6

Managing medical complexity

This competency is about aspects of care beyond managing straightforward problems, including the management of co-morbidity, uncertainty and risk, and the approach to health rather than just illness.

Insufficient Evidence

From the available evidence, the doctor’s performance cannot be placed on a higher point of this developmental scale.

Needs Further Development

Manages health problems separately, without necessarily considering the implications of
co-morbidity.

Draws conclusions when it is appropriate to do so.

Competent

Simultaneously manages the patient’s health problems, both acute and chronic.

Excellent

Accepts responsibility for coordinating the management of the patient’s acute and chronic problems over time.

Appropriately prioritises management approaches, based on an assessment of patient risk.

Is able to tolerate uncertainty, including that experienced by the patient, where this is unavoidable.

Communicates risk effectively to patients and involves them in its management to the appropriate degree.

Anticipates and uses strategies for managing uncertainty.

Uses strategies such as monitoring, outcomes assessment and feedback to minimise the adverse effects of risk.

Maintains a positive attitude to the patient’s health.

Consistently encourages improvement and rehabilitation and, where appropriate, recovery.

Encourages the patient to participate in appropriate health promotion and disease prevention strategies.

Coordinates a team based approach to health promotion, prevention, cure, care and palliation and rehabilitation.