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News and opinion

Practising in the Facebook world

MPS Medical Director Dr Rob Hendry warns of the challenges facing the healthcare profession in keeping pace with the information age

Medicine has always been quick to adopt and adapt new technologies and many advances in care have been due to utilising advances made in other branches of science.

As we enter the new information age, the phenomenon of social networking is changing the way doctors interact with their patients and wider society. Traditional boundaries between private and professional life are becoming blurred and the potential for members to inadvertently fall into medicolegal traps is increasing.

Professional bodies around the world have recognised both the potential for the good that social networking technologies offer and also the risks for the unwary.

Tweeting to one’s friends after a bad day at work or posting details of what you got up to at a party at the weekend on Facebook can often be seen by patients, colleagues and managers. When comments are posted on the blogosphere all control is lost and they are less private than remarks made on the back of a postcard.

The laws of defamation apply to comments that may have been originally designed to amuse your friends or written in the heat of the moment, but which end up being widely circulated just as much as more traditional channels of communication.

In the UK, the General Medical Council has recently published guidance on social media, which states that where doctors identify themselves as doctors in publicly accessible social media, they should also identify themselves by name because any written material by authors who represent themselves as doctors is likely to be taken on trust. This places an onus on doctors to be thoughtful in what they write.

The full impact of new social media technologies will inevitably develop over the coming years. It is important that the way in which the public can become engaged and informed about health issues is not inhibited. However, the regulation of the profession’s use of new media opportunities may struggle to keep up with the pace of technological change and diverging social expectations of the profession.

MPS has always believed that our approach to indemnity allows us to provide the most flexible and adaptive support to our members, especially during times of rapid change in the world of medicine. 

Professional bodies around the world have recognised both the potential for the good that social networking technologies offer and also the risks for the unwary

Surgical site infection pilot launched

The pilot for a new patient safety programme has been launched by the Health Quality and Safety Commission (HQSC), aimed at tackling surgical site infections (SSIs).

Eight DHBs across the country are participating in the pilot, which will be delivered jointly by Auckland and Canterbury DHBs, with the HQSC overseeing. Aside from Auckland and Canterbury, the DHBs involved are: Waitemata, Nelson Marlborough, Hawkes Bay, Capital and Coast, Hutt Valley and Bay of Plenty.

An announcement issued by the HQSC says: “The programme seeks to reduce infections following surgery through the development of sustainable quality improvement activities and a nationally consistent, evidence-based approach to the surveillance of SSIs.”

Dr Sally Roberts, chair of the SSI surveillance programme steering committee and clinical lead for the infection prevention and control programme at the HQSC, said that SSIs remain the second most common healthcare associated infection, occurring in 2-5% of patients undergoing surgical procedures.

The consequences for both health services, and most importantly the patient, mean that the prevention of surgical site infections is extremely important

Dr Roberts added: “Surgical site infections can cause emotional and financial stress, serious illness, longer hospital stays, long-term disabilities, and may even result in loss of life. The consequences for both health services, and most importantly the patient, mean that the prevention of surgical site infections is extremely important.

“By developing a national standardised approach to surveillance and feedback, healthcare professionals will have access to verifiable information that will allow them to drive quality improvements in clinical practice, contributing to national and international efforts to improve patient safety.”

Following the launch of the pilot in March, it is anticipated that a national roll-out will follow in July. The first year of the programme will focus on hip and knee surgeries.

Associate Health Minister Jo Goodhew said: “Quality and safety in the health system is extremely important to the government. We need to ensure New Zealanders received the best health and disability care within our available resources. That is why we established the Health Quality and Safety Commission in 2010.

“This new programme is one of three components of the Commission’s infection prevention and control work, which aims to improve patient safety by reducing the harm caused by healthcare associated infections.


Patient ownership of decisions

Patient expectations and ownership of their treatment decisions are commonly at the heart of complaints and litigation. Patients who are well-informed and highly engaged when deciding between treatment options are placed in a stronger position to take ownership of the final treatment decision and outcomes.

Shared decision-making is both good practice and good risk management

The concept of ‘shared decision-making’ includes clearly communicating the pros and cons of treatment options and continuing to engage the patient, end-to-end, in the decision-making process. Shared decision-making is both good practice and good risk management. Most patients highly value the decision-making process.

  • 96% of patients want to be offered choices and asked their opinions in clinical decision-making (Chung, 2011)
  • 58% would prefer a greater level of involvement than they experienced (Stewart, Abbey et al, 2004).

Failing to meet patient expectations can cause patients and their families any number of emotions, ranging from mild disappointment to extreme distress and anger. This is the reason shared decision-making is a fundamental communication technique for proactively managing your risk and patient satisfaction.

MPS’s Mastering Shared Decision Making workshop

Mastering Shared Decision Making is the latest addition to the MPS Mastering series of communication skills workshops. The workshop explores the specific skills that doctors require in adopting shared decision-making.

Shared decision-making is a fundamental communication technique for proactively managing your risk and patient satisfaction

Participants will learn techniques that can be used in practice to assist in reducing their exposure to complaints and litigation. Take control of your professional development and attend this workshop free of charge – a benefit of your MPS membership.

Register for Mastering Shared Decision Making and other workshops offered by MPS >>

‘Party pills’ Bill welcomed

The Chair of the New Zealand Medical Association has welcomed the introduction of a Bill aimed at making the production and distribution of so-called ‘party pills’ safer. Dr Paul Ockelford said: “We need legislation with a far more stringent set of rules to protect the public from the dangerous side-effects of party pills and other synthetic drugs sold as legal highs.

“Those who sell these drugs currently have no obligation to prove they are safe. Unregulated drugs could be sold until they were proven dangerous, rather than assessing their risk before they were made available for sale to the public.”

The Psychoactive Substances Bill has been introduced by Associate Health Minister Peter Dunne, who was also praised by Dr Ockelford for his commitment to strengthening drug legislation.


Palliative care framework published

Resources and capability for palliative services in New Zealand have been laid out in a framework by the Ministry of Health. Resource and Capability Framework for Integrated Adult Palliative Care Services in New Zealand was published in January and is aimed at DHBs, funders and policymakers, to support strategic planning and the purchasing of palliative care services.

The Framework was commissioned in 2011 after the Ministry of Health received advice about a lack of understanding regarding what constitutes specialist or primary palliative care.


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