Basic Surgical Training

1
Basic Surgical Training

• Accreditation of Hospitals

2
BSTProcess for accreditation of hospitals

• The Board of Basic Surgical Training accredits
  hospitals not posts
• Clinical experience requirements are general and
  very flexible
• Potential positions are more numerous than the
  selected trainees
• The learning environment, range of clinical
  opportunities and generic competencies are more
  important than specific designated competencies

3
BSTProcess for accreditation of hospitals

• Determination of positions for selected (by RACS)
  trainees in approved (by RACS) hospitals with
  designated (by RACS) BST Supervisors
• Positions are best determined as an employment
  issue through a combination of sources or all of
• Trainees
• Hospitals
• Local BST Supervisors
• Jurisdictions (e.g. Post Graduate Medical
  Councils)

4
BSTProcess for accreditation of hospitals

• Hospital sent pre-inspection form requesting
  information which includes
• Facilities for BST including accommodation and
  internet access particularly to the RACS BST
  website
• Clinical audit processes
• Hospital support for trainees to attend
  compulsory BST courses
• Appropriate surgical and other experience
• Hospital support for BST Supervisors and teachers
• Surgeon commitment to BST programme
• (Copy of form at appendix 1)

5
BSTProcess for accreditation of hospitals

• Appropriate Inspectors selected. Criteria must
  include
• Fellow of the Royal Australasian College of
  Surgeons
• Substantive experience as a senior surgeon
• Current knowledge of hospital systems and
  practices
• Current or co-opted members of the Regional BST
  Supervisors Committee
• (Terms of reference for BST inspectors at
  appendix 2)

6
BSTProcess for accreditation of hospitals

• Completed pre-inspection form returned to
  State/Regional Committee
• Reviewed by Inspectors prior to hospital visit

7
BSTProcess for accreditation of hospitals

• Hospital visit undertaken by Inspectors. Hospital
  inspection form covers detailed information
  regarding
• Hospital support for BST supervisors
• Learning resources for BSTs
• Involvement of surgeons in BST programme
• Trainee feedback
• Interviews with senior hospital staff
• Review of terms/rotations
• Assessment of terms/rotations for BST 3 and 4
• Total number of possible posts
• (Copy of hospital inspection form at appendix
  3)

8
BSTProcess for accreditation of hospitals

• Inspection form completed by Inspectors.
• Sequence
• 1) Inspection form is submitted to the hospital
  for verification and feedback
• 2) Inspection form is submitted to the
  State/Regional BST Supervisors Committee for
  information
• 3) Inspection form is submitted to the Board of
  Basic Surgical Training in Melbourne for approval
  or action as appropriate
• (List of accredited hospitals at appendix 4)

9
BSTProcess for accreditation of hospitalsIssues
for resolution to be addressed in the RACS
submission

• What is the optimal size of a region?
• Accreditations need to be uniform across all
  training regions
• Duration of accreditation (5 years Provisional 1
  year)?
• Timing of survey and accreditation sequence
• External inspectors preferable resource
  implications?
• Possible joint inspections for BST and AST
• Eliminate overlap with Post Graduate Medical
  Council criteria
• Funding of process - RACS/Jurisdictions

10
BSTProcess for accreditation of hospitals

• Related issues
• On-line return of survey information
• Mechanism for appealing accreditation decision
• Alignment of BST process with AST process
• Benchmarking with international
  colleges/academies
• Community/consumer review of guidelines/processes

11
BSTProcess for accreditation of hospitals

• Quality of health care Hospital obligations
• Medication utilization committees
• Blood transfusion committees that analyse use and
  support NHMRC protocols
• Root cause analysis training
• Hand hygiene programmes supported by adequate
  infection control presence
• Employee support programmes for de-briefing of
  trainees related to difficult patient scenarios
• Review of clinical/unit protocols
• Other quality issues