Thank you for trusting me with the care of your patients.
After Hours On Call
As practitioners servicing a large region, sustainability is always front of mind. Safe working hours means better outcomes and safer surgery for patients. We now know that long work hours and overnight on call leads to lack of sleep and fatigue. Fatigue increases the risk of forgetting things or making mistakes at work, car accidents and illness. This isn’t safe for patients or for surgeons.
Dr Clancy is committed to RACS safe hours standards which include a 1 in 4 on call roster. It is not possible or safe for 1 surgeon to provide year round after-hours service.
Dr Clancy has collected information over 12 years about how many people need really urgent treatment after hours, in the two weeks after tonsil, nose and sinus surgery. Less than one in 500 people needed Dr Clancy’s urgent care in the first 12 hours after surgery and less than one in 100 needed Dr Clancy’s urgent care in the first 14 days after surgery. All other problems could have been managed by the emergency department staff. When balancing the known risks of fatigue with this information, the safest option is to have a policy of safe work hours.
Emergencies
If your patient needs urgent care, they should be transported to the nearest hospital emergency department.
South West Healthcare protocol for after-hours ENT emergency care.
Dr Clancy recommends patients stay within one hour of a hospital with an emergency department for two weeks after tonsillectomy, nasal surgery or sinus surgery. The emergency department staff can manage most emergency problems following ENT surgery. Dr Clancy provides training and protocols that enable emergency doctors to effectively manage ENT emergencies. Less than one in a hundred people who have tonsil or nose surgery need emergency surgery for bleeding within 2 weeks of surgery. If emergency surgery is needed when an ENT surgeon is not on call, the emergency department staff will start emergency medical treatment and then arrange transfer to the ENT surgical team at the Geelong Hospital
Protocols for ED management
Sudden Sensorineural Hearing Loss
Epistaxis including post nasal surgery epistaxis
Post tonsillectomy haemorrhage
Post tonsillectomy pain, nausea and vomiting
Note that we use the PROSPECT guidelines for perioperative tonsillectomy pain management, with paracetamol, ibuprofen and oxycodone for children, and paracetamol, celecoxib and ibuprofen in adults
Email and SMS for patients
Data security is paramount to protect patient’s privacy and comply with national privacy legislation. Patients often request we email or text them information about their consultation; they prefer digital information to printed information. This allows them to share the information with relative and to click on links in documents to access videos and other information.
We ask patient’s consent to use SMS and email to send appointment information, appointment reminders, informed financial consent documents for surgery and links to information on our website that is already publicly available.
If a patient asks the surgeon to email information about their health that is covered by the Australian Privacy Principles (most commonly their management plan provided at the end of every consultation), a discussion allowing informed consent is undertaken and the patient makes a decision based on their weighing up of the benefits and risks of sending health information via un-encrypted email.
All correspondence between doctors is managed using RSD or encrypted email.
Triage
We receive more referrals that we can accommodate. All referrals are triaged by to ensure urgent access to patients with urgent problems like cancer, patients needing surgery and and to allow pre-visit tests like audiograms to be completed. We will let you know if we can’t provide an appointment for your patient within a clinically appropriate time frame and suggest alternative pathways for care. If you are concerned about your patient, please contact the practice nurse or Dr Clancy.
Pre Referral Guidelines
The Victorian Government referral guidelines for ENT can be found here.
The information can help the referring doctor to:
- commence treatment before referring a patient.
- know when to refer.
- know how urgent the referral needs to be.
ONLINE RESOURCES
Dr Clancy has developed online resources including a YouTube channel to assist patients in understanding their health problems and treatment options. The videos contain animations to help explain complex problems like cholesteatoma. Dr Clancy uses these resources during consultations and patients respond well to having links to relevant resources texted to their smart phone at the end of the consultation.
The services hub has information for patients and their doctors. To cater for the differing information needs of patients, the information is presented in four ways: fast facts (just 4 things to remember), detailed FAQs, post operative instructions and video explanations.
This page, for Doctors, has protocols to help you manage common ENT problems and links to pre-referral guidelines, to help you choose when and where to refer your patients.
The registration page allow patients to complete pre-appointment information and upload their referral or other pertinent documents using an encrypted connection.
Patients can feel anxious in anticipation of office endoscopy; you can reduce their anxiety by showing them the the video of a patient having office endoscopy prior to their appointment.
You can use the information in the services hub to start treatment for your patient, before their first appointment with Dr Clancy. There are links to videos to show your patients how to use saline nasal rinses, steroid nasal sprays, ear drops, nasal ointments, first aid for blood noses and ear plugs.
After surgery, patients receive printed discharge information. This is also accessible online from their smart phones, reducing the risk of lost information.
SOMETHING MISSING?
Is there something you or your patients need from this website that you can’t find? Let us know and we’ll create new content to suit the needs of you and your patients.
Continuous improvement
We conduct patient satisfaction surveys annually. In 2015 our patients told us that they weren’t always clear about the next step in treatment following their consultation. All patients now receive a printed plain English explanation of their problem and a plan for what they need to do next. You will receive a copy of this plan as part of my correspondence back to you after each consultation.
Please contact Dr Clancy or the practice nurse if you have suggestions for how we can improve our care of your patients.
Surgical Audit, Peer Review and Quality activities
Dr Clancy maintains a continuous audit of surgical complications. This data is updated to the website annually and can be accessed on the Quality page.
Dr Clancy engages in self-reflective practice and peer-reviewed audit via annual presentations to the Society of Country ENT Surgeons meeting and the South West Healthcare annual surgical audit meeting.
If you are aware that your patient had a complication from surgery, an unsatisfactory improvement in symptoms after medical treatment or any other concern regarding their treatment with Dr Clancy or an Associate or Locum working in the practice, please let Dr Clancy know. You can do this via the contact page or you can call Dr Clancy directly on 5560 5411.