Entrustable Professional Activities

LG13: Neonatal retrieval medicine

Learning Goal 13

Neonatal retrieval medicine

Managing emergency referral for possible neonatal and in utero transfers, consultation without the need for transfer, and undertaking emergency neonatal retrieval

This activity requires the ability to:

  • triage emergency referrals for retrieval or advice
  • collaborate with obstetricians in triaging requests for emergency in utero transfer
  • undertake an emergency neonatal retrieval
  • manage clinical and logistical elements of the retrieval process
  • lead the retrieval team
  • manage care of the patient during transport
  • handover to the receiving care team

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:

  • assess patients’ eligibility for transport
  • recognise resource limitations of referring centres related to personnel, setting, medications, and equipment
  • provide pre-transfer advice to stabilise the patient, using telehealth where appropriate and available
  • ensure the availability and functionality of appropriate equipment
  • verify medication availability and calculations
  • maintain thermoregulation
  • manage respiratory support
  • monitor haemodynamic stability
  • provide ongoing assessment and interventions

direction
Requires some supervision

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

The trainee may:

  • recognise the process of assessing and initiating neonatal retrieval protocols
  • identify the need for retrieval, and prepare patients in advance
  • accept patients from retrieval teams and support transitions to the unit

Communication

confident
Ready to perform without supervision

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

The trainee will:

  • discuss ongoing care plans with families, whānau, and/or carers, and receiving medical teams
  • obtain comprehensive handovers from referring facilities
  • coordinate with transport teams and receiving units
  • collaboratively establish team member roles and responsibilities
  • conduct a pre-transport discussion with families, whānau, and/or carers
  • document case histories, vital signs, interventions, clinical changes, and transport timelines

direction
Requires some supervision

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

The trainee may:

  • provide partially complete or incorrectly structured handovers
  • refer patients for retrieval

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:

  • record quality metrics
  • participate in clinical debriefs and audits aimed to improve quality of care
  • debrief the transport team and document lessons learnt

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 concerning patients’ safety
  • demonstrate a systematic approach to improving the quality and safety of healthcare teams and patients during retrievals

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:

  • ensure staff are informed about the relevant local protocols for retrievals and how to access them
  • develop and maintain skills in high-acuity, low-frequency events
  • engage in multidisciplinary teaching relevant to retrieval medicine
  • support the teaching and learning of personnel in referring centres

direction
Requires some supervision

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

The trainee may:

  • maintain knowledge of relevant protocols related to retrievals in their health service

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:

  • demonstrate patient- and family-centred care, taking into account and being respectful of cultural or social attitudes to pregnancy, parenting, birth, and illness
  • consider the impact of dislocation from social and cultural supports
  • refer to appropriate support services, such as social work

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:

  • obtain informed consent from parents, families, whānau, and/or carers
  • demonstrate high standards of professional behaviour when interacting with external stakeholders

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:

  • appraise appropriate mode and team composition for transport, considering patients’ location, acuity, asset and personnel availability, and relevant external factors
  • confirm transport vehicle readiness
  • consider external factors that may extend transit time, and have a backup plan
  • triage clinical needs of referrals for retrieval

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:

  • ensure access to the appropriate equipment
  • ensure equipment functionality
  • direct the activities of the team
  • maintain situational awareness
  • adapt plans based on changing conditions
  • anticipate and manage unexpected events with effective leadership and teamwork

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:

  • follow local processes and guidelines