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Safeguarding Healthcare Podcast Series

Safeguarding Healthcare leads you through the intricate corridors of hospitals, taking you behind closed doors on an extraordinary journey. This is the podcast that holds a stethoscope to the beating heart of hospitals to reveal the reasoning behind the clinical governance decision making process.

Join host, Dr David Rankin, a 35-year veteran of medical administration, as he puts some of Australia’s most senior hospital managers in the hot seat to challenge them with major and often complex hypothetical challenges that reflect some of the most contentious issues facing modern medicine. This podcast offers an unfiltered view of the web of patient safety, medical ethics, and healthcare decision-making.

Discover how these passionate professionals navigate medical minefields, striving to ensure the highest standards of care, all while grappling with a broad and ever-evolving healthcare landscape. Whether you’re a seasoned healthcare practitioner, a patient seeking insight into the system, or simply curious about the inner workings of hospitals, this podcast offers an enlightening perspective on the complexities of modern medicine.

Latest Episode

22 May 2024 – A shocking sterilisation surprise

What would you do if you found surgical instruments not being sterilised? In this episode of ‘Safeguarding Healthcare – the Essentials of Clinical Governance’, Dr David Rankin presents such a scenario to Professor Mary O’Reilly, Chief Medical Officer at Austin Health in Melbourne and an infectious disease specialist. Together, they navigate the aftermath of a potential sterilisation oversight involving endoscopy equipment. From assessing patient risk to addressing system failures and ensuring transparent communication with patients, Professor O’Reilly explains the steps that need to be taken. The discussion highlights the importance of proactive measures, open disclosure, and fostering a supportive, blame-free culture within healthcare teams.

DISCLAIMER: The views, thoughts, and opinions expressed in these Podcasts are the speaker’s own and do not represent the views, thoughts, and opinions of the Royal Australasian College of Medical Administrators (RACMA). The material and information presented here is for general information purposes only, and should not be considered health, legal or financial advice. The cases discussed in the Podcast may be specific to the speaker’s organisation or location, and may not be applicable to other organisations, states, territories or countries. RACMA does not endorse, approve, recommend, or certify any information, product, process, service, or organisation presented or mentioned in this Podcast, and information from this Podcast should not be referenced in any way to imply such approval or endorsement. RACMA will not be held responsible for any losses, damages, or liabilities that may arise from the use of this Podcast. The Podcast may contain descriptions of health incidents that may be graphic and triggering for some people, so listener discretion is advised.

All Episodes

Clashing clinical cultures

In this episode of ‘Safeguarding Healthcare – the Essentials of Clinical Governance’, Dr David Rankin explores the complexities of medical administration with Dr Paul Eleftheriou, Principal at Nous Group and former Chief Medical Officer at Western Health. They discuss a hypothetical scenario where tension between medical and nursing staff has contributed to a patient’s avoidable death, emphasising the pivotal role of culture in clinical governance. Dr Eleftheriou highlights the need for structured approaches, diligent diagnosis of problems, and strategic interventions, whether through internal collaboration or external support. By focusing on motives, implementing clear expectations, and leveraging resources, they conclude that it is possible for medical administrators to navigate and transform challenging organisational cultures to safeguard patient care effectively.

AI deceptions in healthcare

How will artificial intelligence influence healthcare in the near future; what is the potential and what are the pitfalls? In this episode of ‘Safeguarding Healthcare – the Essentials of Clinical Governance’, host Dr David Rankin challenges senior healthcare administrator and healthcare futurist Professor Erwin Loh with a striking scenario. Together they delve into what to do when AI makes a mistake, explores biases, grapple with legal implications, and unravel the potential of AI to revolutionise medical decision-making. And they navigate the ethical and practical concerns that are raised. Listen to gain insights into the evolving landscape of AI in healthcare, and what the near future may hold.

Policeman or coach?

What would you do if a senior psychiatrist was slacking off, and staff had gone behind management’s back to report the matter? In this episode of Safeguarding Healthcare, Dr David Rankin presents Dr Leigh Haysom, the Clinical Director of Adolescent Health and Director of Medical Services for NSW’s Justice Health and Forensic Mental Health Network, with this difficult scenario. Dr Haysom offers insights into the complexities of managing poor performance and navigating potential legal ramifications. From addressing communication breakdowns to restoring trust among staff and executives, this episode explores essential elements of clinical governance.

Improving Quality Improvement

In this episode of ‘Safeguarding Healthcare – the Essentials of Clinical Governance’, host Dr David Rankin interviews Professor Andrew Johnson from James Cook University, a veteran medical administrator now working as a consultant. They dissect the importance of measuring improvement effectively and addressing risk tolerance within the hospital system. Prof. Johnson suggests a shift in focus towards understanding and managing complexity in healthcare systems. The conversation offers practical strategies for enhancing compliance, monitoring care processes, and building resilience to tackle unexpected events.

Culture Eats Strategy for Breakfast

In this episode of “Safeguarding Healthcare – the Essentials of Clinical Governance,” Dr Liz Mullins, the Director of Medical Services for Bega Valley Health Service, discusses engaging surgical staff in quarterly specialist craft group meetings with host Dr David Rankin. They address issues of relevance, consultation and the importance of mutual benefit. Dr Mullins emphasizes the need for proactive engagement, personalized communication, and the role of directors of medical services in fostering a culture of trust and collaboration. The conversation extends to meeting dynamics, system-focused approaches to problem-solving, and practical strategies for improving attendance and measuring medical engagement.

Deciphering Consent

What does a medical administrator do when a patient who suffers complications from surgery complains that they weren’t warned? In this episode of Safeguarding Healthcare, Dr David Rankin delves into the intricate world of informed consent with Dr Tony Sara, who is a Medical Advisor at South Eastern Sydney Local Health District, President of the Australian Salaried Medical Officers’ Federation and a fellow of the Australian Institute of Digital Health. Their discussion explores various aspects of informed consent, from legal principles and nuances to the use of interpreters, consent in emergency situations, and more. Dr Sara highlights the responsibility of medical managers in monitoring complication rates and taking action when necessary.

Pillar of the Community

What does a Medical Administrator do when an aging, small town local doctor, in a region with medical staff shortage, starts to get too tired and makes mistakes? In this episode of Safeguarding Healthcare, host Dr David Rankin is in discussion with Associate Professor Kathleen Atkinson. Kath is a very senior clinician and medical administrator with over 35 years’ experience as a rural generalist. She has held health leadership, medical education and clinical governance roles in Tasmania, New South Wales, Queensland, WA and the Royal Flying Doctor Service. They explore a common scenario of an aging rural GP facing burnout and discuss the implications for patient safety. The podcast delves into the complexities of supporting aging practitioners, managing confidentiality, and the need for a sustainable and attractive career path for the future medical workforce. Join Dr Rankin and Professor Atkinson as they navigate the landscape of rural healthcare, offering solutions.

The Art of Departmental Management

What are the best approaches to being an effective medical department manager — even if you come to the job reluctantly? In this episode of Safeguarding Healthcare, host Dr David Rankin speaks with Dr Simon Collins about the challenges faced by medical department heads, focusing on a hypothetical scenario involving tensions between emergency and anaesthetic departments. The episode covers issues like ensuring safe coverage, managing relationships with other departments, addressing after-hours attendance, and educating junior doctors. Dr Collins, who is the Acting General Manager and director of Medical Services at Bankstown Lidcombe Hospital in the Southwestern Sydney Local Health District, provides insights into building credibility, handling moonlighting, and fostering collaboration between critical care departments.

Treating Tragedy with Restorative Justice

When an inpatient takes his own life, it sparks myriad issues and concerns for any Medical Administrator. In this episode, Dr David Rankin and Dr Nick O’Connor explore the challenges of Medical Administration in this tragic scenario, through the lens of the restorative justice approach. Dr O’Connor is the Clinical Lead of the Mental Health Patient Safety Program for the NSW Clinical Excellence Commission. He is a psychiatrist with more than 25 years’ experience in clinical leadership and assessing medical practitioners for the NSW Medical Council. David and Nick discuss the hypothetical case of Ed, a psychiatric patient who experiences a devastating outcome. This episode emphasizes a shift from blame to systemic understanding, tackling issues like psychological safety and compounded harm.

Keeping sight of patient safety

How would a seasoned Medical Administrator handle a doctor whose eyesight is failing? In this episode of Safeguarding Healthcare Dr David Rankin delves into the complex world of medical administration with the Deputy Chief Medical Officer and Former Head of the Gynaecology Unit at Western Health, Dr Rupert Sherwood. Dr Sherwood is presented with the challenges and dilemmas raised by a scenario involving a seasoned gynaecologist whose deteriorating eyesight raises concerns about patient safety and the potential impact on their clinical practice. Dr Sherwood candidly discusses the sensitive issues surrounding this situation, including the need for a confidential, supportive, and well-documented approach. The conversation offers perspectives on balancing patient care, professional integrity, and the emotional and financial considerations that come into play.

An infant lost: navigating ethical quandaries

In this episode of Safeguarding Healthcare, we look at what would happen in a hospital when a newborn dies after a mother and midwife choose to ignore hospital protocols. Host and veteran medical administrator Dr David Rankin presents a senior NSW Health Ministry medical advisor, Dr Paul Douglas, with this hot-button scenario, in a medical landscape where patients are demanding more say in their care. Dive into the heart of the matter as they discuss patient autonomy, policy adherence, and the profound impacts such cases can have on medical team members — some of whom will be traumatized, while others are left angry. Gain insights into the crucial role of documentation, and the pursuit of a culture that prioritizes patient well-being.

Considering the passioned proposal

In this episode of Safeguarding Healthcare, seasoned medical administrator Professor Gavin Frost and host Dr David Rankin discuss the complex scenario of a young, enthusiastic surgeon who is proposing a novel technique for pediatric diabetes management. They discuss the challenges, considerations, and stakeholder involvement necessary for such a venture, from the importance of research and evidence to engaging with various professionals and organizations. Prof. Frost’s insights and advice on clinical governance provide a perspective on ensuring the safety and success of innovative medical initiatives, and how they might, or might not, be tackled.

Contagious insights – managing worsening infection rates

In this episode, another senior medical administrator is confronted with a challenging scenario: how to address high hospital-acquired infection rates. Clinical governance veteran Dr David Rankin speaks with Dr Peter Lowthian, who has worked as a Director of Medical Services and who currently serves on the boards of a large private hospital and the Australasian Cardiac Surgery Research Institution. The two discuss infection issues, particularly focusing on urinary tract infections in orthopedic wards, emphasizing the importance of data accuracy, involving clinicians in data collection, and individualized data feedback to drive accountability and change.

An auditing avalanche

In this episode of Safeguarding Healthcare, we take a deep dive into the world of healthcare audits, their benefits, and pitfalls. Clinical governance veteran Dr David Rankin speaks with Brigadier Dr Darrell Duncan, a highly experienced administrator who is currently responsible for reviewing the standards of care provided to members of the Australian Defence Force. Dr Duncan emphasizes the need to shift from compliance-focused audits to a patient-centric, continuous quality improvement approach. And he highlights the importance of identifying risks through staff engagement and effective communication, fostering a culture of accountability, involving medical staff in the audit process, and fully integrating quality improvements.

The clinical governance grey zone

Let veteran medical administrator Dr David Rankin be your guide through another minefield, as he challenges a senior hospital medical administrator with a staffing situation that threatens to impact patient safety. Dr Rankin explores a complex scenario involving an aging senior surgeon with Professor Alan Sandford AM, the Director of Medical Academic Development – Regional Medical Pathway, Central Queensland & Wide Bay Hospital and Health Services. Explore the ethical dilemmas surrounding aging medical professionals, the duty of care to patients and colleagues, and the delicate balance of maintaining respect while addressing performance concerns. And learn about the strategies for gracefully transitioning senior staff members, while ensuring patient safety.

Navigating the nightmare of wrong site surgery

What should administrators do and what’s best for the patient and the hospital when a terrible mistake takes place? In this episode of “Safeguarding Healthcare”, Dr. David Rankin hosts Dr. Helen Parsons, the District Director Medical Services for the Nepean Blue Mountains Local Health District, as they delve into a nightmare scenario – a wrong-site surgery. Learn about the protocols, patient safety, ethics and legal consequences that emerge after a patient suffers from this terrible mistake, and explore necessary immediate actions, the formation of review teams, and the importance of a no-blame culture in preventing recurrences.

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