The goal of this interactive skill-building session is to expand participant knowledge of clinical governance policies and systems, including an understanding of virtual care quality and safety skills for clinicians to enable safer consumer care within a residential environment.

Background
National standards in clinical governance, which translate into evidence-based safety and quality frameworks across the healthcare setting, are critical to patient-centric, safer care. The Australian Commission on Safety and Quality in Health Care, National Safety and Quality Primary and Community Healthcare Standards (2021) provide the framework for accrediation for general practices for implementing quality and safety requirements. However, it is unclear what level of understanding there is amongst primary care practitioners of these Standards, especially when delivering virtual care and telemedicine. The focus of clinical governance systems is primarily on acute hospital facilities, with less focus on community and primary care, despite financial incentives (Knight et al. 2012). Australian General Practitioner (GP) attitudes and beliefs appear to not be well understood and in particular, the implementation of clinical governance frameworks and systems within community-based general practice remain unclear.(Gosling et al. 2021; Phillips et al. 2010) Clinical governance, with a safety culture,(Zwart et al. 2011) referred to as a framework for continuously improving a service and ensuring mechanisms for safe care, (Macfarlane 2019; Sammer et al. 2010) is fundamental for corporate governance within healthcare (Bismark, Walter, & Studdert 2013).

It is anticipated that participants in this skills based workshop will develop an increased understanding of primary care clinical governance. In addition, take home practical skills to reduce clinical incidences occurring when performing virtual care medicine.

Reference list available upon request.

Learning Objectives
1) Outline the current clinical governance models operating within general practice.
2) Discuss key strategies for improving safety and quality when delivering virtual medical care.
3) Discuss practical steps for how the clinician and consumer relationship, as well as team based care, can be safer, through effective multi-modal communication.

Background:
Sexual harassment is common in the medical workplace, affecting around 33% of doctors. Junior doctors in dependent relationships with their senior colleagues are at higher risk, as are doctors who live with intersectional discrimination. The consequences can be severe, not only for the survivors, but also for the whole profession and for the patients under their care.

Despite the efforts of a multitude of organisations and individuals, sexual harassment remains entrenched, hidden and profoundly damaging. Like other professions that rely on hierarchical systems of management, education and professional advancement, sexual harassment in medicine is profoundly difficult to address.

In Australia, we have recently held a summit for medical leaders to address the unacceptable rate of sexual harms in medicine. The summit was based on our recently completed international, interdisciplinary edited text, and brought together students, junior doctors, senior doctors and leaders from a broad range of organisations, including Universities, Professional Colleges, Advocacy groups, Regulatory Organisations, Medical Defence Organisations and Doctors’ Health Services. Together, this diverse group mapped the various roles of different organisations and disciplines, and began the process of synthesising multiple policies and processes into an accessible framework for GPs and survivors.

Format of the workshop:
In this workshop, we will use the learnings from this symposium to enhance GP skills in managing survivors. Using a variety of scenarios, we will work in small groups to consider the challenges of supporting a doctor reporting sexual harms. Each small group will consider a different organisational perspective, and discuss the issues a survivor may need to consider if they choose to disclose.

Participants will also address barriers to care, including shame and stigma. At the end of the workshop, participants will have a broader understanding of the options available to survivors, and the ways in which GPs can facilitate recovery.

1. Define sexual harms, describe the risk factors that make certain doctors vulnerable and discuss impediments to help-seeking

2. Describe the multiple roles organisations and individuals (including GPs) may have in supporting survivors of sexual harms in the medical workplace.

3. Consider the challenges of establishing and maintaining an effective therapeutic relationship when the survivor’s trust in the medical profession has been eroded by trauma.