Year of a new graduate in the bush Alexandra Van Gemert
Traditionally, the first choice for most new graduates has been to obtain jobs in metropolitan hospitals. I can honestly say that my decision to go against convention and move over 1,000 kilometres away from home to rural New South Wales (NSW) to work as a regional Health Information Manager, has been an enriching and worthwhile experience. My position manages the Clinical Information Services across two activity-based funding sites, and four block funded health services, covering a population of roughly 80,000 residents. I thought I would share some of my experiences and challenges. Day one and we are off to the local pub for lunch with the General Manager, District Clinical Coding Manager and my team of six staff (Clerks and Clinical Coders). What a great way to meet some of the staff who have worked at the hospital for many years, some since they were teenagers, and have a wealth of knowledge. The hospital is their home. As they share their experiences and stories, I begin to reflect on what lies ahead, having already seen records piled on the floor and shelving exploding out the door. After being thrown into presenting at the Junior Medical Officers Orientation during my first few weeks, I started to feel much more confident and settled having met the other new kids on the block. My mission was to ensure they all know where the medical record department is located within the hospital and to encourage them to become frequent visitors, even using our 9am coffee runs from the local cafe as a potential lure. Of course, only for work related purposes and to assist with discharge summary completion and clinical coding queries. The presentation went well, although more of a practice run for future sessions. I am pleased to say the content has since improved, now that I have a better
understanding of the expectations of doctors and their knowledge on clinical coding and documentation. A month in and thinking I am on track having successfully streamlined and updated some of the old processes, I am greeted by our local police. There has been an unfortunate death on the operating table in theatre and I am confronted by the detectives, carrying out a patient’s original hardcopy medical record bagged up as evidence. Hospital security are called, and I intercept this. Not only are they taking hospital property off site, they haven’t even bothered with any paperwork or official court order to seek release of the information to them. The detectives proceed to make numerous calls to our local court but of course it is lunch break and phone lines are shut. An hour is too long for them to wait around, so the detectives are back upstairs with the intention of taping off the operating theatres as a ‘crime scene’ until the medical records are released to them. ‘Crime scene’ – was there a murder? No one told me. You can imagine the adrenaline rush. I can confidently say my expectations are now very clearly known to the local police, including the chief superintendent, who made a special visit the following day to hand over necessary paperwork. Following this incident, all staff involved and nurse managers were debriefed to ensure a similar situation did not happen in the future. The meeting included some education regarding privacy and release of information, with reference to district and NSW Health policies and procedures. All hospitals have those ‘big dreamer’ medical consultants who want everything. I have never come across one as enthusiastic as our own, who expressed to me his dreams of developing an electronic health record that charts observations electronically and automatically triggers rapid responses. Highly
29 HIM-INTERCHANGE • Vol 10 No 1 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)
