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This section is designed to draw you attention to some of the common clinical processes, systems and policies at Westmead, which all new medical staff should know about.

In general, the way of doing things at Westmead should not vary enormously to what you are used to elsewhere, and we will try to draw your attention to any variation under each section.

The one section you should definitely familiarise your self with is at the top of the list: Between the flags - our Clinical Emergency Response System. You need to be aware from Day 1 of the nomenclature used at Westmead and exactly how to call for help in an emergency.

If you are looking for a clinical policy:

  • In general, you should start with the WSLHD policy and procedure repository which can only be accessed inside the hospital from the home page of the INTRAnet - click here
  • You will also find a variety of useful information on the ED home page which can be accessed from the home page of the INTRAnet by a link called "clinical information" in the green "Links for Clinicians" box in the centre of the page


Between the Flags - CERS & ALS

Between the Flags is the statewide Clinical Emergency Response System (CERS), which sets out standard calling criteria for triggering either a "clinical review" or a "rapid response". These calling criteria align with colour coding on the state-wide standardized adult observation (SAGO) chart. A breach of the yellow zone criteria triggers a "clinical review" and a breach of the red zone criteria triggers a "Rapid Response".

In many NSW hospitals, the rapid response is known as a "MET" call, but at Westmead,  we have a two tiered system, with a "Rapid Response"  - which is an urgent review by the specialty team registrar, AND if the clinical situation is more urgent, or the patient does not improve following the Rapid Response - escalation to a Code Blue ALS call, which will activate an emergency response by the Advanced Life Support Team.  A Code Blue call can be activated by the wall mounted red emergency buttons bedside each bed, or by dialing 2222.

Our CERS policy aims to achieve a consistent practice and nomenclature across all of the hospitals in the Local Health District. However, for many years the staff at Westmead have referred to "PACE" (=Rapid Response) and "ALS" (=Code Blue) and you may continue to hear this terminology for a while longer.

Our CERS policy can be found on the hospital INTRAnet which can be accessed by clicking here, from inside the hospital, and other information is available on the CEC website, with specific information about CERS and the Sepsis Kills program

Anti-coagulation Guidelines

Anticoagulants are confusing, and while you can find plenty of guidelines in the literature, Westmead has maintained and updated its own comprehensive set of guidelines for many years. These represent the consensus Westmead approach to the prophylactic and therapeutic use of anticoagulants in a range of clinical different settings.

  • Anti-coagulation guidelines (only available from inside the hospital)
  • Child Protection

    Although you will see very few children at Westmead Hospital, you may come across a few transferred to us from the Children's Hospital, for specialized services. In addition junior medical staff may be rotated to secondment hospital with exposure to children. In short you still need to be aware of Child Protection at Westmead. For more detailed information you can click here for the NSW Health Child Protection website. Don't forget that Child Protection is also a mandatory e-learning module which you will find on "My Health Learning".

    Death Certificate and Coroner

    Writing a Death Certificate is not an everyday experience so we've tried to put together a pack of information, called the D-Cert folder, which will be available on every ward. This walks you through forms and the policies you need to be aware of. We also have a useful Death Certificate Quick Tips section on the JMO Oncall App 

    Just to emphasis a few common points of confusion:
    D-Cert Folder.JPG
    • Even if you have never seen the patient alive, you CAN write a death certificate for a hospital inpatient.
    • The person on the spot should always write the death certificate. If the patient dies after hours, do NOT leave it for the day team to do it later
    • The standard of proof for death certificates is "the balance of probabilities". You don't have to be 100% certain
    • There are a number of mandatory reasons for reporting to the coroner, and they are all are non-negotiable, even when the cause of death seems obvious and may not, to you, be suspicious. We are a Trauma hospital and almost all deaths of patients, who were admitted following trauma, need to be reported to the coroner
    • When you are reporting to the coroner you must NOT also write a death certificate - its can only ever be one or the other
    • Conversely, if the family or the hospital has arranged a non-coronial, hospital post mortem, a death certificate MUST be written beforehand
    • Reporting to the coroner is a legal requirement - the family's wishes play NO role in your decision making. Families often want to avoid a post mortem, and the coroner will often oblige - BUT only the coroner can make this decision

    For those who want to know more about the rules of what you should write on a Death Certificate, here are some detailed instructions from the Australian Bureau of Statistics

    Discharge Summaries

    Discharge Summary Procedure Document is currently under revision and will be available in early January 2021

    Health Care Interpreter Service and Translation

    Westmead is located in a hugely diverse part of the city and booking an interpretter is a skill which you will rapidly need to aquire when working here. We have an excellent Health Care Interpretter Service (HCIS) and they can be contacted by phone or by placing an e-order (see instructions below)

    Incidents & Complaints

    IIMS (Incident Information Management System) is a statewide, on line database for recording clinical incidents and adverse patient events, which is accessible from most computers in every hospital in NSW. By recording incidents as they happen, it helps to inform clinical managers about what is happening in their area, as well as providing valuable aggregate data about what is happening in our hospitals. In both instances is has a important role in helping maintain patient safety. All JMOs should be aware of this system. Anyone is able to report an incident into IIMS, and reporting can be anonymous.

    What should be reported?
    • Anything that you think went amiss or shouldn’t have happened.
    • Any situation where a patient might reasonably have been surprised or concerned about the
    • clinical outcome.
    • Any failure of equipment or clinical process.

    Library and CIAP

    Westmead has a modern, well-equipped and enthusiastically staffed library. For full details about the library resources got to the Library home page.

    Services provided include:
    • Access to a specialist medical collection
    • Skills training (eg CIAP training, literature searches)
    • Literature searches
    • Copyright advice
    • Document delivery
    • Access to computers and printing, copying and scanning facilities
    • Areas for group work and quiet individual study
    • Bookable meeting rooms and clinical exam rooms

    Library membership gives you free access to extensive electronic information through systems such as:

    • Clinical key
    • ProQuest
    • My Athens
    • Up to Date
    • CIAP

    Medical Records

    Pathology - ICPMR

    Patient Information

    Public Health


    Transfusion Orientation Pack Website Image.jpgThe Australian Red Cross Blood Service has put together a useful Transfusion Orientation Pack for JMOs which you can download here. This contains among other useful information a Hb Threshold Table and a Platelyt Threhold Table

    You will find an abundance of other useful resources at including:

    Looking for General
    Orientation information?

    See more

    WSLHD Facilities

    Need to make a room booking?