HIM-Interchange Volume 10 Issue 2

HIM-Interchange PROFESSIONAL PRACTICE JOURNAL OF THE HEALTH INFORMATION MANAGEMENT ASSOCIATION OF AUSTRALIA LIMITED

VOLUME 10 NUMBER 2 2020 ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

HIMAA PROFESSIONAL DEVELOPMENT

NATIONAL WEBINARS

2020

https://himaa.org.au/events/webinars/

The Australian Dictionary of Clinical Abbreviations, Acronyms & Symbols

7

th

EDITION

A dynamic resource for the Australian health industry available in various easy to use formats: 1.

2.

3.

4.

Hard copy Mobile version (iPhone or Android) Single user online Multi user online

Any enquiries to Joanne Williams at dictionary@himaa.org.au To order: For members: email accounts@himaa.org.au For non-members click HERE For 22274VIC Certificate IV in Clinical Classification, CMT and EMT students, contact accounts@himaa.org.au

Contents: Editorial: Letter from the Editor // Joanne Fitzgerald

2

‘Just do it!’: The role of professional practice or work integrated learning in a health information management student’s pathway to employability // Merilyn Riley

4

Personal perspective: Reducing duplicate registrations: a gateway to patient safety // Krista Edwards and Zubair Khan 8 How my placement experience paved my career pathway // Jessica La

12

Experience of a Health Information Manager’s professional work placement // Dusty Ellen

14

Final year placement in a traditional Health Information Manager role – what I have learnt // Abbey Nexhip

16

Reflection on health information management postgraduate studies // Qinhua Shang

18

Health information management student placements: the supervisor perspective // David Mangano, Kirsten Hinze, Rachael Sewell, Emma Parras, Michelle Cope, Maryann Wood and Emma Barker

20

HIM-Interchange Editor Joanne Fitzgerald, Independent Hospital Pricing Authority

Letter from the Editor Joanne Fitzgerald

Associate Editors Stella Rowlands, Sunshine Coast Hospital and Health Service, QLD Jennie Shepheard, Shepheard Health Management Consultants, VIC Chair Maryann Wood, Queensland University of Technology, QLD Subcommittee Members Emma Barker, La Trobe University, VIC Kym Campradt, Lorica Health Patsy Catterson, Ballarat Health Service, VIC Naomi Johnson, Central Adelaide Local Health Network, SA Danica Jong, West Moreton Hospital and Health Service, QLD Carol Loggie, University of Wollongong, NSW Nina Palibrk, Royal Brisbane and Women’s Hospital, QLD Julie Price, La Trobe University, VIC Dwayne Richards, BreastScreen Victoria, VIC Deborah Yagmich, Joondalup Health Campus, WA Representative Members HIMAA Board of Directors: Sharon Campbell, WA Country Health Service and Curtin University, WA HIMAA Administration: Philida Chew, Director of Finance and Operations Correspondence The Editor HIM-Interchange, HIMInterchange@himaa.org.au Advertising enquiries marketing@himaa.org.au Production Typesetting: Red Rabbit Creative Pty Ltd Electronic Production: Prateek Verma, HIMAA Printed by: SOS Print + Media Group Publisher: Health Information Management Association of Australia Limited Locked Bag 2045 North Ryde NSW 1670 AUSTRALIA Editorial Board Editor-in-chief: Joanne Callen, Macquarie University, NSW Editor, HIMJ: Joan Henderson, The University of Sydney, NSW Chair: Sue Walker, Queensland University of Technology, QLD Associate Editors: Kerin Robinson, La Trobe University, VIC Stella Rowlands, Sunshine Coast Hospital and Health Service, QLD Jennie Shepheard, Shepheard Health Management Consultants, VIC Sue Walker, Queensland University of Technology, QLD Members: Sharon Campbell, WA Country Health Service and Curtin University, WA Deborah Debono, University of Technology Sydney, NSW Joanne Fitzgerald, Independent Hospital Pricing Authority Monique Kilkenny, Monash University, VIC Esther Munyisia, VIC Mirela Prgomet, Macquarie University, NSW Beth Reid, Pavillion Health, NSW Phyllis Watson, The University of Sydney, NSW Johanna Westbrook, Macquarie University, NSW Disclaimer The Editors, Editorial Board, HIM-I Subcommittee and publishers do not hold themselves responsible for statements by contributors.

Opinions expressed in HIM-Interchange are those of the authors and do not necessarily reflect the official position of the Health Information Management Association of Australia Limited.

Copyright © 2020 Health Information Management Association of Australia Limited

2 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

Dear HIM-Interchange readers Welcome to the second issue for 2020. This is a special issue focusing on health information management education, in particular, student and supervisor experiences of professional practice placements.

Merilyn Riley (2020) from La Trobe University provides a guest editorial on the topic of ‘work integrated learning’, which is what clinical placements or professional experience placements are. Following this, you can read articles from former health information management students, most of whom are now employed as Health Information Managers (HIMs), on what they gained from their professional practice placements. While the workplaces and the projects students work on during their placements may have changed since I did my training (it does not look like preparing a medical record procedure manual is on the agenda these days), the value of these placements, the skills they help to build and the confidence they give to students remains the same.

The article from Mangano et al (2020), which is the supervisor perspective, supports the position that professional practice placements are not just about the benefits to students. Organisations receive additional resourcing and fresh ideas, and supervisors build their leadership and mentoring skills to name only a few benefits. All our organisations and the health system more broadly benefit from having a workforce of work ready HIMs. This issue comes out in a time of unprecedented change and uncertainty in our lives, our work and the world around us as a result of the COVID-19 pandemic.

Some of you may be working from home, some of you may be in your workplace but having to work in

completely different ways, and some of you may be working directly on the COVID-19 response. There are so many stories to share and we would like you to share some with us. HIM-Interchange will be producing a COVID-19 special issue, with articles being published periodically on the Health Information Management Association of Australia website and then consolidated into a special issue. Please get in touch with any member of the HIM-Interchange Subcommittee if you have something you wish to share.

Enjoy the issue.

References Riley M (2020) ‘Just do it!’: The role of professional practice or work integrated learning in a health information management student’s pathway to employability. HIM-Interchange 10(2):4-7.

Mangano D, Hinze K, Sewell R, Parras E, Cope M, Wood M, Barker E (2020) Health information management student placements: the supervisor perspective. HIM-Interchange 10(2):20-24.

Joanne Fitzgerald Editor

Congratulations SimDay – now coding grouping FASTER and more Accurately with TurboGrouper!

EIS Health Data Solutions is pleased to announce our partnership with ACSS Health. TurboGrouper is now integrated seamlessly into ACSS Health’s hospital management system, SimDay, providing accurate and cost effective grouping as required for Activity Based Funding.

For more details call 02 9411 3711 or visit www.TurboGrouper.com.au

– Fast, Accurate and Affordable

3 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

‘Just do it!’: The role of professional practice or work integrated learning in a health information management student’s pathway to employability Merilyn Riley

“Preparing graduates with professional capabilities required for future practices remains a challenge for higher education……not only because the future job market is uncertain, but also because this demand of a future world-of-work that is increasingly complex, globalised and connected shifts the purpose of higher education (Trede and Jackson 2019)”.

In late 2019, the Federal Education Minister, Dan Tehan released the following statement, ‘‘The performancebased funding model (of universities) that has been finalised makes an explicit link between funding and one of the key goals of every university: to produce job-ready graduates with the skills to succeed in the modern economy” (Bolton 2019 Oct 2). This model has resulted from a slowly simmering shift from a longstanding perspective of universities as harbingers, repositories and gatekeepers of knowledge and truth (Alexander 1931; Forstenzer 2017), to the position of universities being “defined primarily by their capacity to meet market criteria such as balancing the books and delivering customer satisfaction” (Forstenzer 2017 p.3).

Formally linking financial support to employment outcomes is a very pointed message to universities from government on one of their primary priorities – producing employable graduates. But what does this mean? From the federal government perspective, graduate employability is measured by outcomes data i.e. the proportion of university graduates who have gained full time employment (regardless of its relationship to their field of study) within four months of graduation (Quality Indicators for Teaching and Learning 2019). However, this is both short-sighted and limited in interpreting the concept of employability (Jackson 2014), which extends beyond individual graduate skillsets and attributes to include the fluctuating, unpredictable industry dynamics of the current labour market (Jackson 2014).

4 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

What does employability mean?

In its Core Skills for Work Development Framework, the Australian Government effectively summarises employability as “a combination [of ] technical or discipline specific skills and core language, literacy and numeracy (LLN) skills” (p. 1). However, current research on employability shows it is much more complex than the description presented (Mcllveen 2018). The most widely cited definition of employability describes it as “a psychosocial construct that embodies individual characteristics that foster adaptive cognition, behaviour, and affect, and enhance(s) the individual-work interface” (Fugate 2004 p.15). Stated more simply by Pennington and Standford (2019), an employable graduate is someone who, while requiring ‘hard skills’ (discipline specific knowledge), also has the ability for “critical thinking, creativity, problem-solving, and leadership and people management” (‘soft skills’, p.99).

How do you engender employability in university graduates?

The requirement for universities to engender both ‘hard skills’ (discipline specific knowledge) and ‘soft skills’ (critical thinking, creativity, problem solving and leadership and people management) within their graduates can present very specific challenges. While the traditional mandate for a university to impart discipline specific knowledge (e.g. dentistry, medicine, engineering) is long standing, the application of the learning in a work-based setting is something that has historically been largely limited to health, teaching and engineering (Universities Australia n.d.). In 2017, only 37.4% of students had a work-based experience as part of their tertiary studies (Universities Australia n.d.). It has been well recognised that for Australian graduates from all disciplines to be career-ready (employable), more widespread application of work integrated learning (WIL) is required (Universities Australia n.d).

What is work integrated learning?

the other medical, nursing and allied health disciplines have been practicing this for years. ‘Placements’ is the term which you may have heard most often (and sometimes dreaded). These terms are now subsumed under the current vernacular of WIL.

“Work integrated learning – or WIL – is an umbrella term that refers to a range of practical experiences designed to give students valuable exposure to work-related activities relevant to their course of study” (Universities Australia n.d.)”

In 2018, Universities Australia undertook a survey of all universities to identify the types and frequency of WIL experiences in which university students participated in 2017. There were five main categories of WIL: placement, a project, fieldwork, simulation or other.

Work integrated learning is not new. To Health Information Managers (HIMs), the term clinical placement or professional practice would be more familiar. Health information management, along with all

Figure 1: WIL participation rate by type of activity within broad discipline area Source: Reproduced from Universities Australia (n.d.), Work Integrated Learning in Universities: Final Report, p. 16.

Placement

Project

Fieldwork

Simulation

Other

60

50

40

30

20

10

0 Natural and Physical Sciences

Information Technology

Engineering and Related Technologies

Architecture and Building

Agriculture, Environmental and Related Studies

How does WIL work?

Work integrated learning is a partnership between the university, the student and employers. Students are trained by universities to provide graduates to employers, who in turn provide students with opportunities to participate in WIL so they can become work-ready employees. They are each like links in a chain, which are strengthened when they all work together in partnership to reach the common goal of graduate employability.

Health

Education

Management and Commerce

Society and Culture

Creative Arts

Figure 2 shows the symbiotic relationship between university, student and industry but with the addition of the professional association. It is the professional association, in conjunction with advice from educators and industry, who develop the competencies that form the basis of the graduate capabilities. For health information management graduates, this covers both the hard and soft skills, which are embedded in their curriculum (Health Information Management Association of Australia Graduate Capabilities 2017).

5 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

Figure 2: Work integrated learning relationship between the student, industry, university, discipline lecturers and professional association.

What does WIL look like for health information management students?

In this edition of HIM-Interchange, you will read about the WIL (professional or clinical placement) experiences from a range of undergraduate and postgraduate health information management students and from some of their supervisors. You will explore specific project-based placements where students are immersed in producing real world deliverables or hear of students visiting, or being visited by, experienced HIMs who inspire and motivate students through their zeal and enthusiasm.

The application of discipline specific skills in final year student placement is practised through active student participation in assigned workplace projects. You will read of projects related to analysing the source of duplicate patient registrations and potential solutions to rectify this; of reverse engineering data architecture for a newly formed organisation; and of multiple audits related to policy compliance, clinical documentation and evaluation of clerical processes. The activities undertaken by the students develop the core health information management discipline skills (the ’hard skills’), complementary to the theory imparted in the university environment.

Crucial placement experiences enable these students (now graduates) to develop those ‘soft skills’ of creativity, leadership and staff management, that are not always so easily embedded in formal curricula. Each of the students identified key learnings, which can be difficult to emulate in the university environment.

6 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

Table 1: Comments from current HIM-Interchange placement experience articles Student 1

“Challenging myself to learn new skills and unleash my creativity to produce a beneficial tool that will remain as a legacy to my project is a very proud and invaluable moment in my student journey”

Student 2

“I have been shown how to build rapport with other staff and how to handle myself in an organisation which is everchanging and constantly presenting new challenges”.

Student 3

“One of the greatest challenges as a HIM is the management of staff, who you are required to lead and inspire daily ……. the relationship between a manager and their staff is finding the right concoction of communication, motivation, delegation, compassion, trust, and unity – several elements to digest daily.”

Student 4

“An element of the organisation’s culture that impacted me the most was the importance placed on team cohesion”.

What is the value of WIL? Never doubt the power of work-based placements.

Industry partnerships with universities provide both necessary and critical opportunities for health information management students to explore the real world of health information management, transforming them into work-ready, highly employable graduates.

Reflect back five, ten, twenty or even thirty years ago (memory permitting…) upon your health information management studies. Can you remember your own final year placement? Your anxiety on that first day walking into a new organisation; your insecurity as a student among an unknown and experienced workforce; your tentativeness in voicing your opinion (or, in my case, saying too much to cover your nervousness). The gratitude for supervisors who took you under their wing, the challenge of liaising with clinical staff, or presenting your findings to the medical director. Each incremental step taken, each successive task achieved, and each encouraging colleague propelled you forward in the direction of your ultimate goal of employability. In hindsight, it really is a wonderful opportunity.

Jessica La: “The last few months of being on placement …… has made such a huge impact on my life. I have made many personal developments I do not think I could have achieved elsewhere.”

We are achieving our goal of employability of health information management graduates To return to one of the phrases in the first paragraph, “one of the key goals of every university: [is] to produce job-ready graduates with the skills to succeed in the modern economy” (Bolton 2019 Oct 2). We are proudly achieving this goal with our health information management graduates. In one study alone we see over 85% of graduates have obtained health information management related employment within four months of graduation and 94% within six months (Riley et al 2019).

Through the delivery of substantial curriculum by universities and collaboration in WIL between universities, industry, students and our professional association, we are delivering graduate HIMs who are work-ready and employable for “the modern economy” (Bolton 2019 Oct 2).

So why is this article titled ‘Just do it’ If you have read this article and never offered a health information management student placement, then ‘Just do it!’. It does require effort and time but the rewards for investing in and professionally influencing the next generation of HIMs far outweighs any effort expended.

Now, “Just do it!”

References Alexander S (1931) The Purpose of a University. The Political Quarterly 2(3): 337 – 352 https://doi.org/10.1111/j.1467-923X.1931. tb00356 (accessed 9 May 2020).

Bolton R (2019, October 2). University funding to be tied more to producing students who get jobs. Financial Review. Available at https://www.afr.com/policy/health-and-education/universityfunding-to-be-tied-more-to-producing-students-who-get-jobs20191001-p52wkz\ (accessed 9 May 2020).

Department of Industry Innovation Climate Change Science Research and Tertiary Education and Department of Education Employment and Workplace (2013) Core skills for work developmental framework. Canberra, Australia: Australian Government. Available at: https://docs.employment.gov.au/ system/files/doc/other/1._csfw_framework.pdf (accessed 9 May 2020).

Forstenzer J (2017, March 9) We are losing sight of higher education’s true purpose, The Conversation. Available at: https:// theconversation.com/we-are-losing-sight-of-higher-educationstrue-purpose-73637 (accessed 9 May 2020).

References (continued) Health Information Management Association of Australia (HIMAA) (2017) Health information manager (HIM) entry-level competency standards, version 3.0. North Ryde, New South Wales: HIMAA. Jackson D (2014) Employability skill development in workintegrated learning: Barriers and best practice, Studies in Higher Education 40(2) DOI: 10.1080/03075079.2013.842221 (accessed 9 May 2020).

McIlveen P (2018, January) Defining employability for the new era of work: A submission to The Senate Select Committee on the Future of Work and Workers. DOI: 10.13140/RG.2.2.23333.60646 (accessed 9 May 2020).

Pennington A and Stanford J (2019, October) The Future of Work for Australian Graduates: The Changing Landscape of UniversityEmployment Transitions in Australia, The Centre for Future work in Australia Institute. Available at https://d3n8a8pro7vhmx. cloudfront.net/theausinstitute/pages/3083/attachments/ original/1571640129/Future_of_Work_for_Australian_Graduates_ GCA_Final_Formatted.pdf?1571640129 (accessed 9 May 2020).

Riley M, Robinson K, Prasad N, Gleeson B, Barker E, Wollersheim D and Price J (2019) Workforce survey of Australian graduate Health Information Managers: employability, employment, and knowledge and skills used in the workplace. Health Information Management Journal https://doi.org/10.1177/1833358319839296 (accessed 9 May 2020).

Trede F and Jackson D (2019) Educating the deliberate professional and enhancing professional agency through peer reflect of workintegrated learning. Active Learning in Higher Education. Available at: https://doi.org/10.1177/1469787419869125 (accessed 9 May 2020).

Quality Indicators for Teaching and Learning (QILT) (2019) 2019 Graduates Outcome Survey, Social Research Centre. Available at https://www.qilt.edu.au/docs/default-source/gos-reports/2019gos/2019-gos-national-report.pdf?sfvrsn=cdceec3c_4 (accessed 9 May 2020).

Universities Australia n.d. Work Integrated Learning in Universities: A Final Report, Available at https://apo.org.au/sites/default/files/ resource-files/2019-04/apo-nid242371.pdf (accessed 9 May 2020).

Merilyn Riley BAppSc(MRA), BTh, PostGradDipEpi&Biostats

Acting Discipline Lead, Health Information Management Department of Public Health, School of Psychology and Public Health,College of Science, Health and Engineering La Trobe University Bundoora VIC 3086 Tel: 61 3 9479 5678 Email: Merilyn.riley@labtrobe.edu.au

Fugate M, Kinicki AJ. and Ashforth BE (2004) Employability: A psycho-social construct, its dimensions, and applications.

Journal of Vocational Behavior 65(1): 14-38. https://doi. org/10.1016/j.jvb.2003.10.005 (accessed 9 May 2020).

7 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

Reducing duplicate registrations: a gateway to patient safety Krista Edwards and Zubair Khan

Background The Australian Digital Health Agency has developed the National Digital Health Strategy with a remit to evolve digital health capability. The strategy proposes seven strategic priority outcomes, including digitallyenabled models of care that improve accessibility, quality, safety and efficiency, to be achieved by 2022 (Australian Digital Health Agency 2017). A digital medical record platform is paramount to achieving these outcomes. With the deadline of 2022 approaching it is a pivotal time to recognise trends and provide potential solutions and lessons learnt after implementation of a digital medical record.

Patient registration is an essential process in the healthcare journey. All patients must be allocated a Unit Record Number (URN) for secure identification and storage of patient data and healthcare provisioning. For their final year health information management professional practice placement, two students were assigned to placements at two hospitals in Queensland, identified as Queensland Health Facility A and Queensland Health Facility B throughout this report. A key trend identified at these Queensland Health facilities was that after implementation of a digital medical record there was an increase in the creation of duplicate patient registrations. The students were tasked with a project to analyse possible root cause/s for this increase as well as creation and implementation of potential solutions for this problem.

Impact and importance Duplicate medical records occur when one patient has an association with more than one medical record and this crucial patient information can be fragmented between two or more medical records (Joffe et al.

2012). Furthermore, duplicate medical record errors are

8 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

created by minor errors and inconsistencies that occur during the patient registration process, with a study confirming that 92 percent of the errors that create duplicate records are caused by patient registration errors (Bittle et al. 2007).

The creation of a duplicate patient registration poses a significant patient safety risk, as clinicians will not have access to critical medical history, drug and allergy alerts or previous pathology and radiology results. Without this critical information the clinician is at risk of misdiagnosis, prescribing contraindicated medications, ordering unnecessary invasive tests or missing clinical indicators from previous medical history, all of which have the potential for significant unnecessary harm to patients. Reducing the error rate of duplicate patient registrations will reduce this patient safety risk. Therefore, it is essential for Health Information Managers (HIMs) to establish good working relationships with frontline staff such as with administration officers (AOs) and triage nurses to reduce occurrence of these errors.

Current situation in the digital environment HIMs are the data custodians for patient health information and as such play a pivotal role in the provision and monitoring of accurate, current and confidential patient information for clinicians. A key role for HIMs is the management, monitoring and merging of duplicate patient registrations. Queensland Health envisioned the Integrated Electronic Medical Record (ieMR) would achieve greater accessibility to complete and longitudinal patient health information in order to improve the quality, efficacy and safety of healthcare delivery (Queensland Health 2015).

The ieMR was introduced at Queensland Health Facility A in May 2018. During the placement the health information management student performed extensive analysis on data reports extracted from the patient administrative system (Hospital Based Corporate Information System (HBCIS)) and ascertained that during the transition month, from paper to electronic, there was an increase of 137.5% in duplicate patient registrations. Upon further analysis, data from the first year of digital compared to the previous year showed an increase of 69.1% in duplicate patient registrations. Analysis into the comparative data between the duplicate patient registrations found that the duplicate registration had exactly the same patient demographics as the original registration 35.9% of the time, thus it is assumed an inadequate patient search was conducted.

The ieMR was introduced at Queensland Health Facility B in April 2019. During the placement the health information management student established that prior to the ieMR implementation, duplicate records created ranged between 0.75% and 1.9% of all patient registrations and that after implementing the ieMR this figure spiked up to 4.5% of all patient registrations.

Identifying the root cause of the problem allows a targeted approach to the correct solution, leading to better outcomes. At both hospitals, the root cause was identified as the ‘Quick Registration’ process conducted by triage nurses in FirstNet (the emergency department (ED) module of ieMR). The ‘Quick Registration’ process was introduced as the best practice for registering patients in FirstNet. The process involves the triage nurse searching for the patient’s details with their date of birth and last name.

If the initial search returns the correct patient the nurse will click ‘Add Encounter’. If the correct patient is not found, the nurse will select ‘Add Person’ and generate a new URN for that patient. The AO performs a four step patient search (concurrently with the triage nurse if possible) in HBCIS to ensure the patient’s URN matches the URN pre-existing or newly created in FirstNet. The AO will then update patient information or identify a duplicate URN has been created in HBCIS. If a duplicate has been created the AO is to notify the HIMs at the facility to remedy.

After student observation of the ‘Quick Registration’ process in ED it was clear there were faults in the process leading to increased patient duplicate registrations. Due to the intense and chaotic nature and patient acuity of an ED, incorrect patient information can be given and searched; misspelt names and dates of birth can be entered by the triage nurse therefore duplicate URNs are created. Prior to the introduction of ieMR, patients were all registered directly into HBCIS by an AO. Currently the best practice process for registering patients through ED is for AO staff to search HBCIS post the triage nurse registering a patient in FirstNet. However, due to busier periods, the chaotic nature of an ED, system issues (i.e. messaging fails between FirstNet and HBCIS) and staff errors (i.e. not asking the patients the right identification questions or not verifying identification appropriately) duplicates can be created. Therefore, without performing the appropriate patient searches in HBCIS prior to registering a patient in FirstNet, a duplicate patient registration will be created in HBCIS. It was concluded that the ‘Quick Registration’ process was indeed the root cause for the increase in duplicate patient registrations post ieMR implementation.

Potential solutions Duplicate patient registrations should be every healthcare workers concern. It has a far reaching flow on effect for staff and patient and can lead to preventable harm or even death. The first step to achieving this universal concern is educating staff on how duplicate patient registrations impact patient safety and what role they can play in the prevention and reduction of these duplicates. An awareness campaign is a simple way to bring this topic into focus. It can be as easy as a poster in a hospital corridor, an announcement on a screensaver or an information-based staff email. Having specific ways that staff members can incorporate tips and tricks in the prevention of duplicate patient registrations into their day-to-day tasks will help facilitate any change in processes that need to be implemented.

Investigation into this prominent digital implementation issue emphasises the importance of accurate patient searches in HBCIS and FirstNet. The foremost solution to this is education and training of AOs and triage nurses. As they are frontline

9 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

staff it is difficult to take them away from their positions to attend training. An essential solution to this challenging problem is to provide an online education tool or convenient process map that is easily accessible at their workstation. The student projects both implemented a solution of this nature.

It is challenging to quantify the effect these solutions have had on duplicate patient registrations within the time limits set in the student project scopes. However, with a longer interval between implementation of the solution and evaluation it is predicted there will be a significant reduction in duplicate patient registrations, and these tools have been left with the project sponsors for their continued monitoring.

Personal perspective – student at Queensland Health Facility A The original project plan was to gather and analyse data, provide a root cause for the increase in duplicate registrations via a data report and introduce changes in processes and education to try and rectify duplicate registration creation. The three key outputs of the project included an information campaign, data report and eLearning module. The project scope was subsequently amended to include an evaluation phase after the key outputs and changes in processes were delivered.

The project had many highlights; my favourite was working on the fundamental output of the project; the data report produced for key stakeholders. This data report was instrumental in the introduction of the duplicate registration key performance indicators (KPIs) in the ED in addition to the critical information it provided on the root cause of duplicate registrations.

The vital input received during the elicitation process from end users was the basis for the analysis.

Correlating and presenting these essential statistics and feedback to the frontline staff who contributed was a very fulfilling moment as it allowed for a positive response to the changes in processes and KPI introduction and made for a more cohesive work relationship between HIMs and frontline staff.

The information campaign included in the staff newsletter was another major highlight of the project.

This exposed staff from Queensland Health Facility A to the project and the importance of duplicate registrations and their role in how to reduce them. The information campaign included many tips on how to conduct better patient searches, and was targeted

10 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

to pique clinician interest and obtain support for the project by showing the impact duplicate registrations have on patient safety. It was a surreal experience to walk around the hospital and see posters of my face from the information campaign placed in work areas and tea rooms. After my face was put to duplicate registrations, I was stopped and asked many questions from clinicians and administration staff on what I was studying and what my project was about. It sometimes led to confusion into what I was actually studying, and I was asked several times to come help doctors fix their computers! Nevertheless, this experience was overwhelmingly positive and pivotal in getting the message of duplicate registrations and the role of HIMs out to the Queensland Health Facility A community.

The project included one major innovation, which was the eLearning module. This module provides the HIMs of Queensland Health Facility A an education tool that was not available to them prior to the project. This education tool will be used as an ongoing training tool for current staff as well as orientation training for all new administration and triage nurse staff. The eLearning module is innovative in that it allows training that does not impact on staff’s ability to perform their daily duties and can be completed outside the facility as it is not limited to face-to-face training schedules.

The module comprises of interactive scenarios, filmed HBCIS patient searches, tips and tricks for patient questioning and a built-in quiz for each module. The staff member needs to achieve 100% on the quiz before the module will close. Once the module is complete an email is sent to their line manager and the health information management department for the purpose of documentation of training. Working on the eLearning module was by far the most enjoyable part of the project. Challenging myself to learn new skills and unleash my creativity to produce a beneficial tool that will remain as a legacy to my project is an immensely proud and invaluable moment in my student journey.

Overall, the project was very successful and received encouraging feedback from all stakeholders. In particular, the response to the eLearning module has been remarkable, with many facilities wanting to adapt the module for their own hospital needs. This project would not have been so successful without the ongoing support and knowledge from the wonderful HIM community involved in this student placement and I would like to take this opportunity to acknowledge and thank them.

Personal perspective – student at Queensland Health Facility B Reducing the creation of duplicate medical records at Queensland Health Facility B was a project aimed at providing an improvement program for administration staff to minimise the creation of duplicate medical records during the patient registration process. The key deliverables for the project focused on improving the patient matching skills by developing a HBCIS process steps flowchart, improved training material and education and monthly statistics identifying staff who were responsible for the majority of duplicates.

Initially the scope involved looking at both duplicate and overwritten medical records. However, due to the volume of duplicates created in comparison to overwrites, it was decided by the project team to focus only on duplicate records.

Due to time constraints, it was foreseen that developing the training and education material was not possible. Hence, an observation report (a key deliverable) was added. This report documented observations that were encountered during the lifecycle of the project in terms of: • Observations and issues identified at the bookings and referrals centre (BARC) and the ED (these two departments being problematic for duplicate record creation) • Observations, issues and gaps identified with the training and education material provided for HBCIS and FirstNet and • Recommendations and potential solutions for the continuing problem of duplicate records.

While there were multiple valuable deliverables, the ‘HBCIS Patient Registration Process Steps Flowchart’ was an output that was nonexistent prior to the project. This invaluable resource contained a well-structured, clear process inclusive of all the fundamental elements required during patient registration. Included in the process steps flowchart were well-ordered and precise questions that needed to be asked of patients to avoid creation of a duplicate registration. Compiling this resource was the favourite of many highlights encountered during the project.

It allowed me to challenge myself in liaising with numerous and various frontline stakeholders (AOs, triage nurses) across Queensland Health Facility B while attaining new and improved knowledge and

skills. This opportunity also enabled establishing good working relationships, particularly between HIMs and frontline staff, an essential element to reduce duplicate registrations.

Upon completion of the project, I received positive feedback and the HIMs within the health information service were more than satisfied with the outcome of the project. It was rewarding to hear that the HIMs were interested in presenting all the resources created to various managers across different service lines and stakeholders (FirstNet, ieMR, HBCIS) to encourage implementation and ultimately to assist in reducing the creation of duplicates. I would also like to take this opportunity to thank the highly professional HIMs at Queensland Health Facility B for their continuous support and expertise, which was a contributing factor to the success of the project.

References Australian Digital Health Agency (2017) National Digital Health Strategy. Available at: https://conversation.digitalhealth.gov.au/ australias-national-digital-health-strategy (accessed 8 May 2020).

Bittle M, Charache P and Wassilchalk D (2007) Registrationassociated patient misidentification in an academic medical center: causes and corrections. Joint Commission Journal on Quality and Patient Safety 33(1): 25–33. https://doi.org/10.1016/S15537250(07)33004-3 (accessed 8 May 2020).

Joffe E, Bearden CF, Byrne MJ and Bernstam EV (2012). Duplicate patient records–implication for missed laboratory results. AMIA Annual Symposium Proceedings Vol. 2012: 1269-1275. American Medical Informatics Association. Available at: https://www.ncbi. nlm.nih.gov/pmc/articles/PMC3540536/ (accessed 8 May 2020).

Queensland Health (2015). 21st Century Healthcare: eHealth Investment Strategy. Available at: https://www. health.qld.gov.au/__data/assets/pdf_file/0031/442939/ ehealthinvestmentstrategy.pdf (accessed 8 May 2020).

Krista Edwards BHIM Health Information Manager; Redland Hospital Cleveland QLD 4163 Tel: +61 7 3488 3351 Email: krista.edwards@health.qld.gov.au Zubair Khan BHIM Senior Health Information Manager; Royal Brisbane and Women’s Hospital Herston QLD 4029 zubair.khan@health.qld.gov.au

11 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

How my placement experience paved my career pathway Jessica La

While I was studying my Master’s degree in health information management, I was very excited and thrilled by the diversity of potential career pathways.

For me, this was a perfect university degree to broaden my horizons and discover my passion, based on my strengths and weaknesses. At the time, I was still unsure of what direction I wanted to head in (or even the different kinds of roles Health Information Managers [HIMs] could be in!). Luckily, in my final year, I had the pleasure of completing a full block placement (11 weeks) at Family Safety Victoria, with a highly experienced HIM who helped pave the way for my future career.

When I first read about this placement, I was very excited as I had recently discovered an interest for criminal justice and community services work. While working part time at an adult mental health service, dedicated to assisting those involved in the criminal justice system, I heard about Family Safety Victoria’s recent inauguration in response to the 2015 Royal Commission into Family Violence. I was interested in the findings and recommendations, and being selected to complete my placement at Family Safety Victoria felt like the perfect opportunity to understand these better. This placement was initially based within their information management space. I was provided with various opportunities, which allowed me to develop my skills within their systems, data management, governance and much more.

When I started my placement, I identified my main challenge to be the lack of confidence in both myself and the knowledge I had gained from the last year and a half of studying. I was unsure of how to apply my university experience to a real-life work setting. I made sure this was communicated to my supervisor, as I believe in transparency and ensuring they are

12 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

aware of my personal concerns. This also provided an opportunity to work with my supervisor to identify strategies to overcome this challenge. I am very glad to say that I was able to overcome this challenge by the conclusion of my placement.

My main project was to reverse engineer the current data architecture of the organisation. This was a highly important task as Family Safety Victoria’s systems and processes were implemented prior to the identification of foundational data and information management requirements, such as a data dictionary, service models and process flow diagrams. Ultimately, this led to an organisation-wide misalignment of understanding the data’s purpose, how it flows throughout the organisation and who reports and requires such information.

It was my responsibility to commence the development of a Family Safety Victoria data dictionary, a common service model and assist in the evaluation of the organisation’s current information management maturity status. I also learnt about international and national standards for representing metadata that I did not know existed. I had previously heard of some of these terms during university classes but being able to do hands-on work really introduced new meanings and allowed me to understand the complications that can arise if good practice is not consistent, or non-existent, within an organisation.

This task was already quite complex, but I was faced with another challenge of working independently as my supervisor was unfortunately away from work for my last few weeks. This was difficult, but it was the most enjoyable and rewarding time of my placement.

This was when I learnt about approaching the right people who were experts in their field and overcoming the barrier of being ‘just a student’ who is there for a

few weeks. This challenge taught me the importance of building rapport with others and how useful it can be to use other people’s knowledge to enrich your work. I also learnt that information management is a tricky space. However, good information management maturity does not just arise from one person, it requires the whole organisation to be on board and willing to learn and grow together.

At the end of my placement, news was released about a whole organisational restructure. This was an interesting learning experience as I was able to observe both the management strategies by senior leaders and the responses by staff. This gave me a new perspective on change management and allowed me to observe how to manage staff resistance to change.

It also demonstrated how important it is, as a manager, to look after your staff and to ensure they do not feel alone in times of change. As a manager, you must be there to support your staff to keep them motivated, and encourage them to try their best every day.

My placement at Family Safety Victoria has made a huge impact on my life. I made many personal developments I do not think I could have achieved elsewhere. I learnt a lot in various aspects of working life; I have been shown how to build rapport with other staff and how to handle myself in an organisation which is ever-changing and constantly presenting new challenges. I was constantly surprised with the number of opportunities I had to put theory into practice. While the classroom learning environment was enjoyable, it does not compare to the learning experiences made when you are out there contributing to an organisation.

While the classroom learning “ environment was enjoyable, it does not compare to the learning experiences made when you are out there contributing to an organisation.

”

Finally, this placement experience allowed me to discover my interest to work as a HIM in the community services sector and coordinate ways to respond to vulnerable Australians who are experiencing difficult circumstances. The skills and experience I gained from this placement have been so valuable; I have been able to transfer these skills to my newly appointed role as a Project Officer at Berry Street, an organisation dedicated to supporting children, women and their families within Victoria.

I am very thankful for this placement experience and look forward to seeing what the future holds for me as an upcoming HIM.

Jessica La MHIM Project Officer, Client Information Systems, Berry Street 1 Salisbury Street Richmond VIC 3121 Tel: +61 3 9429 9266 Email: jla@berrystreet.org.au

13 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

Experience of a Health Information Managers professional work placement Dusty Ellen

My name is Dusty Ellen and I am a Health Information Manager (HIM) from Perth, Western Australia (WA). As a HIM, I have been educated in a broad range of topics throughout my university and career experiences. The variety of skills and knowledge I have attained enable my flexibility and ability to efficiently apply myself to complete a myriad of projects and has facilitated my capability to action changes within the workplace.

My confidence in my abilities allows me to accept unfamiliar tasks, as I understand that I can apply my research and problem-solving skills, in order to accomplish organisational tasks.

As a part of the professional placement, I was able to immerse myself within an established group of the alliance and embrace the opportunity to connect and network with multiple skilled people.

I prioritised building rapport and liaising with the staff to learn from the information they shared about their work practices. I had been assigned the task of communicating with several teams within the WAPHA to understand their work practices, as the goal for the project was to implement a standard operating procedure and contribute to the overall effectiveness of the organisation.

As a part of my health information management training at Curtin University, I completed a professional work placement at the Western Australia Primary Health Alliance (WAPHA). The WAPHA is an organisation that oversees the strategic commissioning of primary care services across all three WA primary health networks: Perth North, Perth South and Country WA. The role of the alliance is to simplify and increase access to primary care through planning, guiding and investing in priority services which is part and parcel of the Australian Government’s national Primary Health Network program. The WAPHA’s structure has allowed for innovation of the delivery of healthcare within the WA community and has positively contributed to the health, and improvement of services, within WA. One of the WAPHA’s primary focuses is responsibility for the integration and cooperation of local health care systems within WA. It was these unique features of the alliance that inspired me to be involved with the WAPHA to understand how I could embody their vision throughout my future career.

building rapport and liaising “withI prioritised the staff to learn from the information they shared about their work practices. ”

14 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

One challenge I faced was the hesitation of employees to divulge workplace information and procedures to an unknown and unfamiliar person, who was also not an employee. Apart from the social and political challenges, which presumably are ubiquitous across all organisations, the staff at the WAPHA had to adhere to strict data governance guidelines and procedures, further preventing me from attaining the information I required to complete the task at hand. To overcome this barrier, the WAPHA, as part of the on-boarding process, provided me with a brief induction enabling me to better understand the restrictions imposed on the datasets I would be working with. Throughout my placement and particularly in the early stages, I focused on engaging in micro conversations across the various teams to build rapport among the different staff I would be working with. My purpose of investing time with people was to build trust and increase a strong level of communication, and this enabled the staff to better understand my position and purpose for

pursuing them for information. Conducting myself in a professional and understanding manner and following the values of the organisation, while adhering to their data governance and confidentiality practices outlined during the on-boarding process, I was able to build rapport with the various teams. Involving them in each step of the procedure allowed me to develop a sense of cohesion and collectiveness between teams, which aligned with the WAPHA’s values and created a combined vision to contribute to the growth of the organisation. Furthermore, I believed my transparency and honesty allowed team members to gain a greater understanding of the task I was completing and the potential benefits it would have for all employees.

My purpose of investing time with “ people was to build trust and increase a strong level of communication, and this enabled the staff to better understand my position and purpose for pursuing them for information.

”

An element of the organisation’s culture that impacted me the most was the importance placed on team cohesion. In this environment, I was able to express kindness and helpfulness in all tasks I completed, and all conversations I engaged in with the team.

I believe it is important for an organisation to have clear values, like the WAPHA, which allows for

employees to align themselves with the goals, vision and values of the organisation and the people around them. From this professional placement, I have recognised the importance of a team that understands how to embrace and practice company values, which facilitates teams to build rapport with one another and enhances effective communication. I believe it is these elements that allows the WAPHA to operate as successfully as it does, and I aim to implement similar practices throughout my career as a HIM where I will always work within a team. I am grateful for being a part of a unique and innovative organisation where I was able to learn new skills that are applicable and relevant to the real-world working environment that is constantly evolving with the modern world.

My professional placement for Curtin University at the WAPHA has allowed me to more rapidly implement innovative changes within my workplace. I believe this has provided me with skills that are transferable and highly sought after as a HIM within Perth.

Dusty Ellen BScHIM Health Information Manager; Armadale Kalamunda Group PO Box 460 Armadale WA 6112 Tel: +61 8 9391 2144 Email: dusty.ellen@health.wa.gov.au

15 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

Final year placement in a traditional Health Information Manager role – what I have learnt Abbey Nexhip

Final year placement is an opportunity to build upon interpersonal and industry-specific skills, develop networks and advance your professional profile to the health information management world. You are required to develop your professional maturity, practice effective communication skills, and present unique thinking to achieve desirable outcomes. Final year placement is the culmination of your student life, where everything you have learnt in lectures and workshops comes to fruition in the workplace environment.

In this article, I will describe the challenges of my final year placement, what I learnt and a discussion of the assimilation of theoretical concepts to real-life.

Out of the four main domains of health information management; health classification, health informatics, data analysis and management – this article will be presented in the context of traditional health information management tasks. Throughout my 11 week placement experience, I was involved in a range of different tasks, including auditing, exposure to health information exchange processes, electronic medical record preparation activities, clinical coding and other ad hoc duties. The audits performed surrounded policy compliance adhering to the National Safety and Quality Health Service Standards, clinical documentation compliance, and evaluation of clerical process in the sorting of incoming loose documentation and pathology reports.

Studying health information management exposes you to a range of subjects that demonstrate the application of differing skills, from calculating p-values and confidence intervals, to integrating change management within a department of staff. However, despite learning this in classes and lectures, it is not until you are exposed to the real-life environment,

16 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

that you fully understand the expansive knowledge of a Health Information Manager (HIM). We are a unique profession, with unique skills, who contribute significantly to the health sector in our community, state, nation and more widely, the world.

There are multiple learnings that you can take away from a placement including; the diversity of a HIM, the level of attention to detail required within such roles, the understanding of key resources, the strategies used to manage staff and the tools for effective communication. Eleven weeks is ample time to draw conclusions about the idiosyncrasies which develop an effective HIM. HIMs are resourceful, studious, supportive, inventive, logical, organised, and adaptable – just to name a few qualities. The preceding list of HIM quirks are attributed to the increasingly complex and forever growing nature of healthcare. I have learnt that you will find yourself left behind in an industry of perpetual growth and revolution, if you do not open your mindset to new and improved solutions.

There are multiple learnings that “ you can take away from a placement including; the diversity of a HIM, the level of attention to detail required within such roles, the understanding of key resources, the strategies used to manage staff and the tools for effective communication.

”

Arguably, one of the greatest challenges as a HIM is the management of staff, who you are required to lead and inspire daily. In this role, not only are you required to have exceptional industry-specific knowledge and experience, but you are required to connect with your staff on a level that is greater

than the workplace environment. The relationship between a manager and their staff is finding the right concoction of communication, motivation, delegation, compassion, trust, and unity – several elements to digest daily. The connections between management and staff are pivotal in the efficiency of workflow in the department, which is an integral role in a traditional health information management environment.

At the conclusion of our placement, students are required to present their knowledge and experiences at a three-day placement conference to the final year health information management cohort, with agency supervisors and academic staff also attending.

As I was involved in multiple small audit activities, I took this as an opportunity to synthesise the concepts learnt about the applications of ‘auditing’ and align them to a theoretical model to deliver my presentation – ‘Auditing: A multi-faceted quality tool within the healthcare environment’. Through this, I was able to demonstrate the nexus between the audits performed on placement, and how the success of these auditing outcomes is enhanced through the application of theory.

Forty students presenting 15-minute presentations in a lecture theatre for a total of 24 hours seems monotonous; however, the exhibition of diversity in health information projects, depth of thinking, and quality of presentation skills contradicts everything we know about monotony. Walking out the doors on the last day of the presentations leaves you feeling prideful, passionate and excited to begin your health information management journey.

Abbey Nexhip BHIM Associate Lecturer, Health Information Management La Trobe University Bundoora VIC 3086 Tel: +61 3 9479 3193 (italics) Email: A.Nexhip@latrobe.edu.au

17 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

Reflection on health information management postgraduate studies Qinhua Shang

I am a postgraduate student in the Master of Advanced Health Service Management (majoring in health information management) at the University of Technology Sydney. I am also a mother with two school-aged children. Returning to university 15 years after graduating is a significant challenge for me. It is an extraordinary journey with difficulties and achievements.

Balancing different roles As mature age students, we are different from younger undergraduate students. Once we make decisions, it is not easy to change, because these choices are not only for ourselves but also for our families. Attending university means less time to look after our children and to go to work, which would influence the parenting and financial situation of the family. How to balance the postgraduate education and parenting is a new issue to me.

“

As mature age students, we are different from younger undergraduate students. Once we make decisions, it is not easy to change, because these choices are not only for ourselves but also for our families.

”

To overcome these obstacles, I developed efficient time management and organisation skills. I designed a detailed study and parenting plan with my family, which told us what to do in each hour. Being time poor meant I had to reschedule my sleeping time and sacrifice my recreational time. For example, during exam periods, I went to sleep at 9pm with my children and woke at 4 am to utilise the quiet hours to study.

I believe that short-term pain is for long-term gain.

18 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

Integrating theory and onsite practice During my postgraduate study, I attended several field trips with my lecturer and other postgraduate students to hospitals and institutes to obtain first-hand experiences. These trips provided real-life experiences and supported our theoretical knowledge base. At the Australian Institute of Health and Welfare (AIHW), we were informed about how health information supports the national public health network. The authoritative and accessible information and statistics inform decisions and improve the health and welfare of all Australians.

We learnt about how to use health data to drive policy and make decisions. Health professionals collect data, analyse information, compile statistics, compare hospital performance, publish professional reports, and improve our population health, for example, increasing the immunisation rates.

We also understood how to transfer the health information to ensure the patients receive seamless continuum of care from inpatient health care to outpatient rehabilitation care. A well-integrated and more accessible health information system assists in completing this process (America Sentinel University 2015). For example, My Health Record helped to make available the health information between several health providers for patients with complex care requests (Van et al. 2017).

Being inspired by professional ethics I was also inspired by the Health Information Managers (HIMs) in a more intangible way. Some HIMs came to our class and shared their experiences with us. I could sense the passion from these vibrant HIMs. The HIMs are committed to improving health service delivery by prioritising health information management. With

this commitment, they can keep progressing on their career path.

One of the HIMs, Ms Navreet Bhattal, had diverse roles during her career path, from a Clinical Coder at a hospital to a technical officer at the World Health Organization and a project leader at AIHW. Key messages she conveyed to us include the importance of life-long learning and always being up to date with your knowledge and skills. She emphasised the need to attend lectures, read literature, talk to experts, and perhaps even return to university to study. She is detail-oriented and ensures she pays attention to data accuracy to enhance the quality of health information and to support evidence-based decision making.

These lectures from HIMs provided me with a very good understanding of the HIMs commitment and passion. Progressing on the career path will neither be easy nor be fast and there will be plenty of hard work and lifelong learning. Ongoing learning will help postgraduate students to obtain knowledge and skills to tackle new challenges in the digital world.

Developing a professional network During our postgraduate study, we have many opportunities to connect with professional people in health information management fields. We can establish professional networks when participating in our health information management lectures, visiting health information management institutes and attending professional seminars. From these opportunities, we have been exposed to advanced industry knowledge from the HIMs and had the opportunity to hear about their many valuable

experiences. Establishing these networks will help us to move forward in our career path.

We can establish professional “ networks when participating in our health information management lectures, visiting health information management institutes and attending professional seminars.

”

As a health information management student, I feel very lucky to have the opportunity to enhance my professional knowledge and increase my self-esteem.

As a mother, I hope that I can be a role model for my children with lifelong learning and the development of professional identity.

References American Sentinel University (2015) Different nursing roles in the continuum of care. Available at: https://www.americansentinel. edu/blog/2015/07/21/nursings-role-in-the-continuum-of-care (accessed 28 April 2020).

Van Kasteren Y, Maeder A, Williams PA and Damarell R (2017) Consumer perspectives on My Health Record: a review. Studies in health technology and informatics.239: 146-152.

Qinhua Shang Student, Master of Advanced Health Services Management University of Technology Sydney Email: Qinhua.Shang@student.uts.edu.au

19 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

Health information management student placements: the supervisor perspective David Mangano, Kirsten Hinze, Rachael Sewell, Emma Parras, Michelle Cope, Maryann Wood, Emma Barker

Introduction Student practical placements, or work integrated learning experiences, are an important component of any degree as it is an opportunity for the student to assimilate the theory and knowledge they have gained during the degree in a workplace setting. It is also an opportunity for the student to practice and further develop their skills and knowledge in a safe environment, with the aim to ultimately produce work ready health information management graduates.

Students have an opportunity to engage with Health Information Managers (HIMs) through placement activities including health information management tasks, work shadowing, projects and clinical classification, allowing the student to begin to develop their own HIM network.

Placement programs are not possible without the ongoing support provided to universities by HIM colleagues who take on the essential role of placement supervisor. Several supervisors from both the La Trobe University (LTU) and Queensland University of Technology (QUT) health information management degrees were provided with a set of questions around benefits of placement, what works well, what could be improved and key messages for those considering becoming placement supervisors.

20 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

What are the benefits to you (and your organisation) from hosting students on placement?

Benefits to the organisation Supervisors have identified a number of benefits to both themselves and their organisations, including the opportunity to ‘give back’ or support the universities, as it is seen as a crucial part of the ethos of the organisation. On behalf of their organisations they note that the student can be an additional resource to assist in completing work that would not have otherwise been completed and to have evidence based practice applied to workplace activities.

David Mangano, Northern Health, Victoria The right student can provide your organisation with an additional resource who enables work to be completed that otherwise may sit on the back burner due to time pressures or resource constraints. For example, students can assist with audits and general department projects.

Over the journey, Northern Health health information management students have also assisted with the development of valuable resources such as manuals, training materials, procedure reviews and project communication strategies or material. The placement is also seen as a way of identifying the potential of the student to be recruited into their organisation.

Kirsten Hinze and Rachael Sewell, Gold Coast Health, Queensland Gold Coast Health consider placements as integral to developing the personal and professional capabilities required of all HIMs, including the capabilities of self-awareness, resilience and reflective practice.

Health information management students bring new perspectives, skills and enthusiasm to our team. Our health information management students have quickly becoming valuable members of the team during their placements and have assisted us in achieving critical project milestones. This has included during our digital transformation project by tackling short-term projects and providing extra support for our busy staff during high activity periods.

By hosting students we have also been able to discover new talent, with the potential of recruiting future employees to our team. We also have the benefit of promoting our organisation to students as a great place to work that offers career satisfaction. With a shortage of HIMs in our workplace, this is a convenient way to recruit new staff with essential skills we need. We have made many strong connections and networks through our health information management students.

Emma Parras, UnitingCare Health, Queensland By having access to health information management students to complete the project part of the placement, UnitingCare Health (UCH) hospitals benefit from the fresh perspective that the students provide. As the students are in their final year of study, they are equipped with the right skills to enable them to deliver evidence-based projects that are of a very high standard with minimal supervision.

There is an industry-wide shortage of experienced HIMs and Clinical Coders (CCs) which has made recruiting sufficient staff to meet the demands of the Health Information Services Department extremely difficult.

Although there is a significant difference in efficacy between newly qualified and experienced CCs, the benefits of hiring recent graduates and investing the time to develop their skills internally is widely accepted as a successful long-term strategy for building an experienced clinical coding team. We always try to offer positions to third year students that have been placed in our hospitals and are already orientated to our organisation.

Michelle Cope, Redcliffe Hospital, Queensland Access to students for placements supports succession planning, continued service delivery, increases the opportunity to test innovations and provides a foundation for future on the job expectations.

We welcome students into the department for coding and mini project work to create new relationships and offer support within the health information management community, wherever they work following their placement, for continuous information sharing benefits.

We have a long history of contracting and permanently recruiting previous students that have worked with us on placements and view this as a recruitment strategy.

Benefits to the supervisor As noted by the supervisors, from a personal perspective the supervisors identified being able to develop or enhance their own skills in areas such as training and supervision, mentoring students and watching them ‘grow’ during the placement period.

David Mangano From a professional development perspective, hosting a student placement can develop staff supervision and training skills while also consolidating the information you and your team know about your department and organisation. Finally, student supervision is an extremely rewarding experience. It is rewarding to witness students transition from ’students’ during the early days of placement, to ’employees’ who can operate at the level expected of new graduates.

Kirsten Hinze and Rachael Sewell Our staff also have professional development opportunities to mentor students and grow their leadership skills.

Emma Paras UCH hospital HIMs are committed to giving back to the profession, and supporting the health information management student placements is one way we can do this. It is very rewarding to see the growth in our students during the thirteen week placement, with the program designed to cement the theory they have learnt at university into real world practice.

21 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

What works well with the placements?

In determining what works well with the placement, supervisors noted that the support material and resources (guides, manuals) and support during placement from the universities were an important part of making sure the placement progressed successfully.

They also noted that the format of the placement programs assist in providing an overall good experience for the students. A number of supervisors emphasised the importance of making sure that the supervisor meets regularly with the student and is available to respond to queries from the student.

David Mangano LTU run an excellent student placement program, ensuring you as a supervisor have the right resources and guidance to provide a successful placement experience for both the students and agency. As an agency supervisor, it is important to understand what the university expects of you and what the students are expected to achieve on placement. Thankfully, the Supervisor’s Manual and the Student Journal provided

by LTU detail this information. These resources assist to establish expectations and ultimately assist a supervisor when planning the upcoming placement. Another aspect that works well, is the support provided by the LTU academic supervisor. From experience, the academic supervisor is a great resource to answer queries or provide guidance as required, either before, during or following a placement.

From an agency supervisor’s perspective, it is best to be as prepared as possible when supervising a student. A strong understanding of the Subject Intended Learning Outcomes (SILOs) will ensure that the university, student and agency goals align. Further to this, it is beneficial to plan the student timetable with the SILOs in mind.

At Northern Health, we find it advantageous to provide students with a timetable that gives them insight into their placement meetings and activities. In addition to this, we ensure students are orientated as best as possible, including a network login and access to the relevant systems required during their placement. To ensure these orientation type tasks are not forgotten, we developed a comprehensive checklist that the student and supervisor work through together on day one of placement.

22 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

During the placement, I like to meet with the students regularly and discuss the day or week ahead. We also debrief at the conclusion of meetings or appointments to ensure the student understood what was discussed and the purpose of the meeting or appointment.

Where possible, I attempt to tie these discussions back to the SILOs. In my opinion, spending enough time and touching base frequently with students is a key contributing factor to a successful placement. It is during these debriefs that students have an opportunity to consolidate what they have learnt and ask the questions that may assist them to mentally join the dots.

Kirsten Hinze and Rachael Sewell The benefits of exposing students to practical placements is to experience real-life business days for a HIM. The shadowing component works very well as it is an opportunity for the student to witness dayto-day activities. For example, participating in a statewide video conference to discuss the latest electronic medical record challenges from a HIM perspective.

Students have the opportunity to contribute their learnings to understand the problem and trouble shoot some opportunities for solutions. Project activities provide students with a current problem that a site has limited capability to address due to lack of time or resources. Projects are a win-win for both the student and our team.

Employers want HIMs who can walk onto the job with knowledge of information management principles in a health environment, especially with an appreciation for continuous quality improvement. Data integrity is a critical concept health information management students learn pre-employment. It is critical that the student has a solid data integrity foundation to understand the importance of the correct data being associated with the correct patient. Health information management students with the knowledge of the ramifications of inaccurate data and the need for ongoing monitoring is essential.

Clear, responsive and timely communication and collaboration regarding expectations, making reasonable adjustments as necessary, and raising any concerns arising is essential to a successful placement.

All partners are responsible for sharing information about the placement and this will support students’ health and well-being and enable them to fully participate within the placement and achieve their learning outcomes.

Emma Parras

David Mangano

The students are able to contribute in a meaningful way to health information service departments as they can see that the work that they are involved in will be used by the hospital. At UCH hospitals students gain an appreciation of working as a HIM in the private sector and insight into the complexity of private sector funding models and health fund contract compliance.

The program is split between coding, project and shadowing which allows for a distribution of resource required across a number of staff in the department.

The health information management student placement program at Northern Health is well embedded within our department and has evolved over the years to be as robust as what I believe it can be. However, given the healthcare environment is constantly changing, I think it is important to regularly review and refine placement schedules. Constantly reviewing the SILOs against the placement schedule ensures you are fulfilling your obligation as a supervisor and guarantees students are provided the opportunity to learn the outcomes they are expected to achieve.

Michelle Cope The placement gives supervisors the opportunity to set expectations for the work environment and start to nurture the student’s growth in what is to come.

Supervisors nominate projects that add value to the service or address issues and students select topics that resonate with their areas of interest. Supervisors meet with the students as an introduction to the department and provide the plan for the duration of the placement.

They are introduced to key contacts and orientated to their new environment. The objectives of the placement are reviewed and monitored throughout the placement and a calendar is provided for meetings and education.

Clinical coding placements are well structured to support the student and assist supervisors in delivering targeted feedback and advice. Students on project placements deliver a departmental presentation for feedback and advice prior to the university assessment.

Is there anything you would do differently for future student placements?

When asked what they would do differently, supervisors noted the importance of reflecting on past experience to continue to improve on the experience for the student, themselves and the organisation. They also noted that regular review is important for an overall positive placement experience. Reaffirming placement requirements prior to commencing the new placement is a key process supervisors need to undertake. Being aware of the student’s needs, their overall sense of comfort in the placement environment and understanding the balance required of the student between work, study and personal life were also identified as things supervisors should also consider.

It should be noted that some of what the supervisors have identified is not so much things to do differently, but more a case of things to ensure they continue to do.

Kirsten Hinze and Rachael Sewell While previous placements have worked well, we always aim to improve each time by discussing the experience with the student and asking for feedback. Through busy day-to-day work life, there is the potential for us to not pay adequate attention to student health and well-being while on placement, including the impacts of distress for the student due to other competing priorities and study commitments. Setting up a buddy system of available support staff available for the student is important to ensure students have options for support. We also aim to ensure careful observation of patterns of attendance and meeting deadlines, identifying withdrawn or unusually quiet behaviour and employing an open and interested approach to the student’s experience.

We will aim to attend the final project presentations at QUT to observe students, as a way of celebrating our student’s success and to improve future student placements through their lessons learnt and collaboration with placement hosts from other health services.

Emma Parras It could be beneficial to agree to more than one student placement at a time. The ability for students to work together on projects and support each other, especially for the clinical coding component, could work well.

Michelle Cope It is always a challenge to dedicate enough time to guide students while meeting usual service demands, so I would encourage students to maintain open communication with supervisors and informally check in to ensure they aren’t too overwhelmed.

23 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

If there was one key message you would give to colleagues thinking about hosting students on placement, what would it be?

Placement supervisors were overwhelming in their support of hosting students and encouraging colleagues to take up the opportunity. Comments such as ‘rewarding’ and ‘just do it’ were noted. Other supervisors also noted some things to make sure you have in place prior to or as the student comes on board in the organisation.

David Mangano Do not underestimate how rewarding a student can be for you and your organisation. Students can bring new knowledge, ideas and can provide a fresh set of eyes or skills which can be valuable to your organisation. Finally, supervising students is a great way to share knowledge and give back to the profession by assisting the next generation of HIMs. Kirsten Hinze and Rachael Sewell Consider projects that are achievable for a student – the more complex the project the less likely you and the student will find value. The right project for both parties will allow you to celebrate success and be rewarding.

In the same way that we ensure thorough on-boarding for new staff, we also ensure that the same on-boarding process applies for students so that they feel part of the team. On-boarding should include: • Welcome to the organisation, including the Director, team members and buddies for support • Recognising and valuing student contributions to the team • Practicing inclusive and culturally responsive education and supervision • Creating a ‘safe space’ for student sharing of concerns throughout the placement • Using evidence-based and student-centred supervision practices • Working with QUT lecturers to present clear and consistent information on expectations of conduct and performance.

Emma Parras A simple yet powerful statement: Just do it.

24 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

Michelle Cope Invest your time now to achieve the full benefit of succession planning for years to come.

Conclusion Student placements are a critical part of all health information management students’ university experience and are reliant on the generosity of the supervisors in the health information management profession. A well planned and considered placement can be beneficial for the student, the supervisors and their organisation. The placement experience provides an opportunity for skill development and knowledge, growth of the student and the avenue to apply theory in a safe practical environment. Placement supervisors leave you with a couple of key messages: invest now for the future, celebrate success, be rewarded and just do it.

David Mangano BHIM (Hons) Operations Manager, Health Information Services, Northern Health 185 Cooper Street Epping VIC 3076 AUSTRALIA Tel: +61 3 8405 2023 Email: David.Mangano@nh.org.au Kirsten Hinze BBus (HIM), GradCertHSM, CHIA Director, Clinical Informatics; Gold Coast Health Southport QLD 4215 Rachael Sewell MHlthSc (HSM), BBus (HIM) Clinical Applications Manager, Clinical Informatics; Gold Coast Health Southport QLD 4215 Emma Parras BBus (HIM) Group Health Information Manager; UnitingCare Queensland Brisbane QLD 4000 Michelle Cope GradCertHSM, BHSc (HIM) Director, Clinical Health Information Services; Redcliffe Hospital Redcliffe QLD 4020 Maryann Wood MHSc (HIM), BBus Lecturer, Queensland University of Technology Kelvin Grove QLD 4059 Emma Barker MHlthInfoMgt, BHthSC Associate Lecturer, La Trobe University La Trobe University VIC 3086

Production Schedule

Subscriptions

ISSUE

DATE OF PUBLICATION

Volume 10 Number 3, 2020

October-November

Volume 11 Number 1, 2021

March-April

Volume 11 Number 2, 2021

June-July

It is intended that articles dealing with the HIMAA competencies listed below will be included on a regular basis. Please refer to the HIMAA website for further details about these competencies:

Competencies Generic professional skills Communication skills; Organisation and engagement; Information communication technology (ICT) literacy and knowledge management skills; Teamwork – within the work unit and as part of a multidisciplinary team; Problem-solving and decision-making; Lifelong learning; Ethical behaviour; Social and cultural awareness.

Health information and records management Health data and records; Healthcare information standards and governance Language of medicine Medical science; Medical vocabularies Healthcare terminologies and classification Code systems, clinical terminologies and classification such as ICD-10-AM, ACHI, DSM, SNOMED CT; Clinical coding; Casemix management and activity based funding methodologies Research methods Healthcare statistics and research Health services organisation and delivery Healthcare delivery systems; Quality and safety management and performance improvement management Health information law and ethics Healthcare privacy, confidentiality, disclosure, legal and ethical practice E-health Information and communication technologies; Data security; Health information systems and health informatics Health information services organisation and management Human resource management; Business/operations management; Project management; Financial and resource management

Rates quoted cover a subscription to HIM-Interchange only 12 MONTH SUBSCRIPTION (all amounts in AUD)

Individual subscriber including online access to HIM-Interchange: Australia $175 incl GST & postage Overseas $265 incl postage Student subscriber Australia Overseas

$145 incl GST & postage $225 incl postage

Institutions/Organisations/Libraries including multiple online HIM-Interchange access and one copy of HIM-Interchange per issue

Subscription rates vary depending on the number of IP addresses requiring access to HIM-I. Please contact information@himaa.org. au for further details.

SINGLE COPY OF HIM-I For postage within Australia For postage overseas

$75 $135

Membership of HIMAA (except free student membership) includes a subscription to the printed HIM-I. Free student members have access to online HIM-I. Subscription and membership enquiries and notification of change of address to membership@himaa.org.au or by telephone to +61 2 9887 5002.

Information for Contributors Contributions are invited in the form of Reports, Case Studies, Personal Perspectives, Sounding Board, Professional Profiles, Professional Practice Placement Profiles, Conference Reports, Reviews, HIMAA Reports, Letters to the Editor.

Recommended word limit ~ 2,400 words.

Submitting a manuscript for review All contributions are reviewed by an editorial panel made up of two editors and at least one other member of the HIM-I Subcommittee.

Manuscripts are to be submitted electronically, saved in Word format, and with no headers and footers. Do not submit papers in PDF format.

Digital photographs only should be provided as separate files, clearly identified and captioned. Subject’s permission to publish may be required.

Data for tables and graphs should be provided in separate Excel files as well as in their final form.

Formatting of the document should be kept to a minimum.

Further information may be sought by contacting Stella Rowlands, Associate Editor, at HIMInterchange@himaa.org.au.

Submission of manuscripts: Please email manuscripts to: Stella Rowlands, Associate Editor email: HIMInterchange@himaa.org.au © 2020 Health Information Management Association of Australia Limited

25 HIM-INTERCHANGE • Vol 10 No 2 2020 • ISSN 1838-8620 (PRINT) ISSN 1838-8639 (ONLINE)

Copyright C 2020 Health Information Management Association of Australia Limited