Curriculum standards
Entrustable Professional Activities
LG7: Emergency and longitudinal care
Emergency and longitudinal care
Manage emergencies and coordinate the longitudinal care of patients with chronic illness and/or long-term health issues
This activity requires the ability to:
- recognise and assess patients requiring urgent care that may be seen in the sexual health setting, and facilitate patients’ care in a timely manner
- recognise and manage anaphylaxis, and perform basic life support according to resuscitation council guidelines
- manage chronic and advanced conditions, complications, disabilities, and comorbidities
- develop management plans and goals in consultation with patients, families, and/or carers
- facilitate patients’ and/or families’ and/or carers’ self-management and self-monitoring
- collaborate with other care providers
- ensure continuity of care
- engage with the broader health policy context
Professional practice framework domain
Medical expertise
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- regularly assess and review care plans for patients with chronic conditions and disabilities based on short- and long-term clinical and quality of life goals, including people living and aging with HIV
- ensure patients contribute to their needs assessments and care planning
- monitor treatment outcomes, effectiveness, and adverse events
- coordinate patients’ management in a multidisciplinary team environment, including collaborating with other specialties as required
- systematically identify causes of acute deterioration in health status and levels of physical and cognitive functioning
- ensure appropriate initial management of emergencies, such as anaphylaxis
- ensure appropriate referral for emergency ongoing care
- provide urgent care when required and appropriate
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- assess patients’ knowledge, beliefs, concerns, and daily behaviours related to their chronic condition and/or disability and its management
- provide documentation on patients’ presentation, management, and progress, including key points of diagnosis and decision making, to inform coordination of care
- recognise seriously unwell patients requiring immediate care
- identify potential causes of current deterioration, and comply with escalation protocols
- facilitate initial tests to assist in diagnosis and develop management plans for immediate treatment
Communication
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- encourage patients’ self-management through education to take greater responsibility for their care, and support problem solving
- encourage patients’ access to self-monitoring devices and assistive technologies
- communicate with multidisciplinary team members, and involve patients in that dialogue
- negotiate realistic treatment goals, and determine and explain the expected prognoses and outcomes
- employ communication strategies appropriate for younger patients or those with cognitive difficulties
- explain the situation to patients in a sensitive and supportive manner, avoiding jargon and confirming their understanding
- determine the level of health literacy of individual patients and their level of understanding of agreed care decisions
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- provide healthy lifestyle advice and information to patients on the importance of self-management
- work in partnership with patients, and motivate them to comply with agreed care plans
- demonstrate communication skills to sufficiently support the function of multidisciplinary teams
- if possible, determine patients’ understanding of their diseases and what they perceive as the most desirable goals of care
- triage patients requiring urgent care
Quality and safety
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- use innovative models of chronic disease care, using telehealth and digitally integrated support services
- review medicine use and ensure patients understand safe medication administration to prevent errors
- support patients’ self-management by balancing between minimising risk and helping patients to become more independent
- participate in quality improvement processes impacting on patients’ abilities to undertake normal activities of daily living
- identify evidence-based practice gaps using clinical indicators, and implement changes to improve patients’ outcomes
- coordinate and encourage innovation, and objectively evaluate improvement initiatives for outcomes and sustainability
- analyse adverse incidents and sentinel events to identify system failures and contributing factors
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- participate in continuous quality improvement processes and clinical audits on chronic disease management
- identify activities that may improve patients’ quality of life
- evaluate the quality and safety processes implemented within the workplace, and identify gaps in their structure
Teaching and learning
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- contribute to the development of clinical pathways for chronic diseases management and comorbidities, including people living and aging with HIV, based on current clinical guidelines
- educate patients to recognise and monitor their symptoms, and undertake strategies to assist their recovery
- mentor and train others to enhance team effectiveness
- provide constructive feedback to junior colleagues to contribute to improvements in individuals’ skills
- seek guidance and feedback from healthcare teams to reflect on encounters and improve future patients’ care
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- use clinical practice guidelines for chronic diseases management
- contribute to team education, including education for junior colleagues
Research
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- prepare reviews of literature on patients' encounters to present at journal club meetings
- search for and critically appraise evidence to resolve clinical areas of uncertainty
- evaluate the value of treatments in terms of relative and absolute benefits, cost, potential patient harm, and feasibility
- evaluate the applicability of the results of clinical studies to the circumstances of individual patients, especially those with multiple comorbidities
- specify research evidence to the needs of individual patients
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- search literature using problem / intervention / comparison / outcome (PICO) format
- recognise appropriate use of review articles
- use information from credible sources to aid in decision making
- refer to evidence-based clinical guidelines and protocols on acutely unwell patients
- demonstrate an understanding of the limitations of the evidence and the challenges of applying research in daily practice
Cultural safety
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- encourage patients from culturally and linguistically diverse backgrounds to join local networks to receive the support needed for long-term self-management
- negotiate health care decisions in a culturally appropriate way by considering variation in family structures, cultures, religion, or belief systems, particularly in the priority groups seen in sexual health medicine
- integrate culturally appropriate care of Aboriginal and Torres Strait Islander peoples and Māori into patients’ management
- consider cultural, ethical, and religious values and beliefs in leading multidisciplinary teams
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- provide culturally safe chronic disease management
- practise cultural competency appropriate for the community serviced
- proactively identify barriers to care access
Ethics and professional behaviour
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- share information about patients’ health care, consistent with privacy laws and confidentiality and professional guidelines
- use consent processes for the release and exchange of health information
- assess patients’ decision-making capacity, and appropriately identify and use alternative decision makers
- consider the consequences of delivering treatment that is deemed futile, directing to other care as appropriate
- facilitate interactions within multidisciplinary teams respecting values, encouraging involvement, and engaging all participants in decision making
- demonstrate critical reflection on personal beliefs and attitudes, including how these may affect patient care and health care policy
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- share information between relevant service providers
- acknowledge and respect the contribution of health professionals involved in patients’ care
- communicate medical management plans as part of multidisciplinary plans
- establish, where possible, patients’ wishes and preferences about care
- contribute to building a productive culture within teams
Judgement and decision making
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- implement stepped care pathways in the management of chronic diseases and disabilities
- recognise patients’ needs in terms of both internal resources and external support on long-term health care journeys
- recognise the need for escalation of care, and escalate to appropriate staff or services
- integrate evidence related to questions of diagnosis, therapy, prognosis, risks, and cause into clinical decision making
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- recognise personal limitations and seek help in an appropriate way when required
- involve additional staff to assist in a timely fashion when required
Leadership, management, and teamwork
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- coordinate whole-person care through involvement in all stages of patients’ care journeys
- use a multidisciplinary approach across services to manage patients with chronic diseases and disabilities
- develop collaborative relationships with patients, families, carers, and a range of health professionals
- work collaboratively with staff in the emergency department, intensive care, and other subspecialty inpatient units when relevant
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- participate in multidisciplinary care for patients with chronic diseases and disabilities, including organisational and community care, on a continuing basis, appropriate to patients’ context
- encourage an environment of openness and respect to lead effective teams
Health policy, systems, and advocacy
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- use health screening for early intervention and chronic diseases management
- assess alternative models of care delivery to patients with chronic diseases and disabilities
- participate in government initiatives for chronic disease management to reduce hospital admissions and improve patients’ quality of life
- help patients access initiatives and services for patients with chronic diseases and disabilities
- use a considered and rational approach to the responsible use of resources, balancing costs against outcomes
- prioritise patients’ care based on need, and consider available resources
- demonstrate understanding of the social determinants of sexual health and wellbeing, such as financial impact, stable housing, education and literacy, transport, and accessibility
- collaborate with other specialist colleagues to develop policies and protocols for areas of need
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- demonstrate awareness of government initiatives and services available for patients with chronic diseases and disabilities, and display knowledge of how to access them
- understand the systems for the escalation of care for deteriorating patients
- understand the role of clinician leadership and advocacy in appraising and redesigning systems of care that lead to better patient outcomes