PURPOSE OF AN INSPECTION?
This is to determine the ability of an institution to deliver Specialist Training in Obstetrics and/or Gynaecology according to the requirements as defined by the Institute’s Curricula of Training.
[See TRAINING CURRICULA for BST, RTP, HST]
WHO NEEDS TO BE INSPECTED?
Any Hospital/unit which has training posts for one of three Institute training programmes - Basic Specialist Training (BST), Registrar Training Programme (RTP) and Higher Specialist Training (HST). There are at present nationwide 26 such units.
[NB.The FTTA programme ceases with this present group end June 2011]
Some units may be looking for to increase the number of trainees in their unit, upgrade a post from BST to RTP to HST or to add a new level of training into their institution. These are separate add-on issues but provided the Institute is notified of the intent and appropriate forms submitted prior to the inspection, this can usually become part of the remit of the visiting panel. Units seeking recognition as training institutions for the for the first time are also requried to notify the Institute.
WHAT IS AN INSPECTION?
This is an on-site visit to the training unit conducted by a panel. This usually consists of two Institute members, recruited by the Chair of Hospital Inspections Committee from the speciality and one appointed by RCPI from a different discipline.
During their time there they conduct detailed interviews with consultant trainers [ROLE OF THE TRAINER 2009], trainees and management representatives, and inspect the facilities [HOSPITAL INSPECTIONS MANUAL 2009]. The Institute is then advised by the panel in writing [General Report Form Final Recommendations] as to suitability to train or otherwise in appropriate categories and how many posts are approved in each training programme/unit.
HOW/WHEN IS THE VISIT SET UP?
The Medical Training Department in RCPI keeps a list of the approved units, dates of last inspection and due date for next inspection. This is based on on the results of the last report and/or and feedback that had been requested.
The Chair of the Hospital Inspections Committee is notified as to when an inspection is needed. If possible, rather than imposing a date on a unit, dialogue between the Chair of Hospital Inspections and the Hospital consultant [he/she in turn taking advice from the hospital CEO] agrees on a date and time to start approximately 2 months in advance.
Lynn Coady, who administers the hospital inspections process on behalf of the Institute, sends out a confirmation letter to the CEO, the Consultant Liaison and other appropriate staff. Encolosed with this letter will be a copy of the last report (if any) and the hospital inspections documents. These documents need to by completed by the unit and returned at lease 4 weeks in advance of the inspection. These are the HOSPITAL ACTIVITIES AND DEPARTMENTAL ACTIVITIES FORMS and the TRAINEE CONFIDENTIAL QUESTIONNAIRES Feedback forms.
Meanwhile the Chair of the Hospital Inspections Committee puts together an inspection panel. Two weeks before the inspection date, each member of the panel is briefed about the visit by being given a dossier containing copies of these reports and that of the last visit made [if any].
TIMETABLE FOR VISIT
A proposed timetable [visits usually last a half day] is sent for comment when the visit date is agreed:
• Arrival of Visitors
• Short private visitors meeting
• Introductory coffee session with panel and management team (including CEO or Deputy, Nurse/Midwife, Representative trainers and as many consultants as possible, even if not recognised trainers)
• Formal discussion between inspectors, hospital management and trainers regarding past, present and future developments in the unit (approx 30-45 mins)
• Tour of department and related on-site facilities
• Meet the trainees (with the aid of their questionnaire replies)
• Private Panel Meeting
• Conclusion/feedback session with panel, management team and trainers
• Meeting adjourns
REPORT WRITE UP
This is completed in draft on the GENERAL REPORT FORM-FINAL. Recommendations are made by the inspection panel, drafted to by the Chair of Hospital Inspections and submitted to other panel members for comment. An agreed final document is compiled and sent to the Institute Executive for Approval. The results can then be fed back to the unit concerned.
HOW ARE THE INSPECTION RESULTS FED BACK?
A synopsis of the visit is sent to each unit, providing both positive and negative findings. The conclusions drawn and recommendations made are taken from the final report and are communicated back to the unit [Consultant liaison and CEO].
CONSEQUENCES
The unit may be recognised for training in obstetrics and gynaecology for up to a maximum of a further 5 years, provided no further issues arise during that period. However, if problems have been found that need attention, a progress report on these may be required within a specified time frame and an additional inspection could be needed on major issues a specified time after this is received.
If extreme changes occur in a unit which would impact on that unit's capacity to deliver training, then recognition of training in that unit can be withdrawn.
FURTHER READING
There are a number of documents that are relevant to training and hospital inspections, which are available through Lynn Coady in the Medical Training Department in RCPI. I strongly recommend that all involved in the hospital inspections process in each department request and read a copy of the following:
• Institute Curricula for BST, RTP and HST
• The Role of the Trainer Document (2009) and application forms to become a trainer
• Hospital Inspections Manual
Robert Harrison
Chair of Hospital Inspections Committee