of the
of between fi ve and 21 years.
• A community survey highlighting the Geoffrey Kaye Museum of Anaesthetic
need for more public education about • Revised educational governance structure History.
anaesthesia and anaesthetists. with new educational committees for the • Expansion of the EPM program,
new curriculum, including evaluation for
• Widespread media publicity through supporting global health.
evolution (not intermittent “revolution”).
hundreds of reports reaching a combined
audience of millions (see ANZCA in the • Restructure of the Anaesthesia and Dr Lindy Roberts
news on page 11). Pain Medicine Foundation, recruitment President, ANZCA
to the Board of Governors for more
effective fundraising and launch of a TV
commercial to raise research funds.
5
Chief executive
offi cer’s message
College including continuing professional Evaluations and interactions with the
development (CPD) and training staff as Trainee Committee confi rm that weekday
well as with a number of special interest evening work pressures when webinars
groups to investigate the collation and are scheduled have an impact on
linkage of relevant journals, books, attendance. The newly formed Education,
videos and other educational material Training and Assessment Development
from the website. Committee is exploring alternative means
The number of online textbooks in the to capture the interactions between
library continues to grow and the usage trainees, such as the publication of key
from Fellows and trainees has increased discussion points from webinars for those
exponentially. There is now a selection of trainees that cannot attend.
Oxford handbooks and ClinicalKey. There ANZCA and FPM Fellows continue to
were over 150,000 downloads from the evaluate the ANZCA Foundation Teacher
online book collection this year – close Course as highly valuable in improving
to doubling the number of downloads their teaching ability. In 2013, four full
recorded for 2012. While online textbooks face-to-face courses and two abridged
have increased, the loans from the print face-to-face courses were held, with
library collection continues to grow with demand exceeding the number of places
more than 700 books lent to Fellows available.
and trainees around Australia and One Online Foundation Teacher
New Zealand. Course has run throughout the year
The library provided additional as the content for each module has
online access to two journals this year been fi nalised. The Clinical Teacher
ANZCA and FPM Fellows and trainees
– the Medical Journal of Australia and Development Working Group (CTDWG)
continue to make good use of College
Anaesthesia and Intensive Care. The large has reviewed the face-to-face and
library services as part of their
selection of specialised online journals online courses this year in light of the
membership, and have particularly
is still a popular resource for Fellows introduction of the revised curriculum.
utilised the expert searching skills of
and trainees with ongoing high usage Recommendations for the new
library staff.
recorded. More Fellows and trainees are Teaching and Learning Subcommittee
The number of literature searches
becoming aware that the library can relate to the introduction of a “training
increased in 2013 with almost 100
obtain articles not available to them the trainer” model for a wider roll out of
requests fulfi lled. Library staff searched
personally. Library staff have sourced the course to reach the demand.
on topics to provide information for
about 2000 articles for Fellows and Throughout the year, the Education
clinical evidence, training and study,
trainees from networks, other libraries, Unit has scoped the requirements for
research, and quality and safety. Fellows
and publishers. ANZCA’s new learning and collaboration
and trainees also continue to do their
Fellows and trainees are also management system. The system will be
own searches in the variety of medical
continuing to utilise College learning introduced in 2014.
databases available through the library,
resources as part of their membership,
with over 110,000 search terms recorded.
particularly the podcast resources that Ms Linda Sorrell
While the ANZCA Library still receives
cover broader areas of the curriculum. Chief Executive Offi cer, ANZCA
regular visitors to head offi ce, the main
This year has seen the introduction
traffi c to the library is online. There were
of podcasts to support key areas of the
more than 200,000 visits to the library
newly-defi ned introductory training
website in 2013, a big increase on 2012.
period. Overall, 20 new podcasts have
Earlier this year the library team
been published. Fifteen webinars were
demonstrated services fi rst-hand at
also held throughout the year, led by
this year’s annual scientifi c meeting in
Fellows with expertise in specifi c areas of
Melbourne. It was a great opportunity
anaesthesia and pain medicine.
to receive feedback from Fellows and
The number of trainees in webinars
trainees.
can be up to 100 and typically 50 per cent
Library resources will be further
of those that register actually attend.
enhanced in 2014 with direct and
The average number of registrations per
seamless access to material such as
webinar in 2013 has been 25, so the size
articles and books from “apps” and
is smaller compared to previous years.
other programs. The library website
will be refreshed and library staff are
already working with others in the
6 ANZCA Bulletin December 2013
Blue Book is here!
The 2013 edition of ANZCA and FPM Fellows and trainees
Australasian
can download the Blue Book in the
(the Blue Book) is
Anaesthesia
“fl ipbook” format onto all devices from
now available.
the ANZCA website – www.anzca.edu.
au/resources/college-publications. The
Published by ANZCA every two years, the
fl ipbook format features navigation and
Blue Book covers a diverse range of topics search functions to fi nd topics of interest AUSTRALASIAN
opfa iinnt mereedsti ction aen paheyssthiceiatinstss. and specialist faster, and includes zoom and full-screen ANAESTHESIA
modes for ease of reading.
This year’s edition has been made 2013
While in recent years many have voiced
possible thanks to the work of 56 authors
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number by December 31, 2013 and we will
obstetrics and gynaecology, regional
post the Blue Book to you in the new year.
anaesthesia, anaesthesia practice, pain
and education and research.
Awards
Two awards for Alan Merry Stephen Bolsin awarded
ANZCA councillor Professor Alan Merry from Auckland has Adjunct Professor Stephen Bolsin from Geelong Hospital
recently received two prestigious awards – honorary membership delivered the eponymous Frederic Hewitt Lecture at the Royal
of the American Society of Anaesthesiology (ASA) in recognition College of Anaesthetists’ (RCA) annual Patient Safety Meeting
of his extensive work in patient safety, and the 2013 Gluckman in the UK in October. Professor Bolsin also received the RCA’s
Medal, the University of Auckland Faculty of Medical and Frederic Hewitt Medal. Professor Bolsin has been referred to as
Health Sciences’ premier recognition of research excellence. The the “Bristol babies whistleblower” for his work 20 years ago in
honorary ASA membership has been given to only 34 individuals bringing to light the unusually high numbers of deaths and poor
in the world since 1935. As well as being a practising anaesthetist, outcomes of babies undergoing open-heart surgery. This led to the
Professor Merry is chair of New Zealand’s Health Quality & Safety Kennedy Inquiry, which made more than 200 recommendations
Commission board, head of the School of Medicine at Auckland to improve patient care.
University and a board member of Lifebox, an international non-
profi t organisation that works to improve the safety and quality
of surgical care in low-income countries.
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I was interested in the article “What would you do?” in the June and readily available. I can’t see that this should be an issue.
2013 ANZCA Bulletin. Any reasonable surgeon surely could understand the possible
I spent two valuable years of my training in Australia and had consequences of not adhering to this practice.
some brilliant teachers, one of whom impressed upon me that a
surgical operation begins with the induction of anaesthesia. Suzanne Powrie, FANZCA FRCA
7
Your ANZCA:
Continuing Professional Development (CPD) Committee
Setting the standard for
professional development
MANY FELLOWS ARE UNAWARE OF THE WORK THAT GOES ON
BEHIND THE SCENES AT ANZCA. THIS ARTICLE ABOUT THE CPD
COMMITTEE IS THE SECOND IN A SERIES ABOUT THE ACTIVITIES
UNDERTAKEN BY ANZCA’S COMMITTEES.
Though it’s one of the smallest CPD unit staff at ANZCA keep track of Many Fellows have spent hours
committees, ANZCA’s Continuing and report to the committee issues raised developing or piloting resources for the
Professional Development (CPD) by Fellows (and others), monitor the audit new program, working on electronic
Committee infl uences the professional process and outcomes and have specifi c interface and generally being available
working life of every specialist. knowledge of the complexities of the to bounce ideas off. Despite the tight
As such, unlike some committees, program, and regulatory requirements, deadlines, differing views and strongly
the members are not there for their when questions and diffi culties arise. held opinions, this has been achieved
geographical representation (except for They fi eld at least half a dozen queries with a degree of humour and collegiality
the obvious need for both Australian per week from hospitals and the medical at which one can only marvel.
and New Zealand representatives). board authorities enquiring about Fellows who would like to help with
Rather, they bring the perspective of all individual Fellows’ compliance with CPD. this committee would be very welcome.
types of practice (public, private, urban, They also are available to Fellows for If you wish to put your hand up, please
and remote/rural) as well as all types advice about their individual situations, contact [email protected].
of practitioners (clinical, non-clinical, passing questions to a Fellow on the
interventionists, non-interventionists, committee if necessary. Dr Vanessa Beavis
anaesthesia and pain medicine) to Our major work over the past 18 months Chair, CPD Committee
the table. or so has been the revision of the CPD
The primary roles of this committee standard and program. We are fortunate
are to oversee our College’s CPD standard to have high quality education experts
and our College’s CPD program. This advising us, as well as the Policy unit,
means we must ensure that our standard who help prepare for meetings with, and
and program are up to date with documentation for, the Medical Board of
international developments and research, Australia and the Medical Council of New
and importantly make sure that the CPD Zealand, and issues such as qualifi ed
program complies with the jurisdictional privilege for the program in Australia or
requirements. This must all be balanced protected quality assurance activities in
against the absolute requirement to ensure New Zealand.
that the program is acceptable to all and The committee members are Dr
“doable” by everybody. Business as usual Vanessa Beavis (NZ, chair and councillor),
for the committee is usually able to be Dr Rod Mitchell (SA, chair Fellowship
covered in three teleconferences a year Affairs Committee and councillor), Dr
and one face-to-face meeting around the Sarah Green (NSW), Dr Kerry Gunn (NZ,
time of the annual scientifi c meeting. and chair of the online advisory group),
Dr Penny Briscoe (SA, pain medicine), Dr
Peter Roessler (Vic, director of professional
affairs), Dr Lindy Roberts (WA ex-offi cio)
and Dr Mick Vagg (Vic, CPD chair pain
medicine and co-opted for the project).
Further information about ANZCA
committees, including their terms of
reference, can be found at www.anzca.
edu.au/about-anzca/Committees.
8 ANZCA Bulletin December 2013