Work health and safety and critical incidents
Practice reporting requirements
Throughout a registrar’s placement, reporting by the practice allows us to monitor that the registrar is achieving their training outcomes and that the practice is providing the expected training environment and clinical experiences for the registrar. We expect practices to contact us regarding any issues likely to impact on their ability to meet training requirements. Examples include concerns about a light workload resulting in insufficient clinical experiences for a registrar or the availability of accredited supervisors for daily supervision and teaching.
Any issues that are identified will be promptly managed by the local RACGP team. This may take the form of a discussion with the supervisor and/or practice manager or the provision of additional support or remediation. Any issues with the supervisor or practice will be documented and, if necessary, escalated to the Regional Accreditation Panel for consideration of the ongoing appropriateness of the supervisor or practice remaining accredited.
Work health and safety
Each practice has work health and safety obligations that are governed by federal and state/territory legislation. Staff should be familiar with the practice’s policies on managing hazards, adverse events, near misses and critical incidents.
All staff, including supervisors and registrars, have a duty to take reasonable care of their own and others’ health and safety. This includes managing fatigue and ensuring their actions and omissions don’t adversely affect others. Refer to Safe Work Australia for more information.
Stress and fatigue in general practice
We encourage all practice staff to read our policy position statement on stress and fatigue in general practice. It discusses some of the causes of stress and fatigue in general practice and some potential solutions.
We also encourage you to look out for warning signs of fatigue and burnout in yourself, registrars and colleagues. Signs of burnout include:
- mental and physical exhaustion
- making mistakes
- preoccupation with work
- feeling negative or cynical about work
- emotional numbing or detachment.
If these signs are not addressed, they can lead to further physical and mental health problems, an increased risk of clinical errors and conflict in relationships.
Maintaining appropriate boundaries
The RACGP recommends that registrars not provide medical treatment to staff at their practice. Please do not ask your registrar for medical care or prescriptions for yourself (or your family) if there is a realistic alternative available.
Helpful resources
The RACGP White Book has a helpful chapter on Keeping the health professional safe and healthy: Clinician support and self-care.
You can find other self-care resources and support services on the RACGP GP wellbeing webpage and in the Support for practices section.
Adverse events (including critical incidents)
Reporting adverse events and critical incidents is important. Reporting enables prompt assistance and support to be given which can help to reduce the impact on your registrar's training. It also enables the RACGP to monitor issues on a national basis and reduce risks, promote safe learning environments, and continue to make improvements.
Practices are required to have processes to manage adverse events and critical incidents, whether they involve registrars, supervisors and/or the practice itself. It is important that all staff are familiar with and understand these processes.
Under Australian Medical Council requirements, the RACGP is responsible for ensuring the safety of registrars and patients. An adverse event and critical incident must be reported to us if it involves a registrar or impacts their training.
An adverse event is any disruptive event that causes, or risks causing, significant harm to patients, registrars, supervisors, practice staff, training program staff or the associated organisations involved in program delivery.
A critical incident is any adverse event that results in a serious negative outcome for patients, registrars, supervisors, practice staff, training program staff, the RACGP and/or its staff, the reputation of the AGPT program or any combination of these.
Reporting an adverse event
It is everyone’s responsibility to ensure events and incidents are reported as soon as possible. The privacy of all involved will be protected, and the report will be accessible only to RACGP staff who require access.
Practice managers and supervisors should be familiar with the Adverse event and critical incident management and reporting guidance and promptly notify the RACGP of any event. For further information about reporting a critical incident or adverse event, contact the RACGP at adverseevents@racgp.org.au