Key Learning Objectives
- Apply defensible documentation to improve and simplify your documentation
- Professionally document with confidence
- Achieve the best outcomes for clients, your organisation, and yourself
About the course
Defensible documentation is a documentation method that the reader quickly understands, is legally compliant, contains factual information that minimises the likelihood of incidents, enables high-quality care, and provides the required information when care is questioned.
The defensible documentation course has been developed from experience gained in seeking information from documentation and staff when serious incidents or complaints are investigated. Often reasonable care is found when interviewing staff. However, their documentation does not provide evidence of its provision, facts are unclear, gaps exist, and care becomes difficult to defend.
This course introduces you to what is relevant to document and ways to write it clearly and concisely, to leave the reader with the impression of a competent professional.
This course is split into a combination of 3 online modules filled with valuable tips and examples, followed by a live interactive webinar, which will provide you with the opportunity to put your new skills into action and receive feedback from our expert course instructor.
Who Should Attend
- Medical Officers
- Allied Health
ONLINE MODULE 1:
- The professional expectation of documentation and legal requirements
- Correct language and words to communicate information objectively and respectfully
- Tips for documenting clearly and concisely to save time for the writer and reader
- Documenting relevant information to communicate your role’s duty of care
ONLINE MODULE 2:
DEFENSIBLE DOCUMENTATION IN PRACTICE
- Method of defensible documentation to simplify the process
- Progress note documentation to achieve person-centered, goal orientated, and consistent care
- Incident report documentation to provide evidence of reasonable care to minimise harm and prevent incident reoccurrence
- Critical documentation elements to provide evidence of informed decision making when a client chooses to take risks with a likelihood of harm
ONLINE MODULE 3:
INCORPORATING THE METHOD FOR DEFENSIBLE DOCUMENTATION WITH ISBAR
- Overview of the frequently used ISBAR communication method (ISBAR = Identity, Situation, Background, Assessment, Recommendation).
- Using defensible documentation skills to improve the quality of ISBAR
Live Interactive Session
21 February – 1 March 2022 Course: 1st March 10:00 – 11:30 (SGT)
Live Interactive Session
5 – 13 September 2022 Course: 13th September 11:00 – 12:30 (SGT)
Attend a 90 minute live and interactive session where our expert facilitator will guide you to use defensible documentation skills to write professional, legally compliant, accurate progress notes and incident reports for real-life scenarios.
On-site & in-house training
Deliver this course how you want, where you want, when you want – and save up to 40%! 8+ employees seeking training on the same topic?
Talk to us about an on-site/in-house & customised solution.