Safety Policy

Introduction:

The Royal College of Physicians and Surgeons of Canada mandates the residency program committee to have a written policy governing resident safety related to travel, patient encounters and patient transfers. The policy should allow resident discretion and judgment regarding their personal safety and ensure residents are appropriately supervised during all clinical encounters.

The document, Postgraduate Medical Education Health and Safety Policy available at:
http://www.fhs.mcmaster.ca/postgrad/documents/HPSP.pdf provides procedures for reporting and responding to specific circumstances are contained in that document. The Neonatal Perinatal Medicine Fellowship Program formally acknowledges, endorses and agrees to adhere to these guidelines.

The concept of postgraduate trainee safety includes physical, emotional, and professional security. This policy is periodically revised at the level of the Residency Program Committee (RPC).

KEY RESPONSIBILITIES

For postgraduate trainees:

  • To provide information and communicate safety concerns to the program and to comply with safety policies

For residency training programs:

  • To act promptly to address identified safety concerns and incidents and to be proactive in providing a safe learning environment

PHYSICAL SAFETY

  • When postgraduate trainees are traveling for clinical or other academic assignments by private vehicle, it is expected that they maintain their vehicle adequately and travel with appropriate supplies and contact information. Provincial laws prohibit cell phone use and text messaging in the performance of residency duties while driving.
  • For long distance travel for clinical or other academic assignments, it is expected that postgraduate trainees will ensure that a colleague or the home program office is aware of their itinerary.
  • Postgraduate trainees are not to be on call the day before long distance travel for clinical or other academic assignments by car. When long distance travel is required in order to begin a new rotation, the trainee must request that they not on call on the last day of the preceding. If this cannot be arranged then there should be a designated travel day on the first day of the new rotation before the start of any clinical activities.
  • Postgraduate trainees are not to be  expected to  travel  long  distances during  inclement weather  for  clinical or other academic assignments. If such weather prevents travel, the resident  is  expected  to contact the program office promptly. Assignment of an alternate activity is at the discretion of the Program Director.
  • Postgraduate trainees should not work alone after hours in health care or academic  facilities  without adequate support from Security / Protection Services.
  • Postgraduate trainees are not expected to work alone at after-hours clinics.
  • Residents are not expected to make unaccompanied home visits unless they have had training relevant to the context.
  • Postgraduate trainees are not to communicate with patients or families using a method that discloses the trainee’s personal contact information.
  • Call rooms and lounges must provide trainees with a healthy and secure environment.
  • It is expected that postgraduate trainees will not walk alone for any major or unsafe distances at night.
  • It is expected that postgraduate trainees will arrange safe transportation home if they feel unduly fatigued after their duty hours.
  • Postgraduate trainees are not to assess potentially violent or psychotic patients without the backup of security, and an awareness of accessible exits.
  • The physical space requirements for management of violent patients must be provided where appropriate.
  • Special training must be provided to postgraduate trainees who are expected to encounter aggressive patients.
  • Site orientations must include a review of local safety procedures. As employees of the institution, postgraduate trainees must be aware of and follow the institution’s policies and procedures.
  • Postgraduate trainees are expected to familiarize themselves with the location and services offered by the institution’s Occupational Health and Safety Office. This includes familiarity with policies and procedures for infection control and protocols following exposure to contaminated fluids, needle stick injuries, and reportable infectious diseases.
  • Postgraduate trainees must observe universal precautions and isolation procedures.
  • Postgraduate trainees must keep their required immunizations up to date. Overseas travel immunizations and advice should be sought well in advance when traveling abroad for electives or meetings.
  • Postgraduate trainees working in areas of high and long term exposure to toxic substances, including but not limited to chemotherapeutic agents, re-agent dyes etc., must follow the institutional safety policies.
  • Postgraduate trainees working in areas of high and long term exposure to radiation must follow radiation safety policies and minimize their exposure according to current guidelines.
  • Radiation protective garments, such as aprons, gloves and neck shields, must be used by all postgraduate trainees using fluoroscopic techniques.
  • Pregnant trainees are expected to be aware of specific risks to themselves and their fetus in the training environment and request accommodations where appropriate.

PSYCHOLOGICAL SAFETY

  • Learning environments must be free from intimidation, harassment, and discrimination.
  • When a postgraduate trainee’s performance is affected or threatened by poor health or psychological conditions, it is expected that the trainee will be granted a leave of absence and receive appropriate support. Such trainees are not to return to work until an appropriate assessor has declared them ready.
  • The program has an Ombudsman for consultation if residents are in difficulty.
  • Residents should be aware of and have easy access to the available sources of immediate and long- term help for psychological problems, substance abuse problems, harassment, and inequity issues.

PROFESSIONAL SAFETY

  • Postgraduate trainees may experience conflicts between their ethical or religious beliefs and the training requirements and professional obligations of physicians. Resources are to be made available to residents to deal with such conflicts. Examples include the College of Physicians and Surgeons of Ontario.
  • Programs are bound by PARO contract allowances for religious holidays.
  • Postgraduate trainees must have adequate support from the program following an adverse event or critical incident.
  • Programs must promote a culture of safety in which postgraduate trainees are able to report and discuss adverse events, critical incidents, ‘near misses’, and patient safety concerns without fear of punishment.
  • Residency program committee members must not divulge information regarding residents. It is the responsibility of the residency Program Directors to make the decision and to disclose information regarding residents (e.g. personal information and evaluations) outside of the residency program committee and to do so only when there is reasonable cause. The resident file is confidential.
  • Programs must be aware of and comply with the Freedom of Information and Protection of Privacy Act (FIPPA) in relation to postgraduate trainee.
  • Postgraduate trainee feedback and complaints must be handled in a manner that ensures trainee anonymity, unless the trainee explicitly consents otherwise. However, in the case of a complaint that must be dealt with due to its severity or threat to others, a Program Director may be obliged to proceed against the complainant’s wishes. Depending on the nature of the complaint, the affiliated institution and/or the College of Physicians and Surgeons of Ontario may need to be informed and involved. In general, the Program Director should serve as a resource and advocate for the resident in the complaints process.
  • Residents must be members of the CMPA and follow CMPA recommendations in the case of real, threatened, or anticipated legal action.

Sources of assistance for Trainees

Mohawk Shared Services, powered by Lifeworks: Employee Assistance Program

Employee Assistance
Human Solutions provides counseling, substance abuse and addictions, behavioral health care, bereavement and crisis management. All services are fully covered for all residents within Hamilton Health Sciences Corporation.

PARO Helpline: 1 866 HELP-DOC
The PARO 24 Hour Helpline is available to Trainees, their partners and family members. In order to provide this service, PARO has partnered with Distress Centres of Toronto and counselors provide counseling or referrals support related to:

  • Stress management
  • Eating disorders
  • Sexual, emotional or physical abuse
  • Anxiety
  • Anger management
  • Depression
  • Gender issues
  • Intimidation or harassment
  • Substance abuse
  • Relationship counseling
  • Career or work-related crisis
  • Sexual issues

Postgraduate Medical Education Office McMaster University
MDCL 3101 (905) 525-9140 ext. 22118

Resident Support Systems Handbook can be found on the Postgrad Website:
http://fhs.mcmaster.ca/postgrad/trainee_well_being.html

Chaplaincy Centre at McMaster University
http://www.mcmaster.ca/chaplain(905) 525-9140 Ext 24207
E-Mail: chaplain@mcmaster.ca

Childcare
Learn more about day care in the Hamilton area at Co-ordinated Access for Child Care
(http://www.cafcc.on.ca/index.php).

Need more information?
Contact your chief fellow, PARO representatives, Program Director, Program Administrator or the Postgraduate Medical Education Office.

Harassment/discrimination/professionalism concerns:
Access to complaints procedure and mediation supports:href=”mailto:fhsprof@mcmaster.ca” fhsprof@mcmaster.ca
Policies on Equity / HRES / Anti – Harassment, Discrimination, and Bullying:
http://www.mcmaster.ca/hres/documents/Quick%20Facts.pdf
http://www.mcmaster.ca/mufa/handbook/antidisc.htm – Anti-Discrimination Policy
http://www.mcmaster.ca/mufa/handbook/sxharass.htm – Sexual Harassment Policy

Postgrad Wellness Page:
http://fhs.mcmaster.ca/postgrad/trainee_well_being.html

REVIEW

  • This Policy will be reviewed every 3 years.

Reviewed and approved by NPM Residency Program Committee on Nov 15, 2016