Risk assessment and management
Risk assessment and management is an integral part of a remote supervision placement to ensure the safety of the patients, the registrar, the remote supervisor, the training site and the community. Although any clinical experience learning placement has risks, the potentially higher level of risks with the distance factor added means that a more stringent risk management approach will be needed for remote supervision terms. Risks must be identified, and the strategies to prevent and control each risk should be documented, with resources available for these strategies to be implemented if necessary. It is recognised that medical practice will never be risk free, but that careful consideration of possible risks associated with remote supervision and practice can assist with risk mitigation.
The Remote supervision risk management plan template is designed to be downloaded and completed by the training site and remote supervisor. Risk categories include environmental and training site risks, registrar risks, training risks and risks to the supervisor–registrar relationship.
The Remote supervision risk assessment and management – examples is a completed version of the template and provides risks, potential consequences and mitigation strategies that may be considered to help plan for each remote supervision placement. It is important for the training site to develop its own risk management plan using the template, contextualising the items so the plan is relevant to the site.
The remote supervision risk management plan needs to be started by the training site during the accreditation process to identify any red flags that need to be addressed early on. The plan is then completed during the orientation period by the remote supervisor in consultation with the training site and the registrar. It is important that the risks and mitigation strategies are discussed with the registrar and reviewed throughout the duration of the training term. Completion of the risk management plan will not only identify issues that need to be addressed early in the placement, but will also serve as a resource for future placements.
Safety for patients is the ultimate goal of training, encompassing all of the risk categories, and will include:
- safety – registrar selection, monitoring of registrar–supervisor interaction and good project management
- quality care – supervisors’ availability, approachability, backup arrangements and willingness to be called whenever needed
- emergencies and escalation pathway – this is an essential activity during the orientation period.