Early learning educators play a pivotal role in the development and well-being of young minds. As you prioritise the mental health of the children in your care, it’s equally important to create an environment that supports the mental well-being of the dedicated educators in your service.

Mental health is integral to overall well-being, and creating a mentally healthy workplace is crucial for the happiness, productivity, and job satisfaction of staff. A positive work environment not only benefits individuals but also enhances the quality of the service provided.

Strategies for mentally healthy workplaces

• Open communication: foster an environment where open communication is encouraged. Staff should feel comfortable discussing their concerns, ideas, and feelings with supervisors and colleagues.
• Training and education: provide mental health training and resources to staff members. This includes workshops on stress management, coping strategies, and recognising signs of mental health issues. Check companies in your area that can provide this or access free resources from organisations such as SafeWork Australia, whose resources can be found at safeworkaustralia.gov.au/safety-topic/managing-health-and-safety/mental-health/resources
• Work-life balance: encourage a healthy work-life balance by setting realistic expectations for work hours and breaks. Avoid overloading staff with excessive responsibilities.
• Team building: promote a sense of camaraderie among staff through team-building activities and events. Strong interpersonal relationships contribute to a positive work atmosphere.
• Recognition and appreciation: regularly acknowledge and appreciate the hard work and dedication of staff members. Recognition boosts morale and fosters a positive work culture.
• Flexible schedules: offer flexible scheduling options when possible. This can help staff manage personal commitments and reduce stress associated with rigid work hours.
• Mental health support services: provide access to mental health support services, such as counselling or employee assistance programs. Ensure that staff members know how to access these resources confidentially.
• Training on child development and behaviour: equip staff with the knowledge and skills to understand and manage children’s behaviour effectively. This can reduce stress and frustration in the workplace. One option is to access the free resources available from ACECQA at acecqa.gov.au/resources/resource-finder
• Designated break areas: create designated space where staff can relax and recharge during their breaks. These spaces should be comfortable and conducive to relaxation.
• Conflict resolution procedures: establish clear procedures for resolving conflicts in the workplace. Encourage open communication and provide mediation services if needed.
• Regular check-ins: conduct regular check-ins with staff members to gauge their well-being and address any concerns they may have.
• Workplace surveys: periodically conduct surveys to assess the overall well-being and job satisfaction of staff. Use the feedback to make improvements to the work environment.
• Mental health awareness: organise awareness activities to reduce the stigma associated with mental health. Provide educational materials and resources to promote understanding. One place to find this information is at ruok.org.au
• Leadership support: demonstrate leadership support for mental health initiatives. Leaders should be approachable and actively participate in creating a positive workplace culture.

Timely notification to our claims team
Should an employee experience a mental health condition that may result in a workers compensation claim, it’s crucial to notify us as soon as possible at our website guildinsurance.com.au/claims/workers-compensation-claims. Early notification helps us provide prompt support and allows us to work with you to manage the claim efficiently, ensuring both your organisation and the employee receive the assistance needed.

Information about your reporting obligations is available at sira.nsw.gov.au/workers-compensation/what-to-do-if-a-worker-is-injured

In summary…
Creating mentally healthy workplaces in early learning services is a shared responsibility that benefits staff and the children. By implementing these strategies, early learning services can cultivate environments that support the mental well-being of their dedicated staff, ultimately contributing to the overall success and quality of care provided to the children. Remember, a mentally healthy workplace is the foundation for nurturing both the minds of the staff and the young minds under their care.

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Clinical record keeping is an essential part of providing health care services. Good clinical records are important for providing continuity of care, optimising clinical outcomes for a client, and can also help to protect you in case of a complaint. Guild’s experience suggests many health practitioners would benefit from learning more about good record keeping.

While clinical record keeping is a requirement for all health professionals, the following information has been tailored for Credentialled Diabetes Educators (CDEs).

Clinical records and insurance claims

Clinical records can have a negative impact on complaints and insurance claims in two ways:

1. Incomplete or inaccurate records can lead to incorrect clinical advice and decision-making, which can result in compromised clinical outcomes for the client and therefore client complaints.
2. Substandard records may mean that a complaint, and therefore an insurance claim, is difficult to defend due to the lack of detail and evidence.

Why keep detailed clinical records?

1. Continuity of service
It’s not uncommon to hear health professionals claim they can remember the details of their professional interactions. However, at Guild, we regularly see examples where health professionals haven’t remembered key aspects of advice provided, and this has led to an adverse client outcome. It’s therefore imperative to have detailed information recorded to ensure certainty of what’s taken place in the past. It’s also important to be sure you refer to the information within the clinical record. People can suffer harm when key information, such as allergy details, is overlooked or forgotten about and therefore not advised or managed accordingly.

2. Professional requirement
It’s a requirement for all health professionals to keep detailed clinical records. It’s the responsibility of every health professional to be aware of and comply with the various codes, guidelines and policies relevant to them. Not knowing is not an excuse for not complying. As documented in the ADEA Code of Conduct, ADEA members are expected to keep accurate records that document all care given, and they’re expected to store and dispose of records securely. All health professionals regulated by the Australian Health Practitioner Regulation Agency (Ahpra) have a Code of conduct that contains information about a practitioner’s obligations and requirements regarding record keeping. These can be found at ahpra.gov.au/Resources/Code-of-conduct.

3. Defence of a complaint
If there’s any allegation of wrongdoing made against a health professional, their clinical records will be incredibly important. Those clinical records provide the health professional’s perspective of what took place and why. Without this, the health professional will be relying on their memory as a defence. The information recorded at the time of the consultation is going to hold greater weight as a reliable defence than a health professional’s memory months after an event. As the saying goes, ‘Good records = good defence, poor records = poor defence and no records = no defence’.

4. Funding audit
Funding providers, such as private health insurers, regularly review the rebates they pay for healthcare and may conduct audits to ensure that health professionals are billing appropriately. It’s not uncommon for a health professional to receive a request from a funding provider to produce clinical records to justify their billing practices. If the reasons behind services and advice provided, and therefore billing, isn’t clear, funding providers can demand repayment.

What to record?

The key question many health professionals ask when it comes to clinical record keeping is ‘how much detail do I need to record?’. Exactly what to include will vary according to each unique clinical situation, yet it should be comprehensive enough to support continuity of care.

Generally, clinical records should include, but aren’t limited to:

• Client identifying details and contact information.
• Name of the consulting health professional and the date of the consultation.
• Reason for the client presentation.
• Presence of any third parties, such as family members, support people, or interpreters.
• Clinical assessment details, including documentation of the client’s relevant medical and psychosocial history, lifestyle factors, current symptoms and diabetes management plan. Include details of the assessment of self-care and the client’s goals.
• Consultation details – capture all clinical findings, even if in range, and include the diagnosis and any consent obtained.
• Education or management plan.
• Education provided and the client’s response.
• Recommendations made to the client.
• Any educational materials or items provided to the client.
• Referrals to, or liaisons with, other health professionals.
• Follow-up arrangements.

In some cases, it’s worth noting what didn’t occur as well as what did. For example, if a client hasn’t agreed to follow what would be considered the most ideal or obvious option for them, the clinical record should reflect that it was discussed and declined. If it’s simply left out of the record, it could seem that it wasn’t discussed.

When a health practitioner is unsure if they’ve included enough detail, they should ask themselves whether another health professional could read the clinical record and understand the full picture of what took place and why, without the health professional filling in any gaps. If the full story isn’t there, there isn’t enough detail.

Professional and objective

Health professionals must use language in the clinical records that’s professional and objective. Negative comments about the client can be included; however, they must be professional and recorded only when relevant to the clinical situation. This may occur when the client chooses not to follow your instructions or advice, which can be detrimental to their health. However, it’s important to remember that clinical records can be accessed and read by several people, including the client, so always be mindful of the language used. The language should match the professional language a health practitioner would use when speaking to the client during a consultation.

Using artificial intelligence

As with many other parts of our lives, the use of artificial intelligence (AI) is increasingly creeping into record keeping practices. While there are numerous potential benefits of using AI, there are also risks that health professionals need to understand and manage. The first step requires health professionals to thoroughly research any AI tools they intend to use and be sure they understand how they work, particularly in relation to the storage and use of information input into them.

The task of creating appropriate clinical records can’t be left to AI; health professionals must review any AI-generated information to be sure it’s detailed and accurate. When doing the review, they must keep in mind that AI isn’t perfect; it will at times leave out important information and even make things up. It’s also important to be sure clients are aware of the use of AI. Before entering client data into an AI tool or recording consultations, you must obtain informed consent.

Further information about the use of AI in healthcare can be found on the Ahpra website at ahpra.gov.au/Resources/Artificial-Intelligence-in-healthcare

This information will benefit any health professional, whether they’re registered with Ahpra or not.

Disposing of records

There’s no requirement to dispose of clinical records, and from a risk mitigation perspective, it’s advisable to keep them for as long as you can. In New South Wales (NSW), Victoria and the Australian Capital Territory (ACT), it’s required that records for an adult client are kept for 7 years from the last date of entry. For persons under 18 years of age when the last record was made, those records need to be kept until they turn 25 years old. Other states and territories don’t have specific legislation regarding time frames for keeping health records. However, it’s recommended that practitioners in those states and territories adhere to the requirements for NSW, Victoria and ACT and seek legal advice.

Conclusion

In summary, always remember that as a health professional, your clinical records support you to provide appropriate clinical care and serve as a reminder and record of what’s taken place. That’s why it’s vital you keep detailed, accurate and up-to-date records of all clinical interactions. Really, you’d be lost without them.

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Guild Insurance regularly analyses claims data to understand factors contributing to claims and complaints. This analysis has highlighted a trend where claims involve treatment by at least two people within the same profession. This finding led Guild Insurance to explore why a client seeing more than one exercise and sports science professional may lead to a claim arising and what can be done to prevent this.

Why would a client see a second professional? Common scenarios where a client would see a second professional includes:

• Some clinics operate in a way where seeing a client is shared between various professionals
• Clients may change clinics over time, such as when they’ve changed work location or moved house
• A client may require an urgent appointment and can’t get in to see their usual exercise and sports science professional, so chooses to see another

The situations that are most concerning are the occasions when a client is unhappy with the treatment or session they’ve received and therefore chooses to go elsewhere for a second opinion or further treatment/sessions.

What can go wrong? Not all situations where more than one professional is involved in treatment will lead to issues arising. However, the following cases highlight how complaints can occur.

Case example 1 A client was receiving treatment for chronic shoulder pain over a period of a few months. She then moved interstate so went to see another exercise and sports science professional for the same complaint. This second professional disagreed with the course of treatment and proceeded down a different path. The client then complained to the first professional, and demanded a refund of fees paid, alleging he provided treatment which exacerbated her condition.

Case example 2 A client had been undertaking a program with an exercise and sports science professional. He didn’t feel that he was experiencing any benefit after a number of sessions so decided to see someone else who made some minor changes to the program. As the client’s condition improved, the client formed the view that original program was unsuitable and therefore complained to ESSA alleging professional negligence.

How can this be avoided? Don’t make comments to a client judging the treatment or session another exercise and sports science professional has provided; it’s possible the situation you’re seeing isn’t exactly the same. Also, if the client has told you what the diagnosis and treatment was, it’s possible they might be wrong due to their lack of understanding. Making what you might see as a small or insignificant comment to a client regarding the choice and quality of treatment provided by another exercise and sports science professional could be enough to encourage that client to make a complaint or a demand for compensation.

If you’re seeing a client for the first time, be careful to not fall into the trap of simply relying on the client telling you what their regular treatment or session entails or just relying on previous client notes. You need to have a thorough understanding of the client’s condition and how it may have changed over time. Only then can you decide what will be most appropriate.

If you’ve taken over the treatment of a client from another exercise and sports science professional whose notes are insufficient, you may need to spend some time doing further assessment before continuing on with their ‘usual’ treatment. It’s advisable to engage the client in a positive conversation on why you’re doing that, so as to manage their expectations.

Managing client expectations from the outset is vital. Make clients aware of what to expect from their sessions; they won’t want surprises. The more they understand about their sessions and likely outcomes, the less likely they are to be dissatisfied and go elsewhere.

Building relationships with clients is an important element in running a successful business. Get to know your clients and give them a reason to trust you and come back to you.

Where appropriate, contact your clients after their treatment/session. If you expect them to be in some pain or discomfort following the session, they may appreciate you making contact to check how they’re feeling. If your clients haven’t returned for a follow up appointment, call them to find out why. This gives you the opportunity to discuss any concerns they may have about their treatment/session.

Clients can become frustrated with ongoing costs of sessions, especially if they aren’t seeing the benefit they’d expected. Always be open and upfront about the cost of treatment/sessions. And where possible, let them know how many appointments you anticipate they’ll need as well as what they can do to self-manage their condition.

When you’ve been seeing a client over a long period of time, continue to keep your communication with them up-to-date and professional. Clients generally expect to be given the most current information on their treatment and what outcomes are likely. Never assume they have a complete understanding, and continue to educate them on positive lifestyle habits.

Avoid offering refunds or free sessions in the event of a poor or unexpected outcome. This may be seen by the client as an admission of responsibility or liability and they may expect that discounted or free sessions will continue. Always contact Guild Insurance on 1800 810 213 before offering any form of compensation to a client.

Documentation is vital! The key to dealing with a dissatisfied client who’s considering making a claim or complaint against you is your accurate client records. If your work is being questioned by a client, another professional or ESSA, you’ll need a record of the facts behind your decision making.

And finally, maintain a high level of professional and appropriate behaviour at all times, both when treating clients and also anytime you’re communicating and interacting with them. This not only reflects well on you, it can also improve the public perception of exercise and sports professionals.

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Professionals, in all different fields, rely on their equipment and tools of varying types to run their business. This equipment could be very specific to a field of work, such as an x-ray machine, or it could be very common and used by all, such as an air conditioner. Regardless of what it is, when equipment is no longer working as it should, this can significantly impact a business’ operations.

Understanding Insurance

Breakdown insurance is designed to replace or repair an item or piece of equipment when it fails to operate as intended, following a sudden and unforeseen event that causes physical damage to parts and components. This damage may be due to mechanical, hydraulic, electrical or electronic breakdown, or a faulty circuit.

However, breakdown insurance doesn’t cover gradual deterioration over time due to regular, normal usage. Equipment doesn’t last forever. It should be expected that equipment will cease working as parts near the end of their usual or expected lifespan; this is generally referred to as ‘wear and tear’.

The Importance of Looking After Equipment

Given insurance won’t cover your equipment for wear and tear, business owners and their staff should consider what they can do to improve the longevity and effectiveness of the equipment they rely on.

Correct installation: When equipment needs to be installed, be sure this is done correctly and by a qualified professional where necessary. It’s quite common to see equipment stop working sooner than expected when it’s been incorrectly installed. Proper installation can include, but isn’t limited to, adequate ventilation, correct location, surge protection and securely fastened connections and fittings.

Understand your warranties: When you purchase and install equipment, you’ll often be provided with a warranty. Be aware of the duration and terms of the included warranty and consider purchasing an extended warranty for more valuable and critical electronic equipment.

Create a maintenance program: This program should detail what needs to be checked and possibly serviced and when, and it should include reminders to alert you when this is due. Be sure to include details about who in the business is responsible for organising the maintenance check as well as previous maintenance which has been undertaken. And think broadly about the term ‘equipment’ and what needs maintaining. Some equipment may be out of sight or not obvious from a maintenance perspective.

When your business relies on particular equipment, hope isn’t enough. You need to be proactive in looking after your equipment.

Cost of Ownership

As an insurer we often hear of cases where issues with equipment are identified, yet for financial reasons, repairs are put off. While financial limitations of businesses are understandable, putting off repairs could end up costing the business more in the future.

You should also depreciate your equipment and put aside sufficient funds to allow for its replacement at the end of its working life.

Use equipment as intended and designed: When equipment is used for purposes or in ways that it wasn’t designed for, this can increase the wear and tear and lead to it needing to be replaced sooner than it should have been.

Know what you’re responsible for: If you’re a tenant in a premises, it’s vital that you understand what equipment you’re responsible for maintaining on behalf of the landlord. It’s recommended you have a documented maintenance program, agreed with the landlord, that clearly states who’s responsible for what. Don’t make assumptions and be sure you understand what’s in your rental agreement.

Your Insurance Cover

When insuring your business, it’s important you understand what you are and aren’t covered for. Don’t make assumptions about this; speak to your account manager or insurance advisor if you’re unsure.

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Don’t Go It Alone

Contact us: 1800 810 213
guildinsurance.com.au

While there are laws for advertising any business in Australia, The Australian Health Practitioner Regulation Agency (Ahpra) has specific requirements for anyone advertising a regulated health service. And these requirements apply equally to all types of health professionals regulated by Ahpra.

These advertising requirements are set under Section 133 of the Health Practitioner Regulation National Law. Therefore, breaching an advertising requirement is a criminal offence for which prosecution and financial penalties can apply. For an individual, there may be a penalty of up to $60,000 per offence and $120,000 for a body corporate.

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Clinical record keeping is unfortunately one of those dreaded risk management topics. Guild Insurance understands that it isn’t the most interesting topic for health practitioners to spend time thinking and talking about. However, it’s incredibly important, and Guild’s experience suggests many health practitioners would benefit from learning more about good record keeping.

Clinical records and insurance claims

Clinical records can impact insurance claims in two ways:

1. Poor records which lack detail can lead to incorrect clinical decision making and poor clinical outcomes for the patient and therefore patient complaints.
2. Poor records may make a complaint, and therefore an insurance claim, difficult to defend due to the lack of evidence.

Why keep detailed clinical records?

1. Continuity of patient care

It’s not uncommon to hear health practitioners claim they can remember the details of patient consultations. However at Guild, we regularly see examples where practitioners haven’t remembered key aspects of prior consultations and treatment, and this has led to a poor outcome for the patient. It’s therefore imperative to have this information recorded to ensure certainty as to how and why you’ve treated a patient in the past.

It’s also important to be sure you refer to the information within the patient’s record. Patients can suffer harm when information, such as allergy details, is overlooked or forgotten about and therefore the patient isn’t treated accordingly.

2. Regulatory requirement

All Australian Health Practitioner Regulation Agency (Ahpra) regulated practitioners need to be well aware of their many regulatory requirements; good record keeping is one of these. Each profession’s Code of Conduct contains information about a practitioner’s obligations and requirements regarding record keeping. Several Ahpra National Boards have also created a separate document on guidelines for clinical records which further explains what’s required.

It’s the responsibility of every registered health professional to make themselves aware of and comply with the various codes, guidelines and policies relevant to them. Not knowing is not an excuse for not complying.

3. Defence of a complaint

If there’s any allegation of wrong doing made against a practitioner, their records are going to be incredibly important. Those records provide evidence of what took place and why. Without this, the practitioner will be relying on their memory as a defence. Information recorded at the time of the consultation is going to hold greater weight as a reliable defence than a practitioner’s memory months after an event. As the saying goes ‘Good records = good defence, poor records = poor defence and no records = no defence’.

4. Funding audit

Funding providers, such as private health insurers, regularly review the rebates they pay for healthcare and can conduct audits to be sure health practitioners are billing appropriately.

It’s not uncommon for a health practitioner to receive a request from a funding provider to produce clinical records to justify their billing practices. This is another example of when a practitioner needs documented evidence of what they’ve done and why. If the reasons behind treatment, and therefore billing, isn’t clear, funding providers can demand repayment.

Record keeping requirements

What to record?

The key question many health practitioners ask when it comes to clinical record keeping is ‘how much detail do I need to record?’. Practitioners should refer to their Code of Conduct, as well as the guidelines on record keeping if one exists, to better understand the detail required in a clinical record.

Exactly what to include can vary according to the type of health profession as well as the specifics of the patient’s condition and treatment. However, generally records should include, but aren’t limited to:

• Patient identifying details and contact information as well as health history
• Name of the consulting practitioner and the date of the consultation
• Reason for the patient presentation
• All examinations and investigations conducted and their results, even if there is no abnormal finding
• Diagnosis and treatment plan
• Consent to treatment
• Treatment provided and the patient’s response
• Any items supplied, or instructions given, to the patient
• Referrals to other health professionals

In some cases, it’s worth noting what didn’t occur as well as what did. For example, if a patient has refused to consent to what would be considered the most ideal or obvious treatment option, the record should reflect that it was discussed and declined. If it’s simply left out of the record, it would appear that it wasn’t discussed as a treatment option.

When a practitioner is unsure if they have included enough detail, they should ask themself whether or not another practitioner could read the record and understand the full picture of what took place and why, without the treating practitioner filling in any gaps. If the full story isn’t there, there isn’t enough detail.

Professional and objective

Clinical records need to always be professional and objective. Negative comments about the patient can be included, however, this must be professional and only when this is relevant to the treatment being provided. This may occur in situations where the patient isn’t complying with instructions and this is detrimental to their health. However, it’s important to remember that clinical records can be accessed and read by a number of people, including the patient and your regulator, so always be mindful of the language used. The language used should match the professional language a health practitioner would use when speaking to the patient during a consultation.

Using Artificial Intelligence

As with many other parts of our lives, the use of artificial intelligence (AI) is creeping into record keeping practices more and more all the time. And while there are numerous potential benefits of using AI, there are also risks that health professionals need to understand and manage. The first step in this requires practitioners thoroughly research any AI tool they intend to use and be sure they understand how they work, particularly in relation to the storage and use of information input into them.

The task of creating appropriate clinical records can’t be left to AI; practitioners must be sure they review any AI‑generated information to be sure it’s detailed and accurate. And when doing this they must keep in mind that AI isn’t perfect; it will at times leave out important information and even make things up. It’s also important to be sure patients are aware of the use of AI. When patient data is being input into an AI tool or if consultations are being recorded, informed consent is a must.

For further information about the use of AI in healthcare, refer to guidance available from Ahpra that can be found at www.ahpra.gov.au/Resources/Artificial-Intelligence-in-healthcare.

Disposing of records

There’s no requirement to dispose of clinical records, and from a risk mitigation perspective, it’s advisable to keep them for as long as you can.

In New South Wales (NSW), Victoria and the Australian Capital Territory (ACT), it’s required that records for an adult patient are kept for 7 years from the last date of entry. For a patient who was under 18 years of age when the last record was made, those records need to be kept until that patient turns 25 years old. Other states and territories don’t have specific legislation regarding time frames for keeping health records. However, it’s recommended that practitioners in those states and territories adhere to the requirements for NSW, Victoria and ACT.

There’s varying legislation across the different states and territories regarding processes to adhere to when disposing of records. It’s recommended practitioners make themselves familiar with what’s required, if intending to dispose of records, and seek independent legal advice if needed or speak to your professional association.

Guild Insurance regularly manages claims where a patient has been treated by more than one practitioner. This has led Guild to explore how treatment by multiple practitioners may contribute to complaints by patients which can lead to an insurance claim.

Evaluating another practitioner’s work

It’s quite likely that many natural therapy practitioners will at times treat a patient who’s previously been treated by another natural therapy practitioner.  And in some of these cases the practitioner may have questions about that previous treatment, such as when:

• the treatment may not seem to be up to the appropriate standard,
• the treatment selected may not appear the be the most ideal or obvious choice, or
• it may seem as though the treatment provided has not led to the intended or expected outcome.

Practitioners must be very mindful of how they handle these situations and what they say to or in front of the patient.  It’s understandable that to provide treatment the practitioner will want an understanding of prior treatment.  However, conversations about another practitioner’s treatment, if not conducted appropriately, may contribute to the patient lodging a complaint against that other practitioner.

How can these complaints be avoided?

• Don’t make comments to a patient judging the treatment another practitioner has provided.  It’s possible that the clinical situation you’re seeing is not the same as what the first practitioner saw.  Also, if the patient has told you what their treatment consisted of, it’s possible they might be incorrect due to their lack of clinical knowledge.  Making even what you see as a small or insignificant comment to a patient regarding the choice and quality of treatment provided by another practitioner could be enough to encourage that patient to make a complaint.

• If you’re seeing a patient for the first time, be careful to not fall into the trap of simply relying on the patient telling you what their previous treatment entailed or just relying on previous patient records.  You need to have a thorough understanding of the patient’s condition; only then can you decide what therapy will be most appropriate.

• If you’ve taken over the treatment of a patient from another practitioner whose health records are insufficient, you may need to spend some time doing further assessment before continuing with their ‘usual’ treatment. It’s advisable to engage the patient in a positive conversation on why you’re doing that, to manage their expectations.

• Managing patient expectations from the outset is vital.  Make patients aware of what to expect from their treatment; they won’t want surprises.  The more they understand about their treatment and likely outcomes, the less likely they are to be dissatisfied and look elsewhere for treatment.

• Building relationships with patients is an important element in running a successful practice.  Get to know your patients and give them a reason to trust you and come back to you. 

• Patients can become frustrated with ongoing costs of treatment, especially if they aren’t seeing the benefit they’d expected.  Always be open and upfront about the cost of treatment.  And where possible, let them know how many treatment sessions you anticipate they’ll require to achieve the anticipated outcome. 

• Documentation is vital! The key to dealing with a dissatisfied patient who’s considering making a claim or complaint against you is your accurate health records.  If your work is being questioned by a patient, or another practitioner, you’ll need a record of the facts behind your decision making.

• Avoid offering refunds or free treatments in the event of a poor or unexpected outcome.  This may be seen by the patient as an admission of responsibility or liability and they may expect that discounted or free treatments will continue.  Always contact Guild Insurance on 1800 810 213 before offering any form of compensation to a patient.

And finally, maintain a high level of professional and appropriate behaviour at all times, both when treating patients and anytime you’re communicating and interacting with them.  This not only reflects well on you, it can also improve the public perception of natural therapy as a profession. 

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It’s well recognised that patients don’t necessarily complain simply based on their clinical outcome. Most dentists will have heard of or seen situations where a patient has experienced an outcome which wasn’t ideal yet wasn’t particularly poor, however the patient has been quite annoyed with the outcome and has lodged a complaint.  On the other hand, there are many cases of patients who have experienced quite poor outcomes yet have chosen to not complain.

There are many reasons why the above may occur, some which are easier to identify than others. All patients are different and human behaviour isn’t always predictable.  Good communication and the relationship between the patient and dentist will greatly influence the likelihood of a complaint.  One other very important factor is the expectations of patients.

Patient expectations

Many patients will go into dental appointments with some level of expectation regarding their likely outcome. They may have a very clear and detailed outcome in mind or it may be more broad and open.  Most importantly, some of these expectations will be realistic, however others won’t be.

Unrealistic patient expectations pose very real challenges for dentists. If a patient undergoes treatment which they have unrealistic expectations about, it’s unlikely those expectations are going to be met simply due to them being unrealistic.  If a patient’s expectations haven’t been met, it’s likely the patient is going to be unhappy or dissatisfied with the treatment.  Those unhappy and dissatisfied patients are the ones more likely to complain about the treatment and expect further corrective treatment or compensation.  It’s therefore vital that dentists do all they can to help the patient fully understand treatment and the likely and possible treatment outcomes before treatment begins.

Creating realistic expectations

A key step in making sure a patient has realistic outcomes regarding treatment is to have an open and honest conversation with them. This will not only provide the patient with further information about their treatment, but will also give the dentist a clearer understanding of the patient’s expectations.  A dentist’s clinical skills are vital to what they do, however effective communication goes a long way in providing positive outcomes.

To assist a patient to have realistic expectations, dentists must ensure they explain the treatment and outcomes using simple, clear terms. Technical clinical language should be avoided as many patients won’t understand this.  Dentists should also consider how they tailor their language and the information for each individual patient.  For example, a person with language or literacy challenges may need information presented in a more detailed manner than other patients.  Dentists should also consider using diagrams, pictures or models to assist with understanding where appropriate.

When discussing treatment with a patient, it’s important that dentists don’t make assumptions about what the patient will or won’t understand. It’s easy for dentists to become so familiar with what they do and know that they sometimes forget how foreign that knowledge can be to other people.  Patients will have varying degrees of knowledge and experience regarding dental treatment.  Therefore, what they understand about their treatment will also vary.

When a patient attends a dental clinic and requests a particular form of treatment, this is an occasion when a dentist should be especially mindful of the patient’s expected outcome. When a patient has requested a form of treatment, the patient has clearly formed a decision around what treatment they need to get the outcome they desire.  What they’re requesting and expecting may be reasonable and realistic, however in some cases it may not be.  When presented with this situation, dentists need to be sure they don’t rush into providing the patient with the requested treatment.  As with all patients, there needs to be a thorough assessment and diagnosis process.  Then the patient is to be provided with their treatment options, as well as the risks and benefits of those options.  There may be treatment options which are more suitable for that patient which the patient isn’t aware of.  The patient also needs to be made aware of the likely treatment outcomes for each of those treatment options.

The dentist needs to be sure the patient has all required information before consenting to treatment and this includes understanding the likely outcomes. A patient requesting particular treatment doesn’t alter this required process.  And dentists need to remember that they’re always responsible for the treatment they’ve provided, regardless of whether it was requested by a patient.

In summary…

Dentists should be doing all they realistically can to improve the outcomes for their patients and reduce the likelihood of poor outcomes and complaints. An important step in this process is making sure patients have realistic expectations regarding treatment outcomes.  Dentists have a very important role in using their clinical knowledge in conjunction with practical terminology to assist patients to develop realistic expectations.  Dentists need to remember this is of great benefit to both themselves and their patients.

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Client record keeping is unfortunately one of those dreaded risk management topics. Guild Insurance understands that it isn’t the most interesting of topics for AEPs to spend time thinking and talking about. However, it’s incredibly important, and Guild’s experience suggests many AEPs would benefit from learning more about good record keeping.

Record keeping and insurance claims

Why is an insurer so concerned about record keeping? It’s because client records can greatly impact insurance claims in two ways:

1. Poor records may make a complaint, and therefore an insurance claim, difficult to defend due to the lack of evidence.

2. And surprisingly to some, poor records can contribute to poor or unexpected outcomes following sessions, such as an injury, leading to the client complaining and possibly seeking some form of compensation.

The wellbeing of clients is paramount, therefore reducing the potential risk of injury should be a priority to AEPs.  A potential risk when treating a client is a claim brought against a practitioner, which can lead to insurance claims. This can be a very challenging and confronting experience. Therefore, understanding how to improve the standard of client records really should be a core focus. 

Why keep detailed client records?

Continuity of service

It’s not uncommon to hear professionals say they can remember the details of their clients and any interactions with them. However, at Guild we regularly see examples where professionals haven’t remembered key aspects of their sessions or consultations, and this has led to a poor outcome for the client. It’s therefore imperative to record details about all sessions, with specific information about what exercises were performed and how the client responded to them. It’s also important to be sure you refer to this information within the client’s record when planning future sessions.

Professional expectation

All professionals need to be aware of the various expectations placed on them, which are there to assist people to carry out their work appropriately. And it’s a common expectation that professionals keep detailed records of client interaction. This is no different for AEPs.

In the ESSA Code of Professional Conduct and Ethical Practice, it states that ESSA members and accredited professionals must ‘keep accurate, clear, respectful, up-to-date records documenting services’. This Code can be found at www.essa.org.au/Public/Professional_Standards/ESSA_Code_of_Professional_Conduct___Ethical_Practice

Defence of a complaint

If there’s any allegation of wrongdoing made against a professional, their records are going to be incredibly important. Those records provide evidence of what took place and why when providing services to clients. Without this, the professional will be relying on their memory as a defence. Information recorded at the time of the session is going to hold greater weight as a reliable defence than a professional’s memory months after an event. As the saying goes ‘Good records = good defence, poor records = poor defence and no records = no defence’.

Funding audit

Funding providers, such as private health insurers, regularly review the rebates they pay for services provided and can conduct audits to be sure professionals are billing appropriately. It’s not uncommon for a professional to receive a request from a funding provider to produce records to justify their billing practices.  If the reasons behind the service, and therefore the billing, isn’t clear, funding providers can demand repayment.

What to record?

The key question many professionals ask when it comes to client record keeping is ‘how much detail do I need to record?’.  Exactly what to include can vary according to the specifics of the client’s condition and services provided. However, generally records should include, but aren’t limited to:

• Client identifying details and contact information
• Pre exercise screening information
• Date of the session
• Relevant pre exercise discussion – for example, how the is client feeling and what their expectations are
• Details of the client’s informed consent, including the risks, benefits and potential outcomes that were discussed
• Details of all exercises performed including modifications made to the program and why
• Client’s response to exercises – did they struggle, feel pain or discomfort, are they ready to progress etc
• Any instructions given to the client for exercise outside of the session provided
• Referrals to health professionals or anyone else
  

When a professional is unsure if they‘ve included enough detail, they should ask them self whether or not another professional could read the record and understand the full picture of what took place, without the need to fill in any gaps. If the full story isn’t there, there isn’t enough detail.

Professional and objective

Client records need to always be professional and objective. Constructive critical comments about the client can be included, however this must be professional and only done when relevant to the service being provided. This may occur in situations where the client isn’t able to perform exercises correctly or isn’t complying with instructions when away from session, and this could lead to injuries or a lack of progression. However, it’s important to remember that client records can be accessed and read by several people, including the client, so always be mindful of the language used. The language should match the professional language a professional would use when speaking to the client during a session.

Medical record keeping is unfortunately one of those dreaded risk management topics. Guild Insurance understands that it isn’t the most interesting of topics for veterinarians to spend time thinking and talking about. However, it’s incredibly important, and Guild’s claims management experience suggests veterinarians would benefit from learning more about good record keeping.

Records and insurance claims 

Records can impact insurance claims in two ways:

1. Poor records can contribute to a poor or unexpected outcome following treatment, leading to the client complaining and possibly seeking some form of compensation. For example, a dog’s weight was incorrectly recorded in the record due to a simple data entry error. This led to the dog being given a dose of medication which was too high; unfortunately the dog suffered renal damage and died as a result.

2. Poor records may make a complaint, and therefore an insurance claim, difficult to defend due to the lack of evidence of what took place and why. Poor clinical outcomes and dealing with complaints can be very challenging and confronting. Therefore, understanding how to improve the standard of records really should be a focus.

Why keep detailed records?

1. Continuity of care

It’s not uncommon to hear veterinarians believe they can remember the details of their consultations. However, at Guild we see examples where veterinarians haven’t remembered key aspects of prior consultations and treatment, and this has led to a poor outcome for the animal. It’s therefore imperative to have this information recorded to ensure certainty as to how and why you’ve treated an animal in the past. It’s also important to be sure you refer to the information within the record. Animals can suffer harm when key information is overlooked or forgotten about and they’re therefore not treated accordingly.

2. Regulatory requirement

All State and Territory Veterinary Boards within Australia have some sort of guideline or policy about a veterinarian’s obligations and requirements regarding record keeping. It’s the responsibility of every veterinarian to make themselves aware of and comply with the various codes, guidelines and policies relevant to them. Not knowing is not an excuse for not complying.

If there’s an allegation of wrong doing made against a veterinarian, their records are going to be incredibly important. Those records provide evidence of what took place and why. Without this, the veterinarian will be relying on their memory as a defence. Information recorded at the time of the consultation is going to hold greater weight as a reliable defence than a veterinarian’s memory months after an event. As the saying goes ‘Good records = good defence, poor records = poor defence and no records = no defence’.

What to record?

A question many veterinarians ask when it comes to record keeping is, ‘How much detail do I need to record?’ Veterinarians should refer to their relevant Veterinary Board’s information to better understand the detail required in a record. Exactly what to include can vary according to the specifics of the animal’s condition and treatment. However, generally records should include, but aren’t limited to:

• client identification
• treatment date
• animal(s) identification
• history
• examination details
• diagnosis
• treatment options offered and given, prescribed, or supplied
• informed consent
• response to treatment
• other records/reports such as imaging reports, laboratory reports or specialist/referral reports
• information provided to the client including post treatment instructions

In some cases, it’s worth noting what didn’t occur as well as what did. For example, if a client has refused to consent to what would be considered the most ideal or obvious treatment option, the record should reflect that it was discussed and declined. If it’s simply left out of the record, it would appear that it wasn’t discussed as an option.

When veterinarians are unsure if they have included enough detail, they should ask themselves whether or not another veterinarian could read the record and understand the full picture of what took place and why, without the treating veterinarian filling in any gaps. If the full story isn’t there, there isn’t enough detail.

Professional and objective

Records need to always be professional and objective. Criticisms of the client can be included, however this must be professional and only when relevant to the treatment being provided. This may occur in situations where the client isn’t complying with instructions and this is detrimental to the health of their animal. However, it’s important to remember that records can be accessed and read by a number of people, including the client and your regulator, so always be mindful of the language used. The language used should match the professional language a veterinarian would use when speaking to the client during a consultation.

Changes and corrections

If it’s noticed that errors have been made in a record, changes can be made to correct this. However, information should never be deleted. The original information must remain with a note explaining the correction and when the correction was made. Also, if additional information needs to be added to a completed consultation note, it should be done so it’s clear this is additional information and the date it was added.

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Pet insurance companies will often ask for clinical record information to assist with processing a claim. In the event that a claim is denied, this information may then be provided to the client as part of the explanation as to why the claim has been denied. This means that the clinical records created, and owned, by the veterinarian can end up in the hands of the client. And this potential outcome has led to some veterinarians feeling reluctant to hand their clinical records over to a pet insurer.

Handing clinical records to an insurer – what are the risks?

When considering handing records to a pet insurer, it’s important that a veterinarian is mindful that the records may be seen by the client. But what does this mean for a veterinarian? Not only is there a chance that records can be seen by a client during a pet insurance claim process, but records can also be seen for other reasons by a State Veterinary Board or a professional indemnity insurer. This is one of the reasons why it’s an expectation that records are always written in an appropriate and professional manner. Comments in the record should always be objective and relate to the treatment provided. Unprofessional comments in the clinical record that are then seen by a client are likely to lead to an unhappy client who may complain about the veterinarian’s conduct.

Some veterinarians may be concerned that another risk of the clinical record being seen by a client is that information contained in the record may lead to a complaint by the client and that the complaint won’t be covered by the veterinarian’s professional indemnity insurer. What is and isn’t covered by a professional indemnity insurance policy is detailed in the policy wording. Unless what is recorded in the clinical record amounts to an admission of liability, or otherwise triggers an exclusion clause in the policy, the fact that a client sees a veterinarian’s clinical record is rarely the basis upon which a claim is denied. If a claim is to be denied by the professional indemnity insurer, it’s generally as a result of other actions of the veterinarian, not the action of sharing the record.

There is a possibility, albeit slim, that the client may read the clinical record and form a conclusion that the veterinarian has acted in a manner which is inappropriate or negligent. However, this possibility shouldn’t be a reason to not share the clinical record. It’s important to remember that you can’t stop a client from complaining if they feel they have a reason to do so; it is their right. However, it’s also important to remember that this is why veterinarians have their professional indemnity insurance, to protect them when a claim is made against them.

Not handing clinical records to an insurer – what are the risks?

While there are some risks to consider when handing clinical records to a pet insurer, veterinarians should also understand that there are risks to consider when they choose to not hand over those records. If a veterinarian opts to not share the clinical record with a pet insurer when a client has made a claim, it’s possible that a claim won’t be processed and the client will not be able to receive the rebate they may otherwise be entitled to. Veterinary care can be considered expensive for many clients. Those who take out pet insurance are choosing to buy insurance to attempt to assist with veterinary costs. For them to not be able to make use of that pet insurance would mean they’re paying full costs for the treatment as well as an insurance premium that isn’t being utilised. This occurring may well upset and frustrate the client, and it is often the frustrated clients who are more likely to complain.

A veterinarian also needs to consider the importance of maintaining clients to keep their business running successfully. A situation where one veterinarian refuses to share clinical records with pet insurers, yet another veterinarian does share them, could lead clients choosing their veterinarian based on who will support their pet insurance claims.

Don’t forget…

• Sharing information within a clinical record is not usually the reason for a professional indemnity claim being denied.
• Always keep detailed, accurate and up-to-date records of all clinical consultations and treatment.
• The information contained within a clinical record should always be professional and objective.
• Whilst the veterinarian is the owner of the clinical record, be sure you have the client’s permission prior to sharing the record with a pet insurer.
• If there is any situation that a veterinarian thinks could lead to a claim against them, they should notify Guild Insurance immediately by calling 1800 810 213.

Guild Insurance Limited ABN 55 004 538 863, AFS Licence No. 233 791. This article contains information of a general nature only, and is not intended to constitute the provision of legal advice. Guild Insurance supports your Association through the payment of referral fees for certain products or services you take out with them.

With the holiday season approaching, it's time to remind ourselves of the possible threats to our homes and cars during this time. In the lead up to what should be a fun and festive time with loved ones, it's important to think about what you can do to protect your valuable assets during this period.

Thefts and burglaries increase at this time as a lot of crime is opportunistic; thieves know that houses and cars might be full of newly purchased gifts. Thieves also know that with people away on holidays, there is an increased opportunity to break into cars and homes.

However, holiday dangers aren’t just about thefts and burglaries. People also need to think about what they can do to protect their homes and cars from damage or unnecessary costs while on holidays, as well as keeping themselves safe.

Protecting your home

Before heading off on holidays:

• Be mindful of how you dispose of packaging of gifts or newly purchased items. A bin full of boxes for items such as televisions, game consoles or tablets lets people know what valuable items are in the home.
• Ask a friend or neighbour to collect your mail. A build-up of mail is a sure sign someone isn’t home.
• Use a timer to have your house lights turn on and off at certain periods of the day, creating a look of someone being in.
• Consider what appliances can be turned off within your home. While usage is low, many appliances continue to use power even when they aren’t being used. Items to consider turning off include hot water tanks, televisions, microwaves and computers. However, be sure to think about what you're turning off before you quickly switch off all power; for example, fridges and freezers, unless empty, should be kept on.
• Clear out your gutters. A build-up of leaves and other debris creates a fire hazard as well as a risk of an overflow of water entering the roof space during a storm.

Protecting your car

• If leaving your car at home while on holidays, where possible leave it locked securely in a garage or somewhere else out of sight. Thieves will notice a car sitting in the same spot every day which hasn’t moved.
• Don’t keep valuables in sight that could entice those opportunistic thieves. This applies to items used all year, such as mobile phones. However, over the holiday season it also applies to shopping bags which are clearly full of new items.
• When taking your car on holidays, be sure you have some sort of roadside assistance or breakdown coverage to protect you during those unexpected moments.
• If sharing driving duties during a road trip, be sure the insurance policy for the car covers all drivers.
• Take regular breaks on long drives by either swapping drivers or taking rest breaks. Also, when on long drives, plan your stops to allow for petrol fill ups and food and drink stops.
• Be particularly careful when driving at dawn and dusk as visibility generally isn’t as clear as during the day.

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Artificial turf or grass is, understandably, commonly used in early learning services. This turf can look lush and green all year round without watering or cutting. However, it isn’t necessarily the perfect and simple outdoor solution some of us may think or wish it was. Unfortunately, Guild Insurance sees numerous cases of poorly laid and/or maintained turf which can become damaged over time. This damage can include raised and uneven surfaces, curled edges and rips and tears. Not only does this look unsightly, but it can also create an unsafe surface which could lead to trips and falls and therefore injuries.

Installation

Incorrectly installed turf is likely to lead to issues and complications down the track. This can lead to insurance implications as your policy will not cover you for damage resulting from defective design or faulty workmanship. So, start off on the right foot by having turf installed by a reputable installer who’ll provide a certificate of compliance that supports the Australian Standards with respect to turf preparation and installation.

Be sure the manufacturer’s guidelines are followed when installing turf.  Also, make yourself familiar with the specifics of the warranty provided and retain all documentation and/or information, including receipts, for the installation.

Drainage

Ensure that your turf installation includes appropriate drainage, installed by a suitably qualified plumber.  And be sure existing drains aren’t covered or impeded by the turf and that the directional flow is appropriate for the lay of the land.

Turf without drainage leads to future problems and causes the “fill” under the turf, (also often known as substrate or base), to shift and leach out causing the substrate to wash away.  This can happen quickly during periods of heavy rain and/or storms, and it can also happen gradually over time due to prolonged exposure to the elements. If the substrate/base material was incorrectly prepared to receive the turf and provide drainage for rain and or storm water run-off, this may cause damage to the turf and nearby buildings.  This damage may not be covered by insurance due to faulty design or workmanship.

Maintenance

Artificial turf can seem like an easy option over real turf due to less maintenance. However, maintenance is still required, and the installer’s or manufacturer’s maintenance instructions must be followed to prolong the life of the turf and protect your investment.

Regular checking for wear and tear, or other types of damage, is essential. As is the continual removal of any debris which could impact drainage. It’s also worth occasionally having the turf inspected by professionals who’ll know what damage and drainage issues to look for.

If damage to artificial turf is identified, it’s important to act on this as soon as possible. Putting it off will likely lead to further damage, making repairs more costly.

Again, keep records of all maintenance carried out, with details including what was done, when and by who.

Making a claim

Artificial turf doesn’t last forever, and damage over time may be normal “wear and tear” that’s not covered by your insurance; but other causes of damage, such as fire or storm, may be.

If you hold a Guild Early Learning Business Insurance policy, and you think you may have a valid claim for damage to your artificial turf, or you’re just not sure, contact us first and hold off authorising any repairs until we have approved your claim. 

Employment related disputes are an increasing trend in early learning claims reported to Guild Insurance. These claims indicate that some employers may not be aware of their obligations and the laws governing them as an employer. Our claims also suggest employers aren’t taking the appropriate steps to implement and adhere to processes and policies that ensure their compliance with regulatory requirements.

Employment disputes can have serious implications for a business. There are several legal avenues available to an employee if they feel they have been treated unfairly. These pathways can be stressful and distracting to navigate while also running a business. Further to that, these disputes can create an unhappy working environment which could negatively impact other staff as well as the children attending the service.

Case examples

Both of these case examples led to complaints with the Fair Work Commission.

1. Allegations were made against a staff member of physical abuse towards children. The employee was stood down while investigations were conducted and then terminated upon the outcome of the investigation. The employee commenced proceedings alleging unfair dismissal. The legal fees to defend this matter were in excess of $100,000 and the employee was awarded approximately $40,000 for lost income.

2. An employer sought to make changes to an employee’s rostered start time due to operational requirements. The employee resisted the change stating it didn’t align with their responsibilities as a carer. The employee was offered alternative options however the employee would only agree to keep their original rostered hours. The employee lodged a complaint alleging discrimination. It was found the changes were reasonable and allowed under the contract of employment, yet the matter still cost almost $20,000 to defend.

Understand your obligations

The key first step to avoiding employment related disputes in an early learning service is to understand employment laws and regulations. While you aren’t expected to become an expert in employment law, not being informed carries significant risk. And keep in mind that legal requirements can change over time so be sure you stay informed. There are many resources available to assist businesses understand their requirements.

The Fair Work Ombudsman provides best practice guides to assist businesses and employees manage various workplace issues such as underperforming staff and requests for flexible arrangements. These guides can be found at fairwork.gov.au/tools-and-resources/best-practice-guides.

Small businesses, with less than 15 employees, have unique rules for dismissing staff. Information about the Small Business Fair Dismissal Code can be found at fairwork.gov.au/ending-employment/unfair-dismissal. Further information to support small businesses can be found at smallbusiness.fairwork.gov.au.

There are National Employment Standards (NES) which detail the minimum entitlements which must be provided to all employees in Australia. These standards cover areas such as leave entitlements, superannuation contributions and notice of termination. Details on the NES can be found at fairwork.gov.au/employment-conditions/national-employment-standards.

Create processes and policies for your business

To ensure you and your staff are complying with employment best practice and the law, create processes and policies for your business. These processes and policies will:

• Guide training so all staff know what’s expected of them in their place of work.
• Ensure consistency among all staff when dealing with employment matters.
• Provide support and guidance when dealing with a potentially challenging employment matter or dispute.

Processes and policies are only beneficial when regularly referred to and utilised. It’s therefore vital they aren’t documents that are created only to be filed away. They should be stored somewhere that is easily accessible by staff, and regularly discussed with staff, such as in team meetings. You should also consider integrating these processes and policies into your induction and ongoing training programs.

Seek assistance

If you find yourself in a difficult situation regarding an employment matter, the sooner you reach out for support, rather than trying to navigate the situation yourself, the better for all involved. If you hold a Guild Insurance Early Learning Business Insurance policy, you’re entitled to receive free legal advice with our expert legal advisers, Meridian Lawyers. You can access three free telephone advice sessions (each session is capped at two hours) when you’re dealing with an employment or registration issue.

Keep records

Unfortunately, complaints and insurance claims regarding employment matters can arise some time after an event. To be sure you’re best placed to deal with any complaints should they occur, it’s important to keep records of all discussions had with staff regarding performance and entitlements, even if meetings and discussions are informal.

We’re not asking you to check to see if you’ve made a typo... and called yourself Sara instead of Sarah. While this name error is no biggie and might just mean a bit of paperwork to amend it, the name error Guild often sees is only an Insured’s personal name on their policies instead of the legal entity name under which they trade. This error can expose you as the Insured to face the financial consequences of claims made against that legal entity or your employees.

Which name should be listed on my policy?

The name/s you list on your policy are the names that the policy provides coverage for. Think of it this way, if it’s not listed, it’s not covered. Don’t leave yourself exposed to uninsured liabilities by leaving your legal entity (Pty Ltd) off your insurance schedule.

Not sure you have the right name on your policy?

At Guild, we understand that insurance can be confusing which is why we have a dedicated team to help navigate you through it. To update your policy or to discuss your current policy, speak to one of our friendly Insurance Specialists on 1800 810 213.

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Travelling with children is a great opportunity to spend quality time together and create shared memories. However, it does require some extra planning to ensure you’re prepared for the journey and the common risks you might encounter.

Next time you travel with children, keep these 10 tips in mind.

Before you go

1. Check that everyone’s passports are valid with at least 6 months left before the expiry date.
2. Speak to your doctor to see if any of you will need any vaccinations prior to travelling.
3. If any family members take medications, ensure you take a large enough supply with you to last the entirety of the trip, as well as some extra to cover you in case of any significant delays.
4. Often, children will get served an adult meal, so if your flights include meals, contact your airline to see if you can request kid’s meals for your children. They get served first and often have more kid-friendly food options.
5. Organise your travel insurance, making sure that all members of your family have cover before you head off.

On the way

6. Remember to pack any medications, wipes, nappies and toiletries that kids might need into your carry-on luggage, along with a change of clothing so you’re prepared for anything.
7. Have extra snacks and entertainment to help keep kids occupied while in transit and in case of delays.
8. Bring chewing gum, lollipops, or drinks for kids to help alleviate ear pressure during take-off and landing.

When you arrive

9. Have a plan in case of emergencies. Keep a first aid kit handy and familiarise yourself with local emergency contacts.
10. Most importantly, enjoy! Holidays are a great way to reconnect with your kids outside of the daily routine.

Get a Quote with PassportCard today.

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Lithium-ion batteries are the batteries used in many of our household items. They’re becoming incredibly common, and for good reason – they can be small and affordable yet also have a long lifespan and a high power efficiency. However, they’re not without risk. In fact, the risks of these batteries, especially when not used correctly, is incredibly high and have led to fatalities.

Where are they used?

Lithium-ion batteries are found in many items we use daily. From personal devices such as laptops and smart phones, to household items like vacuum cleaners and power tools and mobility products such as e-bikes and e-scooters. You’ll also find them in electric vehicles. Most of us wouldn’t get through a day without using and charging at least one of these batteries.

What’s the risk?

While all batteries can pose a risk, the risk with lithium-ion batteries is unique and more significant. Lithium-ion batteries contain a liquid electrolyte solution which makes them ideal from a performance perspective. However, this solution is highly flammable, and this is where the danger lies.

When lithium-ion batteries are poorly manufactured, damaged, or misused, they’re at risk of catching fire. These fires are particularly intense and hard to put out, taking over homes and businesses incredibly fast.

What can be done to reduce the risk of fire?

• Don’t overcharge devices – overcharging devices can lead to the battery overheating and then catching fire. Consider setting reminders to take devices off charge when complete.

• Only use compatible chargers – don’t use chargers not recommended by the manufacturer for that device; this can lead to the device overheating.

• Be mindful of where devices are charged – don’t charge a device while it’s resting on flammable material, such as bedding or a couch, as this will impact how fast a fire takes hold. Devices also shouldn’t be charged in a location which will block someone from exiting a room or building should it catch fire; this will potentially trap a person in a fire.

• Don’t use a damaged battery – if it’s swollen and enlarged, leaking or emitting an odour, this is an indication of a damaged battery which is unsafe to use.

• Don’t tinker with a battery – don’t remove, replace or try to fix a battery on any device. This could lead to it being damaged which is when they’re at high risk of fire.

• Don’t leave batteries where they’ll overheat – overheating increases the risk of catching fire, so be sure to limit the time in direct sun. Leaving them in vehicles sitting in the sun is particularly dangerous.

• Only use reputable brands – not all lithium-ion batteries are the same; do your research to be sure you’re using a reputable brand. Generic brands found online may be cheaper, but they aren’t worth the risk.

• Follow manufacture instructions – with any device that utilises a lithium battery and has charging capabilities, always follow the manufacturer’s instructions and/or recommendations regarding charging, storage, and safe use.

• Don’t dispose of them with your regular rubbish – as the risk of fire is increased when lithium-ion batteries are crushed or damaged, they need to be disposed of correctly. Organisations such as B-cycle and Planet Ark offer information on battery recycling locations, as do some local councils.

• Check smoke alarms – be sure your smoke alarms are in good working condition by checking them regularly. While this won’t prevent a fire, it will greatly assist in response time should a fire occur.

All health practitioners would be well aware of their requirements to obtain informed consent from their patients before assessment or treatment takes place. However, Guild Insurance’s vast experience in managing claims made against health practitioners has highlighted that many don’t meet all their informed consent requirements.

What is Informed Consent?

Ahpra have outlined a practitioner’s informed consent requirements in their various Codes of conduct, and these can be found at www.ahpra.gov.au/Resources/Code-of-conduct. Ahpra define informed consent as ‘a person’s voluntary decision about healthcare that is made with knowledge and understanding of the benefits and risks involved’.

This statement highlights the difference between consent and informed consent. If a patient hasn’t been made aware of the benefits and risks, their consent isn’t informed. Informed consent isn’t just required for treatment. Depending on the nature of the healthcare being provided, informed consent should also be obtained for assessment.

Informed Consent and Insurance Claims

Informed consent can feature in insurance claims against practitioners in a couple of ways.

It’s not uncommon when a patient is unhappy following treatment for them to allege they weren’t made aware of the risks when they consented to treatment. Quite often they’ll allege the treatment was negligent and has resulted in harm or suffering and had they been informed of the possible risks, they wouldn’t have consented.

In other cases, patients may not make any allegation about consent, their complaint might solely focus on the clinical outcome, yet when their claim is being managed it’s found that they didn’t give their informed consent prior to treatment being provided. When this occurs, it makes it challenging for Guild to prove that the practitioner has treated appropriately and met their requirements.

The Informed Consent Conversation

Informed consent requires a conversation between the treating practitioner and the patient. This conversation needs to occur prior to assessment and treatment.

The conversation must:

• Detail the recommended assessment and treatment as well as alternate treatment options.
• Include the expected benefits of that treatment.
• Provide information about the risks of the treatment.
• Allow time for the patient to ask questions.
• Use language which can be understood by the patient which means practitioners should avoid technical clinical language.
• Take place in a private area where the patient will feel comfortable being open and honest about their health situation.
• Be tailored to that individual patient and their unique clinical needs.

Recording Informed Consent

It’s imperative that practitioners make a note in the clinical record regarding the patient providing their informed consent.

This needs to be more than ‘IC given’. The record needs to show what treatment options and risks were discussed as well as any questions asked by the patient. The record should also show what the patient consented to as well as what they didn’t consent to where relevant.

The Informed Consent Form

One area which leads to some confusion about informed consent is how to use an informed consent form. Having a patient sign a form is seen as a quick and simplified way of having a patient provide their informed consent and keeping a record of that. However, they’re unfortunately too often used inappropriately.

Signed forms aren’t a requirement. While recording consent is required, this doesn’t need to be done using a form. Notes in the clinical record are sufficient. However, signed forms do provide additional evidence if there’s an allegation that informed consent wasn’t given.

Forms can’t be used to replace the informed consent conversation. A patient cannot read a form and gain the same level of understanding as they would from a conversation with the practitioner. Nor can they ask questions of the form.

A form should only be signed after the conversation with the practitioner has been had and the patient understands what it is they’re consenting to. Patients are occasionally asked to sign consent forms at reception before they’ve seen the practitioner. As there’s been no assessment or discussion about treatment at this stage, this can’t be considered informed consent as the patient hasn’t been informed.

Some practices combine new patient forms with the consent form. This isn’t ideal as the two forms serve different purposes. Also, having them on the one form encourages patients to sign the consent form at reception before they’ve seen the practitioner. Therefore, they should be divided into two separate forms.

Informed Consent is Not a One-Off Event

Practitioners regularly ask how often their patients need to give informed consent. There’s no set time frame for when informed consent conversations or signed forms need to be repeated. The requirement is that when a patient is receiving any assessment or treatment, they need to have given their informed consent to this.

Therefore, informed consent should be an ongoing process; it’s a continual conversation with patients during consultations. And when there’s any change in the treatment being provided, or if the patient has returned following a period of absence, informed consent needs to be revisited. A general ‘consent to all treatment’ for the life of the therapeutic relationship is not appropriate.

Informed Financial Consent

As well as consenting to assessment and treatment, patients should also give their informed financial consent. This means they need to be provided with information about the expected cost of treatment before this treatment commences.

In Summary…

There's no one right way to undertake an informed consent conversation and process. Practitioners must adapt what’s discussed for the patient they’re treating and that patient’s unique circumstances. However, what must occur in all cases is that the patient is informed of and understands the proposed treatment, alternate treatment options and the risks involved. Only with this information can they give their informed consent. The practitioner must also be sure to make a record of this informed consent discussion in the clinical record.

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Are you prepared for a power outage?

Power outages are unfortunately becoming a somewhat common occurrence in parts of Australia. The threat of heatwaves, and therefore higher than usual demands on power, means that power outages are a real threat to many businesses over summer.

Insurance protection during a power outage

It’s important that all businesses understand their insurance cover in case of events which impact the running of the business, such as a power outage. Guild Insurance will provide cover when the power outage is unplanned, and this is defined as when there is less than 48 hours’ notice that the outage will occur. Cover will be provided for the cost of hiring a generator. And the really beneficial part about this cover is that there’s no waiting period with Guild Insurance. So if the power is out for only 2 hours, the policy will still respond and provide cover for that short period.

Planning for an outage

Sometimes there is no notice that a power outage is to occur. And even when notice is given, there may not be enough time to allow a business to adequately prepare for the outage. Therefore it’s vital that all businesses have a plan in place, sometimes referred to as a business continuity plan, for what they’ll do if a power outage was to affect their business.

Some factors to consider when making this plan include:

• Is there a business nearby which provides generators for backup power?
• Can the business continue running from another site or location?
• Is there another location where items, such as refrigerated stock, can be stored so they don’t perish or become damaged?
• Where will emergency contact details (e.g. power company, insurer, clients) be stored away from the business in case the business can’t be accessed?
• What are the implications for both the business and clients if the business doesn’t operate for a period of time?

Remember, planning during an outage is too late. Don’t think this won’t happen to you, have a plan just in case.

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When considering an insurance policy, it’s easy for many of us to think “it’ll never happen to me”.  However, the vast experience of Guild Insurance tells us ‘it’, being events that require insurance claims, unfortunately can happen to people like you. 

Guild Insurance is dedicated to providing risk management information to those insured with us to help reduce the likelihood of events occurring which will have a detrimental impact on their business and lead to an insurance claim.  However, we also know that not everything can be prevented.  Which is why business owners also need to consider what they can do to reduce the severity or impact on their business should an event occur.  And this is where asset registers become so important.

What is an asset register?

An asset register is simply a list of assets held by a business.  These can be created and stored in various ways, such as paper format or electronically, yet should always be stored safely and be easily accessible.

Why are they needed?

All businesses should hold an asset register as they serve a number of important purposes.

It’s estimated that well over half of Australian businesses are underinsured.  A detailed asset register will help a business understand the value of what they own and therefore the level of insurance required to be adequately protected.

An asset register also assists businesses when there is a need to lodge an insurance claim due to property loss or damage.  When there is an up to date asset register, this necessary information can be provided quickly to an insurance company which is likely to speed up the settlement process.  Making an insurance claim for property damage or loss can be quite a stressful process for any business.  An asset register can reduce some of this stress by making the process more straightforward.

When a business has multiple sites, keeping track of all assets is quite a challenge.  An asset register provides the business with a way to manage all assets, even when the assets aren’t physically in sight of those responsible.

What information should be included?

For an asset register to be of any benefit to a business, it’s important that the information is up to date and correct.  Businesses should have a process for how and when the register will be updated and by who.  This process should require adding a new asset as soon as it is purchased.  However, it would also be beneficial doing regular checks of the asset register to be sure nothing has been accidentally left off.

The asset register should include a list of all items which could be lost or damaged if there was an incident at the premises.  Don’t just focus on the costly items; damage to a lot of items which are of lesser value can still add up and you will want a record of these items.  The types of assets to be recorded may include:

• Furniture, both indoor and outdoor
• Computer and other office equipment
• Electrical items such as fridges and air conditioners

The information to record about each of these items may include:

• Description of the item
• Brand, make or model
• Serial number
• Purchase value
• Purchase date
• Location of the item
• Warranty information
• Invoices

Creating an asset register

As previously mentioned, asset registers are really just a list of items so the creation of them doesn’t need to be overly complex.  There are a number of template examples which can be found through internet searches. 

However, the challenging aspect of creating an asset register is being sure the information you have on there is detailed and correct.  It’s therefore recommended that businesses use their accountant to assist with this task.

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