ECI Registrar Update - Emergency Care Institute

The role of the ECIregistrarDr Michelle SpelmanRegistrar/Advanced Trainee Emergency MedicineEmergency Care Institute

Who am I?• I originate from Ireland where I did my internship at TheRoyal Victoria Hospital Belfast.• I then dipped my toe in Australian waters for a year anddid a resident year in Gosford Hospital, Central CoastNSW.• Unsure of my direction I returned home and undertook aMasters in Sports Medicine, Trinity College Dublin.• However I realised the error of my ways• and found myself back in Sydney• I am now in my 4 th year of AdvanceTraining Emergency Medicine

Royal NorthShoreAliceSprings EDand FlyingDoctorsGosford

ECI Registrar• 6 months employment of which 0.5 is FTE with the ECI and0.5 is FTE in RNS ED• It is a special skills term and fulfils the requirement of nonemergency medicine• Special skills of management and administration• I am the first registrar in the position which commencedJanuary 2013• Today I am going to talk about what I’ve been up to overthe past 4 months

‘Running an ED involves far more than leadership trainingapplied to a particular context, or expert clinical skills orrunning a clinical team. It involves operationalmanagement, systems knowledge and manipulation,diverse communication and diplomacy skills, ability tosource information quickly, multitasking and being able todeal with interruptions, all within a dynamic and high-stakesenvironment’Celenza, Antonio, April ‘13 EMA

Can we learn this working in ED?

• Certainly we deal with interruptions and multi-tasking ona daily basis working on the floor.• Team leading is learnt in an ad hoc way, generally whenwe do nights as the Registrar in Charge.• Operational management, systems knowledge andmanipulation, diverse communication and diplomacy arenot skills I have had either informal or formal training in.• Prior to this term I had very little idea about what goes ondown that corridor, away from the ED, leading to theDirector and consultant offices.• And the Garling inquiry? Or ACI?? Or ECI???

The world outside ED

How have I stepped out into the world?• Simply working in the ACI office has exposed me to theexistence of many different clinical networks.• The ECI takes part in various committees and I haveattended meetings for the Incident Advisory Committee,The Research Committee and The Clinical AdvisoryCommittee• I have been on 2 rural and regional ED trips• As part of my job I have had the opportunity to attendcourses, conferences and showcases.

Rural and Regional Visits• Trip 1 to Southern NSW which included Moruya, Batemans Bay,Milton/Ulladulla, Shoalhaven, Shellharbour and Wollongong.• Trip 2, Western NSW, which included Cowra, Forbes and Parkesand an education day in Orange.• It’s enlightening to experience ED’s when released from the fishbowel and the tunnel vision of surviving until your next 10 hourshift.• I found it a privilege to hear the issues, struggles, hopes andachievements of the different hospital’s Nurse Managers andDirectors• In just 2 trips I’ve seen very different emergency departmentsand also how staffing numbers, personalities, relationships,location and even equipment can hinder and help the running ofan organisation

ECI webpage, projects and courses• In conjunction with Dr Mackenzie, we work to produce upto-date,concise and to the point clinical tools regardingtopical and relevant emergency conditions or procedures• Specific personal projects I’ve worked on include :Sedation PackageEnd of Life webpage• To date I have interacted with ACI clinical networks, staff forLHDs, ED directors and a Ministry representative

• I have completed an AIM course (acceleratingimplementation methodology)• I have attended a Showcase for Ambulance Service ofNSW• I have even completed some Management Moodles

Personal take home thoughts• A beneficial 6 months in the lead up to the Fellowshipexam-• On the job I’m being constantly kept up to date with journals and researchingclinical conditions• On the non-ED days you have greater scope to divide study time, attend tutorialsand most importantly manage fatigue.• Recognition that policy making, guidelines and committeesneed representation from nursing and medical staff whoregularly work the shop floor.• More of us need to be aware that we can assist in decisionmaking but more significantly we are an important part ofthe process.

Any Questions?