Rural Perioperative Team Training Program

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Initiative Type

Education and Training

Status

Deliver

Added

02 March 2019

Last updated

09 September 2022

Summary

The Rural Perioperative Team Training Program is an initiative of the Statewide Anaesthesia and Perioperative Care Clinical Network (SWAPNet), sponsored by Clinical Excellence Queensland.

The scenario based education and training program consists of technical and non-technical skills with a focus on team work, team communication and team culture.

The training scenarios (four 'core' based on the Australian and New Zealand College of Anaesthetists (ANZCA) emergency response activities) and five 'elective' include can't intubate/can't oxygenate; cardiac arrest; management of haemorrhage; management of anaphylaxis; general anaesthetic for abdominal emergency surgery; management of sedation; local anaesthetic toxicity; management of malignant hyperthermia and trauma. Scenarios are specifically tailored to reflect local practice at each site.

The two day training program consists of teamwork theory, skill development sessions and six crisis management scenarios and is delivered by a faculty team consisting of an anaesthetist, surgeon and perioperative nurse, supported by the SWAPNet Coordinator (facilitator) and Clinical Skills Development Service (CSDS) Simulation Coordinator.

An evaluation process is conducted at the end of each delivery. Feedback to date has been overwhelmingly positive. Participants are provided with a certificate of attendance and the facility is provided with an overview delivery report outlining attendance, points of discussion and recommended opportunities for improvement.

Key dates

Feb 2018

Dec 2019

Implementation sites

To date, it has been delivered at Atherton, Ayr, Biloela, Bundaberg, Charleville, Cooktown, Dalby, Emerald, Gladstone, Goondiwindi, Ingham, Innisfail, Kingaroy, Longreach, Mareeba, Mt Isa, Proserpine, Roma, St George, Thursday Island and Warwick hospitals

Partnerships

Clinical Skills Development Service and Queensland Surgical Advisory Committee

Aim

The Rural Perioperative Team Training Program is a multifaceted, multidisciplinary team training program that has been developed to support clinicians to deliver and maintain safe, sustainable service delivery in rural and remote Queensland.

Benefits

The Rural Perioperative Team Training Program aims to promote:

Improved patient safety / patient outcomes
Improved performance
Better understanding and appreciation of individual roles and responsibilities
Improved communication and culture
Improved staff satisfaction
Delivery of high quality healthcare

Background

The Queensland Government’s commitment to improving access to safe and sustainable health services for residents of rural and remote communities is outlined in its ‘Future workforce strategy for better healthcare in Queensland 2013-2018’ which states:

‘Queensland’s capacity to deliver health services and achieve positive health outcomes for the population, both now and into the future, is largely contingent upon the health workforce. It is critical to ensure that there are sufficient numbers of the right staff, with the right mix, in the right place and the right time, and that the workforce is appropriately skilled to work collaboratively and efficiently to deliver patient focused care and create positive health patient journeys and experiences’.

The correlation between education and training and the delivery of safe, sustainable patient care is well recognised in the literature.

Simulation based multidisciplinary team training aims to improve team interaction (e.g. communication and coordination) in a systematic manner to improve patient safety/outcomes and reduce the risk of patient harm.

In rural and remote facilities, generalist anaesthetists provide anaesthesia, often practicing alone and working in unfamiliar environments (eg. maternity wards) with staff who are unfamiliar with perioperative practice.

Nurses in these locations are also required to be ‘generalists’ practicing safely across a broad range of skill sets and varied medical and surgical specialties with limited access to education and training. Achieving and maintaining compliance with Australian and New Zealand College of Anaesthetist (ANZCA) PS08 is a significant challenge.

Multidisciplinary team training for rural and remote Queensland was identified as a priority at the 2017 SWAPNET forum. It follows on from the delivery of standardised anaesthetic equipment to 30 rural facilities and the development of the Rural Generalist Anaesthetic Introductory Program in 2013/14 and the review and development of the Transition Support Program - Perioperative for Registered Nurses in 2017 and Enrolled Nursed in 2018.

Solutions Implemented

Training program developed based on nine scenarios identified as greatest need by rural sites across Queensland.
Multidisciplinary faculty established.
To date, 24 rural sites across Queensland have received training.
Clinical Skills Development Service debriefing training for faculty members delivered on 3 and 14 December 2018 and and 25 February 2019. Further training for faculty members scheduled for 25 January 2023.
Evaluation results continuously reviewed and program modified to reflect feedback as required (continuous improvement process).

Evaluation and Results

Training commenced in 28 February 2019. Evaluation includes:

A customer satisfaction survey to identify program roll out performance and provide opportunities for ongoing delivery improvement.
Survey results to date are outstanding.

Lessons Learnt

Developing multidisciplinary education and training programs for clinicians is particularly complex.
Scanning the environment to identify current training programs and ensuring consistency of training content is vital.
Delivering training programs that are relevant and specifically designed to reflect functionality and practice at individual sites and in the local environments maximises opportunities for participation, learning, reflection and sustainability.