Generic Interview Qs Flashcards

Question

What are the challenges for EM over next 10 years? What priorities would you focus on?

Answer 1

Increasing workload, restricted funding, improve productivity Context: Increasing demand Increasing complexity; frail and comorbid Restricted resources; beds, staffing Implications for ED Poor flow, Overcrowding, ambulance waits Reduced productivity Staff retention, reliance on Locum Strategies (national) Community care, increased SDEC: reduce bed occupancy and flow Digital technologies; improve productivity Improve research; evidence to shape policy and future

Answer 2

Clinical governance Audit: against best practise standards - example Risk management: patient safety data - M+M, DATIX, complaints - important not to change processes based on a single event; build a picture of risk and management plans CQC/HIW report - cleanliness and fire safety; roll model and challenge unprofessional behaviour

Answer 3

Is this support I would need in starting role or difficulties faced by department? Flow Overcrowding - safety Ambulance off load Pathways/protocols Help understanding historical events, things that were tried but didn’t work etc Make connections; key stakeholders Experience; honest, open and friendly

Answer 4

Effective triage and flow Patients are able to move through the department to where they need to be; examples: offload ambulances to resus, to ward or SDEC High quality care - adhere to best practice standards ensuring safe, effective pt centred care Compassionate leadership - visible, roll model, civility, motivate team Continuous improvement - audit, QIP, research

Answer 5

Outside of work the most important thing I do to ensure my effectiveness at work is destress. Help me destress and ground me are Wife, son, dog Married; - debrief, destress, reframe, perspective - risk manager; informal learning and management perspective Father; Forming a bond and relationship with my son is an amazing, rewarding and life changing experience. Relate to others esp in paeds. Rescue dog - Dog training Walks and watching my dog enjoy himself Source of happiness and grounding. - reliable, caring and insightful Using healthcare system as patient or family member - mother perforated appendix - Xmas - understand importance work from the service user aspect. Gratitude for the service provided. What great service feels like as a service user. - Wife and miscarriages Research Living abroad; DEI

Answer 6

Overall EM provide excellent experience, always aim to improve Department: research - varied experience, appropriately challenged and appreciated Deanery: HALO training - expanding opportuntiies; oculoplastics Nationally: leadership training - RCEM conference - workload and burnout - compassionate leadership; trusting, inclusive motivated team

Answer 7

Vision Motivate team; compassionate leadership Communication EPR Demonstrate where PRU added value - what did PRU provide beyond scope of standard paramedic Motivate team to complete parts of EPR Quarterly CG impact data End year comms: shared with management Showed 14 bed days saved per PRU shift ~£3.5million gross savings from prevented attendances and admissions Compassionate leadership - attentive, understanding, helpful Example; DoC TID clinical fellow (demotivated) Old: Vision, Motivation, Communication

Answer 8

Engaged, constructive input, communication Example: patient assignment analogue to digital Consultant team Comms: clear, concise, respectful, timely Skilled - honest about abilities/ need for help Work toward common goal - engaged, constructive feedback, Motivated Communication; - clear, focussed, respectful Example: PRU, MDT, digital tech Shows good team, how I can form and motivate good team work

Answer 9

SHO - provide

Answer 10

Arrange meeting with appropriate person Inform about high referral rates - offer comparison Enquire reasons behind this Offer help and assistance Plan for improvement Continue assessment Arrange further meetings

Answer 11

Poorly defined goals/direction Demotivate team Poor communication - unclear, unfocused, disrespectful Example resuscitation. Unclear what is happening, what roles people have, blameing people, upsetting team member

Answer 12

Leader sets course, manager ensures you get there smoothly Role often overlap. Example EPR What they do: - leader creates vision - manager sets goals to deliver vision How they achieve - leader focus on people; motivate - managers focus on systems Time frame - leaders long range - managers short range view

Answer 13

Wide experience various management roles: Workplace manager: EPIC - Know team; names, needs - Allocate resources according to need and experience training requirements Clinical supervisor - clinical fellow Project supervisor: QIP: - manage audit team

Answer 14

Explore why they feel that way - no variety? Challenge Discuss solutions to the issue - more resus, procedures Ongoing plan - Advise they speak to their educational supervisor and EPIC

Answer 15

Patient safety, understand, patient centred plan a as Example: Radiology registrar declined CTAP Or example functional seizure Explore why they disagree Explain your reasoning Explain risks benefits of other management plans ? Shared decision

Answer 16

On reflection I have identified a few behaviours that I experience when I am stressed - anxious - less chatty - reduced laughter Tactics Identify issues and ask for help Home; debrief with my wife , play with son and walk dog: ground me

Answer 17

Example Abx wrong patient - notify patient - apologise - truthful account of what happened - how incident can be mitigated - review incident - inform patient of outcomes Important; trust, honesty: risk management Shows; promote open blame free culture and focus on improving service and supporting staff.

Answer 18

Research active hospitals have been shown to provide higher quality care - better engagement with EBM Core curuculum component; departments need to be able to teach trainees Essentislly: Provides the evidence we use for EBM Example of how research can change practice: NoPAC X Research in your community ensures that the evidence is relevant

Answer 19

All hospitals should be involved in research Benefit, Range roles. Opportunity Ideal: Research team working seamlessly alongside clinicians Doctors involved in basic way; eg eligibility and prescriptions Governance and data collection for specialist research team

Answer 20

Management system to ensure high quality, safe, ethical research Examples - ensuring informed consent; DEXACELL; UGI bleed and hyperglycaemia - compliance with regulation; eg GCP certificate - risk management; learning from adverse events; report adverse drug events Compliance with protocol

Answer 21

Ideally - Audit compares current state of practice with preset standards - understand what needs improving and can demonstrate improvement via QIP - ensure department: safe and high quality care Example EoL QIP Summary audit demonstrates current care against standards and I have demonstrated how I have used this to improve care

Answer 22

Choose topic Define standards: patient centred - ?national Compare current practice to standards QIP: implement intervention to improve care Example EoL care

Answer 23

Audit aims to improve practice by checking current practice against established standards. QIP to improve - EoL QIP Research provides evidence to decide what best practice is - DEXACELL, NoPAC

Answer 24

Process gathering and evaluating evidence t Inform best practice Evidence from research Example EBM in practice NoPAC; multicentre RCT; TxA vs placebo epistaxis. Changed management. Effective and cost effective

Answer 25

Develop individuals, team, system - Team: safe and effective Upskill and staff retention - As a teacher Improve leadership. Up to date, explaining reasoning and assessing team - Test systems; in situ simulation Tested new transfer protocol for patients to CT. As closest CT being repaired and long transfer time. Identified issue gaining emergency porter. Contact info added to transfer bag

Answer 26

Nicky Moore Lead on creation of bristol CEMS Interest in community management Inspired me to take on larger leadership projects Roll model: compassionate considerate leadership

Answer 27

Awareness; - feedback; informal and formal - EM community, colleagues, podcasts and conferences Self reflective practice - HALO Reflection on own practice and practice within department Reflected after M+M Target training: HALO procedures courses, theatres; worked well - Halo procedures Create awareness - Podcasts, conferences Shows reflective, identify needs, continually develop: set example train our trainees

Answer 28

National institute for health and care excellence Independent body provide - evidence based guidance - develops standards - assess new medications technologies for cost effectiveness NICE guidelines; assess for symptoms and use EoL as appropriate.

Answer 29

NRLS aims to improve patient safety - monitors incidents - promotes reporting - develop interventions to reduce risk All incident reports now uploaded to NRLS National reporting and learning service

Answer 30

Assessment - evaluate specific aspect performance - narrow focus - triggered sporadically; exam Appraisals - professional development - Broad focus ; entire scope of practice - annual review - proud of this year is EPR, providing high quality data, used for QIP

Answer 31

Overall Benefit but there can be challenges to this model. Benefits: - experienced staff, diverse skill mix - improve retention, up skill workforce - permanent staff; continuity of departmental care. Challenges: example PA - scope of practice, supervision, training and credentialing ; less widely understood than doctor in training. Importance of consultant training. Something I would be keen on as I know we are expanding our ACP roles

Answer 32

NHS deaneries are regional organizations responsible for coordinating and overseeing postgraduate medical training. Ensure training standards meet GMC requirements - performance, safety, communication, trust Appraisal; CPD, audit, issues, targeted improvements

Answer 33

Protocol mandatory procedures to be followed, Eg research protocol to enrol patient on DEXACELL Guideline general recommendation to guide action, allowing for flexibility and judgment HTN emergency guideline Stakeholders, CG

Answer 34

- Understand how it will effect systems/care - Respond to issues that we find in our practice - Represent department to other leaders Example EPR; - use EPR everyday. Understand how improve productivity by streamlining data capture - owned project. Iteratively change issues/snags given by team. - able to make a business case for this change. Provided the funds to proceed Shows

Answer 35

Departmental job plan made to cover service objectives. Individual job plans Should be ongoing basis to allow flexibility - collaborative agreement amongst colleagues to ensure team job plan complete Keyskills: team work, communication, time management Personal job plans Full time 10 PAs (8:2), usually 7:3 Working time: 4 components - Direct clinical care (DCC); plan sites, PRU, pre hospital streaming, weekends, on calls - Supporting professional activities (SPA); teaching (1PA), CPD (1PA), education support (1PA, 0.25 per trainee) Additional NHS responsibilities; lead clinician; audit, CG, teaching, research External duties: university roles, college work

Answer 36

Opportunities and challenges Pro: variety in practice opportunities to learn from different sites Patient centred; sites close to pt Cons: Complexity, more to learn, potential for missed opportunities Not always convenient for staff, Wrong patient at wrong site Shows: opportunities for providing care close to home. Importance of getting patient to correct site first time. Flow centre and PRU

Answer 37

Issues can arise when implementing changes made to complex systems: Issues can include: - reduce productivity; Time consuming - fail due to Poor stakeholder engagement - Secondary negative effect on system Example mistake; business continuity

Answer 38

- Investigate systems not individuals Compassionate leadership - attentive, understanding, non judgemental, empathetic, act on issues raised by colleagues psychological safety - roll model Open and honest culture. Focussed on improving system Example Duty of candour Nurse gave medication to wrong patient allergic. Issue was similar name in same bay: - open and honest; came for help, no harm. Act to resolve issue at time and have departmental learning to prevent future issues

Answer 39

Pros and cons to any intervention Well planned and considered - not effect other parts of system Not onerous Well communicated Reactionary Over regulation - never events; anaphylaxis Focus on process rather than patient experience in totality (time spent logging on to different systems (4) to check allergy) - resistance to change - poor adherence and failure of initiatives Understand potential issues with governance so that I consider any interventions I make

Answer 40

I: New waiting room and rapid assessment area. R: effect was front sheets went missing as they were transferred from waiting room rack to majors rack. Used to allocate clinicians to patients. S; suggested removal of front sheet rack system and move to tracking and patient allocation on tracking board. To our digital working group, Wrote an SOP Discussed at consultant meeting Enacted in phases Shows engage with others changes, constructive feedback and enact own improvements

Answer 41

Reliable; time management, task management, responsible, team player. Caring: Approachable encourage , act as a role model and Insightful; experience, critical thinking, awareness Role as clinical supervisor Reliable: time management; task management - completing portfolio items Caring; approachable and understanding of clinical fellows needs; international student struggling with interviews. Insightful; multiple practice interview sessions. Constructive feedback Now has training job Shows how; manage staff, role models and work towards inclusive workplace by considering individuals needs.

Answer 42

Ensure patient safety Context specific Understand - check welfare, why is this happening? State the issue and why it is a problem - make plan on how to resolve issue and cause of issue Ongoing monitoring - educational supervisor Shows manage underperforming colleague, ensuring welfare, managing staff

Answer 43

Feedback from multiple sources Self Assesment - reflection Supervisor feedback - reliable, completer finisher Colleague feedback; junior, senior, nursing - approachable, trusted Patient feedback - listen and explains Capture entire scope of practice

Answer 44

AI; X-ray, ECG, Digital solutions Extra staff or training Remote falls referral Dyslexia friendly guidelines

Answer 45

Processes designed to assess and mitigate risk Process to identify and prevent bad outcomes for patients Learning from: M+M Critical incidents DATIX Example; EpiPen, M&M

Answer 46

Aware and Protect ourselves Stress (acute/chronic), - protect; family Work life balance: shift patterns Moral injury Motivates me to improve service X Maximise Positives and minimise Negative; Initially: - Variety: Love being a generalist; treating anything that comes through the door. Working and learning from MDT - Challenge; balancing risk and uncertainty - Appreciated;

Answer 47

Firstly Patient, depetmental safety. Generally Compassionate leader Investigate systems not individuals Culture open and honest. Improve system Example DoC Xxxx Context specific Understand what happened Were protocols followed Sensitive discussion with trainee What lessons did they learn What lessons can the system learn Never just an individuals fault Consultant takes responsibility for department Ensure duty of candour, apology Shows; compassionate responsible leadership and desire to improve

Answer 48

Context specific; generally Patient safety Understand: compassionate leadership Reframe: pt best interest Plan: immediate and systems learning Example radiologist declining scan

Answer 49

Structured Handover - A to E any risks to department Patient safety; sickest seen, plans Department; resus space, pressures in department, walk around, proactive about issues; incivility, challenge inappropriate Staff; breaks, opportunistic training Shows responsible leadership, people first Communication; strength

Answer 50

Issues; increased demand, insufficient funding, need to effectiveness of ED Population and funding Results high bed occupancy, exit block, poor flow, overcrowding, ambulance delays Solutions Strategy; healthier wales - Community management - Digital tech - data driven - Research Shows responsible leadership, continually improve service Demographic and political

Answer 51

I work well as either a leader or a follower Act in according to what is appropriate. Good leader; vision, motivate, communicate Good follower: engage, feedback and anticipate Examples include Leadership: EPR Followership: new waiting room: tech solutions My preference is to lead I have a passion for improvement EPR; dashboard, national KPIs, expand PRU, bring more middle grade trainees to the grange, develop QI project, publish research. Shows; flexibility, passion for leading and developing service

Answer 52

Situational dependent ?patient safety, breaking news Sensitive, Open and honest - issue Gain understanding Encourage reflective practice - Offer Constructive criticism PRN - how to improve - Praise good work Ongoing plan; resources, follow up, educational supervisor Example complaint; functional

Answer 53

Create culture; listens, understands, responds Requires compassionate leaders; roll model: listen, understand, empathise, act ? Active bystander, allyship Example: guidelines, feedback, change practice Context dependent; on shift… Know you staff Understand their needs Plan to ensure needs met Approachable and empathetic Respectful: I would like to see milk provided free to staff; work hard and deserve hot drinks MDT in situ training - fosters team work, comfortable with equipment and high acuity scenarios - trained, self improvement, valued

Answer 54

Lots of advantages - Create tech to suit your needs - low maintenance: Changes persist without ongoing work - Access to data Evidence for effectiveness of service, business plans, QI, research Example EPR

Answer 55

Know your team, understand what motivates individuals and make plans with them tha improve their lives Example clinjical supervisor IMG Compassionate leadership, approachable , attentive, understanding, empathetic, helpful Model these behaviours - ask for help, training, promote civility System: No blame and system learning; M+M Example CT request declined

Answer 56

Patient safe: immediate actions Department safe; epic role; NIC, cons History; inconsistent story? Document Known social services Others in household Parents access to other children Full exam of child; document Call social services or EDT ?Call police Sensitive, honest discussion Deescalate Frame issue as doing best for child Duty of care ?underlying medical issue Admit under Paeds; discuss Complete safeguarding form

Answer 57

Informed consent; risks, benefits, alternatives Persuade Under 16 ?Gillick competent 16-18: mental capacity act (presumed competent) Not competent; Parental consent Fathers may not have parental responsibility Hospital Legal team; other consultants; ED and Paeds Best interests

Answer 58

Context specific; Generally: Immediate concerns: - Patient, Departmental safety Understand; compassionate leadership wellfare plan: resolve and follow up Example: QIP supervising trainee, demotivated interview prep Plan; safe to work; other patients ?go home, how, safe, who is at home Next on shift, locum Ongoing plan Educational supervisor, deanery (HoS) Own support; number, check up Handover Document in eportfolio ? GMC; professional standards

Answer 59

Safe Effective Patient centred Timely Efficient Equitable

Answer 60

Feedback Asked to be an instructor Employed by University Bath; 2 years

Answer 61

Finisher, approachable, good communicator Feedback as part of practise Cons: FEGS: completer finisher - reliable, determined, lead teams well Deliver complex projects MSF: nursing and resident doctors Common theme: approachable Compassionate leader: listen, empathise and help. Want people to come to me for help Common theme good communicator - clear, concise, respectful and timely Important to all aspects work:

Answer 62

EPR - streamlined; feedback - demonstrates where value added, ongoing business case and expansion of service - easy access to data: M&M X Change from analogue patient assignment to digital. Digital development EoL QIP

Answer 63

Opportunities; Department: research Deanery: HALO - oculoplastics lists Nationally; workload and burnout risk and approachability of senior staff. Training in compassionate leadership? - spend more time reflecting on moments of leadership than clinical scenarios

Answer 64

Attending: Being present and listening. Understanding: Diagnosing the situation. Empathizing: understanding their difficulties. Helping: Taking action to support and address challenges. Example: clinical supervisor

Answer 65

Earlier adopter of - digital technologies for change; many QIP changes not maintained, digital changes easily maintained - research; TERN - community management patients; more engaged and use more frequently

Answer 66

Safe, effective and patient centred As Cons ensure care high quality for self and department Examples of ways I ensure Safe - risk management (DATIX), IT - DATIX reporting; roll model, systems not blaming individuals - DATIX responding; EpiPen - M+M Effective - EBM, research, audit, training Patient centred (experience) - Engaging patient and public involvement - complaints

Answer 67

C: Trained S deanery. Currently locum ED consultant at the Grange; S Wales. Perform variety of shift work; CG shifts, EPIC, on calls, RAT, paediatric EM and on PRU. senior ED doctors working on RRV with paramedics; one benefit attendance and admission avoidance. Interest in frailty and community management of patients. Led to developing guidelines and establishing new pathways to refer patients in to community care from the ED. M: interest in developing digital technologies SPA time dedicated to this. Biggest project delivered. new EPR for PRU. Created data fields. Streamlined. Capture value added by PRU. Demonstrate PRU saves 14 bed days per shift. R: Also interest in research; completed associate PI role: multicentre RCT DEXACELL and currently brought research to the Grange as co-PI for multicentre RCT: RESOLVE. E: interest in teaching; daily clinical practice, regular teaching advanced life support courses. Uniquely employed by Bath teach masters pharmacists. 1 day per month Personal basis; recently become a father a family would like to relocate to Cheltenham. The main thing I love about being a consultant is being able to improve the system that I work in. Having worked here I know team: friendly, proactive and supportive. Make improvements to systems to improve care for our patients.

Answer 68

Flow - serogate for exit block, overcrowding Visible, Compassionate leadership - responsive, inclusive - motivation, staff retention Improving service - CG activity, investigate systems not people - active audits, QIPs, research - data led, patient centred, interative improvements - GIRFT SeDIT data

Answer 69

Clinical governance

Answer 70

Understanding and kind Open and honest Always learning and improving

Answer 71

Trained Severn CCTd last year, locum Consultant Breadth of routine practice Special interest areas CPD, upto date Focus on leadership; - conferneces - course

Answer 72

Shared decision making CG Complaints Public survey

Answer 73

Calendar RAID log Delegation

Generic Interview Qs Flashcards

(98 cards)