Entrustable Professional Activities

EPA 9: Clinic management

EPA 9

Clinic management

Manage an outpatients clinic

This activity requires the ability to:

  • communicate with patients
  • manage clinic services
  • oversee quality improvement activities
  • liaise with other health professionals and team members
  • demonstrate problem-solving skills
  • engage with the broader health policy context and empower primary health care providers to be involved in cardiac care
  • liaise with health authorities when appropriate

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:

  • effectively identify and address current clinical concerns as well as longer-term clinical objectives, as appropriate to patient context
  • evaluate environmental and lifestyle health risks, and advocate for healthy lifestyle choices
  • create accurate and appropriately prioritised problem lists in the clinical notes or as part of ambulatory care reviews
  • maintain up-to-date documentation on patients' presentation, management, and progress, including key points of diagnosis and decision making to inform coordination of care

direction
Requires some supervision

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

The trainee may:

  • demonstrate understanding of the importance of prevention, early detection, health maintenance, and chronic condition management

Communication

confident
Ready to perform without supervision

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

The trainee will:

  • help patients navigate the healthcare system to improve access to care by collaborating with other services, such as community health centres and consumer organisations
  • use telehealth and digitally integrated support services to enable patients' access to care

direction
Requires some supervision

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

The trainee may:

  • wherever practical, meet patients' specific language and communication needs, such as the appropriate use of interpreter services and translated materials
  • work in partnership with patients and motivate them to comply with agreed care plans

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:

  • practice health care that maximises patient safety
  • adopt a systematic approach to the review and improvement of professional practice in the outpatients clinic setting
  • identify aspects of service provision that may be a risk to patients' safety
  • contribute to the development of clinical pathways for chronic diseases management based on current clinical guidelines
  • ensure that patients are informed about fees and charges

direction
Requires some supervision

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

The trainee may:

  • take reasonable steps to address issues if patients' safety may be compromised
  • understand a systematic approach to improving the quality and safety of health care
  • participate in organisational quality and safety activities, including clinical incident reviews
  • use clinical practice guidelines for chronic diseases management

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:

  • evaluate own professional practice
  • demonstrate effective learning behaviours and self-evaluation
  • educate junior colleagues
  • maintain professional continuing education standards relevant to the profession

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
  • consult current research on procedures and investigations

Research

confident
Ready to perform without supervision

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

The trainee will:

  • obtain informed consent or other valid authority before involving patients in research
  • search for and critically appraise evidence to resolve clinical areas of uncertainty

direction
Requires some supervision

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

The trainee may:

  • make therapeutic decisions according to the best evidence
  • recognise where evidence is limited, compromised, or subject to bias or conflict of interest

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:

  • apply knowledge of the cultural needs of the community, and adapt practice to improve patient engagement and health care outcomes
  • provide culturally safe chronic disease management
  • mitigate the influence of own culture, beliefs, and biases on decision making and interactions with patients

direction
Requires some supervision

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

The trainee may:

  • consider the social, economic, cultural, and behavioural factors influencing health, both at individual and population levels

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:

  • identify and respect boundaries that define professional and therapeutic relationships
  • respect the roles and expertise of other health professionals
  • manage own time and workload (i.e. be punctual, communicate with patients in a timely way, and ensure schedule is feasible)
  • comply with the legal requirements of preparing and managing documentation
  • demonstrate awareness of financial and other conflicts of interest
  • comply with consent processes, privacy law, and professional guidelines about confidentiality when sharing patient information

direction
Requires some supervision

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

The trainee may:

  • understand the responsibility to protect and advance the health and wellbeing of individuals and communities
  • maintain the confidentiality of documentation, and store clinical notes appropriately
  • ensure the use of social media is consistent with ethical and legal obligations

Judgement and decision making

confident
Ready to perform without supervision

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

The trainee will:

  • integrate prevention, early detection, health maintenance, and chronic condition management into clinical practice where relevant
  • work to achieve optimal and cost-effective patient care that allows maximum benefit from the available resources

direction
Requires some supervision

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

The trainee may:

  • understand the appropriate use of human resources, diagnostic interventions, therapeutic modalities, and health care facilities

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:

  • prepare for and conduct clinical encounters in a well-organised and efficient manner
  • work effectively as a member of multidisciplinary teams or other professional groups
  • ensure all important discussions with colleagues, multidisciplinary team members, and patients are appropriately documented
  • review discharge summaries, notes, and other communications written by junior colleagues
  • support colleagues who raise concerns about patient safety

direction
Requires some supervision

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

The trainee may:

  • attend relevant clinical meetings regularly

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:

  • demonstrate capacity to engage in the surveillance and monitoring of the health status of populations in the outpatient setting
  • maintain good relationships with health agencies and services
  • apply the principles of efficient and equitable allocation of resources to meet individual, community, and national health needs
  • help patients access initiatives and services for people with chronic diseases and disabilities

direction
Requires some supervision

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

The trainee may:

  • identify common population health screening and prevention approaches
  • demonstrate awareness of government initiatives and services available for patients with chronic diseases and disabilities, and knowledge of how to access them