Entrustable Professional Activities

LG6: Communication with workers, patients, communities, third parties, and other stakeholders

Learning Goal 6

Communication with workers, patients, communities, third parties, and other stakeholders

Communicate with a range of stakeholders, including workers, patients, communities, professional bodies, businesses, health administration, insurers, and employers

This activity requires the ability to:

  • communicate with appropriate stakeholders given the specific context
  • communicate within an appropriate cultural context, and include family and/or carers and other team members
  • apply written consent and privacy considerations when involving employers
  • manage employee / worker / insurer / employer expectations when not in a worker/patient-treating role
  • adopt a worker/patient-centred, employee, or client perspective, ensuring consent to share relevant medical information is acquired
  • select and use appropriate modalities and communication strategies
  • structure conversations intentionally
  • verify understanding of information conveyed
  • negotiate mutually agreed management plans when managing workers/patients
  • develop and implement plans or reports for ensuring actions occur
  • ensure assessment, management, and/or rehabilitation plans are documented
  • compose complex reports for workers/patients, employers, and insurers, including those within the medicolegal context

Professional practice framework domain

Medical expertise

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • anticipate and be able to correct any misunderstandings workers/patients may have about their conditions and/or risk factors
  • recognise occupational factors relevant to illness that need enhancement or clarification
  • write a timely letter or report containing a clear opinion back to the referring doctor or party
  • use evidence-based guidelines to inform opinion
  • compose detailed workers’/patients’ reports in response to worker/patient, workplace, and referrer requests, including appropriately answering questions posed by the referrer
  • use internally consistent recommendations, and make use of best practice guidelines and evidence
  • develop a written management, rehabilitation, and/or return to work plan in conjunction with all relevant parties
  • coordinate medical aspects of care with other professionals towards attaining appropriate and time-defined realistic outcome measures
  • monitor goals and define outcome measures, and keep workers/patients and other relevant parties, including the employer (where appropriate), informed of progress towards this plan
  • use the opportunity for worksite visits to explore issues more holistically, in a broader context and in terms of workers’ health and risk management
  • seek to understand the concerns and goals of workers/patients, and plan management in partnership with them and their family, whanau and/or carers
  • educate workers/patients about the work/environmental-relatedness of their conditions
  • provide information to workers/patients to enable them to make informed decisions about diagnostic, management, and therapeutic options

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • interpret information within referral letters
  • recognise information that needs enhancement or clarification
  • use email and internet, and, where applicable, electronic discharge summaries and prescribing
  • apply knowledge of the scientific basis of health and disease to the management of workers/patients
  • demonstrate understanding of the clinical problems being discussed
  • draft initial reports around workers/patients and environmental issues
  • formulate management plans in partnership with workers/patients

Communication

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • use appropriate communication strategies and modalities for communication, such as emails, face-to-face, or phone calls
  • provide information to workers/patients and referrers
  • write timely, concise, internally consistent, and evidence-based reports
  • use plain language, avoiding jargon, acronyms, and complex medical terms
  • obtain consent to discuss workers’/patients’ management plans with workers’/patients’ primary health care providers
  • communicate effectively with management, OHS staff, unions, and workers on all relevant occupational health areas for organisations
  • manage difficult conversations, such as those regarding performance, fitness for work and community outrage
  • confirm worker/patient understanding of discussions and potential management and rehabilitation plans
  • recognise the role of family or employers in communication
  • identify and mediate differences between the expectations of employers, supervisors, return to work coordinators and workers
  • communicate effectively with policy and decision-makers
  • manage communication with the media as required
  • differentiate between objective and subjective arguments

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • manage consultations involving third parties, such as employers in conflict with employees
  • communicate in written and verbal formats with insurers, relevant employers, and return to work coordinators
  • establish rapport with referring doctors
  • select appropriate modes of communication
  • engage workers/patients in discussions, avoiding the use of jargon
  • check workers’/patients’ understanding of information
  • adapt communication styles in response to workers’/patients’ age, developmental level, and cognitive, cultural, physical, situational, and socioeconomic factors
  • collaborate with worker/patient liaison officers as required
  • encourage and answer questions

Quality and safety

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • recognise workers’/patients’ vulnerability in terms of their history and physical examination
  • implement policies and procedures to manage complaints and negative feedback
  • provide information to workers/patients in a way they can understand before asking for their consent
  • consider workers’/patients’ capacity for decision making and consent, particularly if there is a history or signs of cognitive impairment

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • inform workers/patients of the material risks associated with proposed management plans
  • treat information about workers/patients as confidential

Teaching and learning

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • discuss and explain the purpose, nature, and extent of assessments and third-party assessments to be conducted
  • obtain informed consent or other valid authority before involving workers/patients in teaching

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • respond appropriately to information sourced by workers/patients, and to workers’/patients’ knowledge regarding their condition

Research

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • refer to evidence-based guidelines
  • conduct research in accordance with prescribed ethical and institutional research guidelines
  • provide easily understandable information to workers/patients that is based on guidelines issued by the relevant research authorities and guidelines
  • obtain an informed consent or other valid authority before involving workers/patients in research

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • refer to evidence-based clinical guidelines
  • demonstrate an understanding of the limitations of the evidence and the challenges of applying research in daily practice

Cultural safety

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • manage barriers to effective communication within teams
  • demonstrate culturally safe communication with Aboriginal and Torres Strait Islander and Māori peoples
  • effectively communicate with members of other cultural groups by meeting workers’/patients’ specific communication, cultural, and language needs
  • use qualified language interpreters or cultural interpreters to help meet workers’/patients’ communication needs
  • provide plain language and culturally appropriate written materials to workers/patients and clients when possible

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • identify when to use interpreters
  • allow enough time for communication across linguistic and cultural barriers

Ethics and professional behaviour

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • describe the procedure for obtaining consent for the release of confidential medical records and images to a third party
  • identify secure storage of medical information
  • describe the special reporting requirements and obligations of a medical assessment performed on behalf of a third party, including presentation of information to lawyers and insurers
  • explain to workers/patients the purpose of assessments and the reporting arrangements, and seek consent to collect and release relevant medical information
  • recognise local laws and workers compensation guidelines on incapacity payments and return-to-work
  • encourage and support workers/patients to be well informed about their health, and to use this information wisely when they make decisions
  • recognise social determinants of health when caring for workers/patients
  • demonstrate respectful professional relationships with workers/patients and colleagues
  • prioritise honesty, workers’/patients’ welfare, and community benefit above self-interest
  • develop a high standard of personal conduct, consistent with professional and community expectations
  • outline obligations to workers/patients and their management when conducting third party assessments
  • support workers’/patients’ rights to seek second opinions
  • obtain written consent and discuss with workers/patients when communicating with employers about management and rehabilitation
  • recognise personal health, symptoms of mental health changes, and avenues for self-management

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • manage alternative and conflicting views from relevant parties
  • manage the ethical issues of the two roles of communication with workers/patients and external agencies
  • respect the preferences of workers/patients
  • communicate appropriately, consistent with the context, and respect workers’/patients’ needs and preferences
  • maximise workers’/patients’ autonomy, and support their decision making
  • avoid sexual, intimate, and financial relationships with workers/patients
  • demonstrate a caring attitude towards workers/patients
  • respect workers/patients, including protecting their rights to privacy and confidentiality
  • behave equitably towards all, irrespective of gender, age, culture, socioeconomic status, sexual preferences, beliefs, contribution to society, illness-related behaviours or the illness itself
  • use social media ethically and according to legal obligations to protect workers’/patients' confidentiality and privacy

Leadership, management, and teamwork

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • coordinate a team, including a team of nurses and allied health professionals, in occupational health units
  • use conflict resolution skills to facilitate team interactions
  • involve health managers as part of multidisciplinary teams to obtain resources, data, and access to services for better worker outcomes
  • communicate effectively with team members involved in workers’/patients’ care or rehabilitation, and with workers/patients, their families, and/or carers
  • discuss medical assessments, treatment, management, and rehabilitation plans, and investigations with workers/patients, in a collaborative manner
  • facilitate an environment where all team members feel they can contribute and their opinion is valued
  • communicate accurately and succinctly, and motivate others on the health care team

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • work effectively as part of an occupational health and safety team that may include:
    • environmental scientists
    • ergonomists
    • occupational health nurses
    • occupational hygienists
    • risk engineers
  • answer questions from team members
  • summarise, clarify, and communicate responsibilities of health care team members
  • keep health care team members focused on worker/patient outcomes

Health policy, systems, and advocacy

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • collaborate with other services, such as community health centres and consumer organisations, to help workers/patients navigate the healthcare and workers compensation systems
  • demonstrate the ability to detail legal and other obligations of parties
  • describe the special reporting requirements of a medical assessment performed on behalf of a third party
  • recognise relevant state, hospital, and workplace policies and guidelines in preparing reports
  • source evidence-based information, and prepare specific medical, general, and medicolegal communication, including:
    • expert opinion reports, including that for the general population
    • giving evidence in court
    • giving objective and considered opinions
    • preparing opinions for community advocates or guardianship tribunals

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • communicate with and involve other health professionals as appropriate
  • source information and prepare specific medicolegal communication, including:
    • letters of support on behalf of workers/patients
    • police statements
    • reports for insurers and other relevant third parties