Bond students set to benefit from Osler platform

Health sciences students, including medical, physiotherapy and allied health disciplines, are set become the next cohort of Osler platform users.

 

Osler Compliance helps the Faculty manage student compliance with essential tasks such as immunisation status, registration and first aid certification, prior to the commencement of clinical rotations.

 

Faculty Business Director Ms Rhonda Morton said the rollout was the first of several Osler components, including a placement management app, and in-workplace assessments that will facilitate more streamlined supervision and feedback for their students.

Journal review modules – a new Osler feature

Staying abreast of the latest literature is traditionally very difficult for most practicing clinicians.

 

There is a seemingly endless array of journals and papers, some of which may or may not be relevant.  For the hardworking clinical staff performing day to day care for patients, it’s almost impossible to detect signal from noise.

 

 

 

 

Busy clinical staff just like you tell us they just don’t have time to review all the relevant literature – what they need is a brief review that highlights the key points, in an engaging, interactive and tailored format.

 

Osler is here to help.  Our recently launched Journal Module series review the most important literature in your specialty’s landscape.  Designed for clinicians with only limited time, the reviews give you the background, a brief overview of the trial, and how it applies in your daily practice.  Break out slides enable you to explore more detail if you wish.

 

And best of all, all the activity you perform can be captured so you can easily update your CPD program with your efforts.

 

So why not join Osler.community today and take advantage of the Osler platform.

Ramsay’s Noosa Hospital receives award for implementing Osler

Noosa Hospital’s Education department has been awarded a Ramsay Healthcare national innovation in education award for its implementation of the Osler platform across its clinical staff.

 

The annual award recognises one of the earliest adopters of Osler’s pioneering platform, who are using the platform to add consistency to workplace assessment of their staff to maximise patient safety.  In doing so, staff are more aware of their scope of practice, according to Director of Clinical Services, Judy Beazley

 

The rollout of Osler was recently launched at a media event attended by Queensland Minister for Innovation, Information Technology and Science, Ms Leeanne Enoch.

Noosa Hospital is taking part in a world first trial using a new app to help improve the skills of doctors and nurses.Download the 7 News app: http://yhoo.it/2a8SxYV#7News

Posted by 7 News Sunshine Coast on Wednesday, April 12, 2017

Guest blog post : Show me the evidence, by Dr Rob Hackett

This week, the blog features a guest post by Dr Rob Hackett

 

If you went skydiving, would you first ask for scientific evidence from a randomized trial that a properly functioning parachute prevents injury before you’d consider using one during your freefall? Probably not.

 

In fact, no such study exists. Of course, some people without a parachute have survived a freefall from extraordinary heights without injury, and others have sustained injuries even when using a parachute. But it’s clear that you’d use a parachute when skydiving, even without a single randomized trial to prove its effectiveness. Yet, when it comes to medicine, clinicians may be reluctant to employ any intervention without rigorous scientific evidence for its efficacy.

 

The need for sound evidence evolved from a history of medicine that’s littered with practices that were later abandoned after scientific scrutiny showed that they were ineffective, perhaps even harmful.

 

As such, we are among the many who would agree with the general concept of “evidence-based medicine.” However, when it comes to patient safety, there are significant obstacles to this approach. (see here)

 

Because Evidence Based Medicine (EBM) places all of the emphasis on clinical trials, it forgets to ask the first, most basic question of all: does the idea make sense? Through this EBM can be used inappropriately as a tool to maintain the status quo. Evidence Based Medicine was never designed to assess the plausibility of basic science e.g. the effects of gravity on someone jumping out of a plane.

 

Remember, science helps us understand how things are. A more beneficial way to consider evidence is through the framework of Science Based Medicine (see here). Science Based Medicine’s philosophy is that we ought to consider prior probability and plausibility from basic science when determining if a claim is real enough to study. If the claim passes this test, then it should be studied with proper, well-executed clinical research. However in delaying the adoption of obviously better interventions, while waiting for clinical research, we may leave patients at unnecessary risk (see here).

 

Consider too, is it really the evidence from multicentre randomised controlled trials (RCTs) which ultimately lead us to adopt a better practice?

 

Take the example of ultrasound use when inserting central lines – many doctors had honed their skills over years, inserting central lines without the need for ultrasound. Some were then reluctant to use ultrasound when it became available – they hadn’t needed it before so why should they use it now?

 

What was the level of evidence which led to change in practice? Was it a multicentre RCT or was it a collection of other influential issues:

– The basic scientific notion that it’s better to be able to see what one is doing
– A series of heuristic stories of patients succumbing from complications which may have otherwise been avoided*
– Policies introduced obligating the use of ultrasound when it is available (see here)
– A gradual change in culture, and an adoption by sufficient numbers such that those not using ultrasound perhaps begin to feel estranged
– Retirement of those unwilling to change, those who stoically prevent change no matter what, those who Dr Jonn Hinds may have labelled as ‘Resus Wankers‘.

 

We do not live or practise in a laboratory, nor within the boundaries of double-blind, placebo-controlled trials. We live in a real world with patients who are also people. Intuition, clinical experience, and pathophysiologic rationale are indeed important tools, along with evidence-based literature, with which to discern the best care for our patients. To honour such a breadth of perspective, however, requires us to loosen our tenacious grip of currently accepted doctrines of EBM as the definitive measure of good clinical practice. For in the end, it is really our common sense, nurtured by education, experience, intuition, and rationale, that is always our ultimate measure of evidence—in medicine as in life itself. (See Here)

 

When better (in accordance with basic science) interventions  become available we should perhaps be more ready to adopt them.

 

Certainly lack of evidence must not be used inappropriately to stoically defend the status quo – for in the end it is our patients who suffer.

 

 

*It is with interest to note that one of the main presenters of NAP4 data routinely uses a video laryngoscope for intubation. Perhaps he has been influenced by an understanding of Science Based Medicine and exposure to numerous stories of patient demise from difficult tracheal intubation.

 

About the Author

Dr Rob Hackett is a senior anaesthetist from Sydney Australia.  He is a passionate campaigner for patient safety, and the author of the Patient Safe blog

Case Study – how a junior doctor is using Osler to set themselves apart

“Osler has helped me better understand what I’ve done, and where I need to focus my attention going forward.”

Dr Abby McArthur sits back and looks at her activity charts on Osler with a look of contemplation.  “I’ve completed my certification in internal jugular central lines, but it would be nice to do a few more subclavians.”

Abby, a first year trainee in Emergency Medicine and Intensive Care, has been using the Osler platform to track the procedures she performs, her success rates, and her complications.  She’s followed her progress in her journey through three separate hospitals now.

“I was having some trouble early on with my PICCs.  I was struggling to get them in at first, but I changed a few things and my success rate is much better now.”

This improved visibility of Abby’s outcome data has helped her in other ways too.

“I’ll be applying for new training positions for the new year, and I’m going to use the data I collect on Osler to demonstrate the certifications I’ve completed, and my activity data, to help build my resume.”

In fact, Osler has already helped Abby get noticed.

“I was told the CEO of one hospital I worked in complimented me on how much I’d achieved there during my rotation.  Apparently that doesn’t happen very often!”

“Having access to Osler at the bedside is very important.  It means that I can easily record all my procedures right after I do them.

Also, because I’m learning new procedures at this stage of my career, my supervisors can use Osler to give me instant feedback that I can use to improve my technique for next time.”

Osler’s groundbreaking cloud based assessment framework means Abby can capture and access her data wherever she goes, making it as easy as it can be to monitor her progress.