PROFESSIONALISM. Amy Lewis Bergen, LCSW, JD. USF Office of General Counsel. Assessing Professionalism

Transcription

1 PROFESSIONALISM Amy Lewis Bergen, LCSW, JD USF Office f General Cunsel Amy51@health.usf.edu Assessing Prfessinalism The need t teach prfessinalism during residency has been affirmed by the ACGME. Hw t Measure Prfessinalism: Triangulate assessments by multiple verseers in realistic cntexts ver time t get cmplete and accurate picture f prfessinalism Numerus assessrs ver time Get input frm nn-physician prfessinals as well Observatins within realistic cntexts Invlve cnflict...situatins likely t challenge prfessinalism Symmetric acrss rganizatin Nt verly stringent because n ne is perfect Transparent Key takeaway: Use assessments fr nging self-imprvement Assciatin f Medical Student Behavirs with Prfessinalism: Lack f cnscientiusness amng med students crrelates with negative faculty assessments Unprfessinal behavir in medical schl predicts disciplinary actin by state medical bards Medical schl grades crrelate with prfessinalism Test scres crrelate with prfessinalism (MCAT, ITE) Timely cmpletin f required assessments/evaluatins (including self-assessment)crrelates psitively with prfessinalism Available prfessinal rle mdels crdinates psitively Key takeaway: Assess medical schl behavirs in predicting pssible need fr additinal practive interventin Effect f Institutinal Culture n Prfessinalism: Frmal and infrmal curricula Available rle mdels

2 Discipline and interventin styles Practice characteristics Persnal factrs Envirnmental factrs Takeaway: Cultural transfrmatin may be necessary t achieve high prfessinalism levels Teaching Prfessinalism: (A mdel prpsed by the American Academy f Pediatrics) Five day retreat fcusing n factrs imprtant in prfessinalism Hnesty, Integrity, Reliability, Respnsibility Incrprates fur principles f bimedical ethics: Respect fr auttmy, N maleficence, Beneficence, Justice Respect fr thers Cmpassin, Empathy Quality f dctr-patient relatinship Self-awareness Cmmunicatin prcesses (USF Cmmunicatins prgram) Are addressed thrugh rle play Self-imprvement/ Self-awareness, Knwledge f limits Best and wrst situatins as the resident /teacher analyzed thrugh discussin and rle play Ethics/Decisin-making 4 factrs f bimedical ethics Cmmunicatin, Cllabratin Team building, wrking tgether Altruism, Advcacy Perspectives n death/dying Cping skills Surces f Prfessinalism at USF: Huse Officer Cntract Failure t hnr the terms f the cntract can legally be cnsidered breach f cntract.

3 1. D. and E. Prfessinal standards and cnditins fr reappintment and discipline and discntinuatin are defined. G. and H. Grievances r Harassment. Initial cncerns shuld be reprted t the GME ffice. PD may refer t GME ffice. GME ffice can elevate as needed. There is a mandatry duty fr supervisrs t reprt clear harassment t university DEO. C. Leave plicies. Must be apprved in advance. Handbk further states leave must be requested in writing and apprved by PD. Unexcused absences can mean lss f pay and disciplinary actin. Make up time is at PD discretin Huse Staff Handbk Unexcused absences include failure t give advance ntice t chief r PD, and are subject t discipline, deducted frm leave days and payback t fellw residents will be made at PD discretin. Legally, infractins shuld be treated similarly ACGME Cre Cmpetencies: Prfessinalism is an ACGME cre cmpetency. Perfrmance will be evaluate n these cmpetencies and shuld be discussed with PD. Definitin f prfessinalism includes: Cmpassin, integrity and respect fr thers Respnsiveness t patient needs that superseded self interest Respect fr patient privacy and autnmy Accuntability t patients, sciety and prfessin Anther ACGME cre cmpetency is Interpersnal and Cmmunicatins Skills, including: Exchange with patients, families and health prfessinals Expectatins Cmmunicate with patient s families and public acrss a brad range f backgrunds Cmmunicate effectively with physicians and ther health care prfessinals and health related agencies Wrk effectively as a member r leader f a health care team r grup Act in cnsultative rle t ther physicians and health prfessinals Maintain timely and legible recrds Sensitivity and respnsiveness t diverse patient ppulatins. Interpersnal issues can have an impact n quality f care, cllegiality, timeliness, dedicatin t learning, fllwing rules/ plicies

4 Interpersnal issues can have legal ramificatins, e.g., harassment, discriminatin, patient abandnment Relevant GME Plicies: 208 Wrk Hurs Reprting: Failure t recrd may result in discipline/dismissal 208/208B Call Respnsibilities: Thse scheduled t take night call and are nt available r fail t execute respnsibilities are subject t adverse actin 209-A Resident Respnsibilities: Resident must cmply with apprpriate COM plices and /r requirements n leave f absence must institute a persnal prgram f learning t prvide safe, effective patient care, must teach ther residents and/r students 218 Disciplinary and Appeal Plicy and Prcedures: Lapse f clinical judgement r prficiency in clinical skills, medical knwledge, patient care r deficiency in any f the six ACGME cre cmpetencies including prfessinalism and interpersnal and cmmunicatin skills may result in discipline 219 Resident Assistance Prgram: Cnfidential service intended t help the resident cmplete his/her prgram in the healthiest cnditin pssible, whether mental, physical r spiritual 228 Grievance Plicy and Prcedure: Disputes and cmplaints which may arise between a huse fficer and their residency prgram, prgram directr r ther faculty member, including wrking cnditins may be addressed by resident initiating grievance with Prgram Directr r GME ffice 300 Sexual Harassment: Individuals with knwledge are encuraged t reprt t Office f the Dean r Assciate Dean f GME. The GME plicy includes: USF System Plicy Diversity and Equal Opprtunity: Discriminatin and Harassment: Cmplaints are filed with Office f Diversity and Equal Opprtunity (DEO) fr emplyees and Office f Student Rights and Respnsibilities (OSSR) if cmplaint cncerns a student. Office reviews and prvides an apprpriate respnse including cunseling, mediatin, and/r referral fr disciplinary actin. Any actin criminal in nature will be reprted t law enfrcement. Prhibited cnduct: unwelcme tuching; impeding r blcking mvement; cntinuing any cnduct after being made aware actin is unwelcme; singling ut r targeting an individual fr different r adverse treatment. Filing can be vluntary r cmpulsry. Anyne may file an internal USF cmplaint with DEO r OSSR r law enfrcement. Shuld reprt: victim, any student, faculty f staff with direct r indirect knwledge. Mandatry: Supervisry emplyees, Deans, department chairs, crdinatrs, unit heads, managers and principal investigatrs, thse wh supervisr f versee students, all members f faculty, graduate students with instructinal respnsibilities when they are supervising r teaching students; University Plice.

5 External cmplaints can be filed with the EEOC; Department f Educatin, Office f Civil Rights ; Department f Labr, Office f Federal Cntract Cmpliance Prgram; Flrida Cmmissin n Human Relatins 304 Physician Impairment/Substance Abuse: PRN prvides therapeutic alternatives t disciplinary actin. Individuals declining referral will be reprted t the Bard f Medicine. A purpse is t ensure public health and safety by assisting the practitiners. Includes behaviral issues. Dean r designee, r Prgram Directr may suspend resident pending further investigatin if there is reliable infrmatin. PD, faculty r referring party ntifies ffice f GME and prgram chairman. Prgram Directr refers t PRN and mnitrs. RAP may als be cntacted 308 Equal Opprtunity: Discriminatin is prhibited. Discriminatin shuld be reprted t the PD, GME ffice r DEO. Als see USF plicy abve. Key Takeaway: Invlve PD and GME ffice asap. Legal, DEO ffice and ther supprt persnnel can be cntacted as needed Resurces: RAP PRN Olga Skalks, PhD