MedApp allows rotating staff to keep vital term changeover documents up to date via their mobile, improving clinician wellbeing & a positive hospital culture.
Term changeover, handover notes or ROVERs. Irrespective of your naming convention, they are an essential tool to help a new rotation of clinicians get up to speed as quickly as possible, reduce anxiety and promotes a positive hospital culture (everyone is kinder when they are less stressed!).
In this article the following will be covered:
Best practice examples
What is a term handover / ROVER
Helps JMOs migrate from term to term, ensuring they can move as easily as possible between different teams, specialties and hospitals.
Where does Med App fit in?
We can create a mobile, editable document for clinicians to add to over time
Send reminders to update at term changeover & link to the documents
Improve hospital culture & clinician confidence
How does it work for clinicians
Send reminders for clinicians to update & review
Announcements (push notifications) can be scheduled to be sent to a clinicians app reminding them to review/update their term changeover doc. You can also link directly to it for easy access and provide instruction on how to edit.
Open announcements in Med App and click 'create announcement'
Copy the below template into a new announcement
Subject Name: Please update your end of term handover
body: Help your fellow clinicians feel less anxious about their upcoming rotation. Please review and update your term handover! Click the links below for more info. Thank you :)
Link to your handover folder by clicking 'Add content' then 'insert heading'
Add the 'how to update documents' guide for clinicians
Click 'add content'
Open 'A Guide to Med App' category and add the article 'Updating term handover documents'
Schedule or send now: select if you would like to send the message now or schedule for a later time/date.
How to use create an editable term handover
Copy the templates we have listed below for clinicians to fill out. Remember to remove any existing information from the example templates.
Get clinicians to fill them out (sometimes the first version should be filled in on a computer if there is a lot of info to write up for round 1)
Upload to Med App under Rosters & Rotations
Create a new heading
Create a new article as a 'Rich Text' and add the department name in the title
Copy / Paste any of the templates further down in this article into the document
Saving documents to be editable Make sure handover documents are editable when you upload a new template
Tick 'Requires admin approval' - This allows clinicians to make updates to the document through their mobile devices.
Admin's will be notified when changes need approving.
O&G ROVER template
Last Updated: dd/mm/yy (Updaters name)
Head of Department Name
Handover – 8 am (handover room, opposite special care nursery). Roles prior to handover include printing lists for the team (birth suite, maternity rooms + ward outliers) and reviewing overnight progress on eMR.
Teaching is Wednesday 8 am during handover time.
1 Consultant & 1 Reg / SRMO covering birth suite, triage, and emergency caesareans and gynae surgery.
Additional consultants or Regs present covering the antenatal and gynae clinics and elective caesarean lists.
Resident roles include:
Scribing and charting medications for morning ward rounds
Pre-admission clinic (Mon/Wed/Thurs) for elective surgery – clinic will ring if there are any patients scheduled for that day
Afternoon admissions for inductions of labour, including reviewing medical history and charting medications
Attending clinical reviews on the ward
Obstetrically clearing patients post-delivery, including discussing and prescribing contraception options
Tips and tricks
The midwives are excellent and can help with most questions / queries. Often in emergencies, medications are administered and charted in retrospect – midwives keep an excellent record of what needs to be charted (and can help with doses if unsure).
Become familiar with common medication regimes including premature rupture of membranes (PROM), induction of labour (oxytocics) and fevers during labour.
Whilst you are not expected to read and interpret CTGs, RANZCOG has a free online course (FSEP) that covers the theory and interpretation of CTGs, which is extremely useful for understanding the theory.
Most women being admitted to birthing suite will require a (>18g) cannula, group and screen and full blood count.
JMO Role - GP Case Study
Last Updated: dd/mm/yy (Updaters name)
Supervisor: Dr Bob
GPs Dr Xavier, Dr Kylie, Dr Nebula
Location: Appletown* is located ~2.25 hours southwest of Sydney. The town is made up of around 2000 people.
The term is a combined GP clinic/Hospital term
The GP clinic has 4 regular GPs, a practice nurse and a pathology collector. It is pretty busy, with high patient turn over.
The hospital is a 16 bed hospital with an emergency department with 1 resus bed, 2 treatment beds, and 1 isolation/MH room.
JMO Roles and Responsibilities
Start Time – 8am
During my term, I spent all my time in the hospital. The hospital inpatient’s combined with the ED presentations often mean the workload of the hospital is often more than enough to need a full time JMO. The clinic is attached to the hospital and currently has 4 GPs. There are only 4 rooms, however not all the GPs work every day so it would be possible to arrange working out of one of these rooms when one of the GPs are away – *** is very keen to adjust the term based on your preference, just ask
Average Daily Routine
8am – JMO arrive; normally print a list of current in patients and check notes, obs and results from patients overnight
8:30am – GP AMOs start arriving. GPs tend to round on their own patient’s. Rounds will be quick and pretty no nonsense, I found it easier to take a paper list and write jobs on this, before recording eMR notes following the round
Following round– Normally hospital round has finished by this point and JMO can spend a few minutes writing ward round notes
After the round the rest of the day is taken up by doing jobs for patients on the ward and seeing ED presentations
The majority of the days finish on time at 4:30, however sometimes there may still be several patients to see in ED or jobs to wrap up – it is optional for the JMO to stay, but is a great help to the GPs who are normally very busy
The roster is a Monday to Friday schedule, from 8:00 – 4:30. Every second Friday is a payed day of leave. *** is happy for you to shift around the schedule, if you would prefer to work weekends or adjust your days off, just negotiate with him
can be very variable, some days there may be 1 ED presentation and some inpatients awaiting NH placement, so minimal work. Other days there can be 10 ED presentations on top of some higher maintenance ward patients, and you may need to stay back until 7:30-8:00pm. It’s a little bit of a feast or famine
The hospital has 4 ED beds; 1 resus bed, 2 treatment beds and 1 isolation/MH room; and 16 ward beds
The hospital is staffed full time by nursing staff, who are an excellent resource if you need help
There is point of care blood testing available on site – the 3 tests available are troponin, Chem8 (K, Ca, Hb, glu, etc.) and a basic gas
Formal pathology is collected twice per day – at around 10 am and 2 pm. Get used to not having blood results for 6 hours at least after these bloods are sent off
Radiology is available on weekdays except Wednesday. Only plain films are available. The radiologist *** is really helpful if you have any questions or need help.
CT and US – the closest centre is *** (this is also where pathology is sent too) and patients with non-urgent scans can be sent via patient transport to these centres
This was an area that I found to be somewhat confusing as there is no clear referral pathways in many cases
Acute neurology and cardiology ****
Most other referrals can be sent to either ***(1.5 hours) or ****(1 hour). Often it was easier to make a referral based on where the patient had previously been seen/known to specialists. As COVID was making a resurgence during my term I found myself making more referrals to *** as it was less complicated in terms of crossing the border interstate
There is a townhouse provided to the JMO during your term.
It is a 3 bedroom townhouse with 1 bathroom
Approximately 5 min drive from the hospital/clinic
Has heating and cooling in each room
Sheets and towels are available at the site, but if you’re picky about linen or towels you might want to bring your own
Has all basic appliances you can think of (microwave, toaster, TV, washing machine)
The house is serviced every second week usually on a Monday so don't be surprised if you come home and your things have been moved around
There is an IGA which is pretty well stocked but is a little bit expensive. Note it opens at 8 and closes at 7pm
Multiple restaurants: Country Club, Chinese, RSL are all alright for a fee
Your mileage may vary - the Chinese is very expensive and the pub food is pub food.
Coffee: Everywhere in opens late (although the bakery is open from 5am but closes at 3:30pm), coffee from the bakery can be missed. The bakery food is divine - their vanilla slice is famous in the area but you will hear the locals complain about the prices. Next door to the Bakery there is a new café (Bay Laurel) which is apparently good coffee, however is only open from 8:30 until 2:30
Takeaway: the two service stations can deep fry just about anything. Try the $5 burgers on a Wednesday at least once.
The lake has a nice track around it if you’re into running or walking (or birdwatching, you will see lots of swans and their cygnets depending on the time of year, purple swamp hens, dusky moorhens, corellas, and of course ducks). Golf course is surprisingly decent if you get a chance for a hit
There is a gym which is reportedly well appointed for a small town courtesy of the Rotary club.
As for surrounding towns - there are a lot of excellent sites to see within 30-40mins drive. A must do is to visit Cactus Country. Try the cactus cake and icecream just for fun. The big strawberry is 20mins drive. *** is an aviation town with a small but interesting aviation museum, and a big Murray Cod to take photos with on the foreshore. Lots of Ned Kelly themed sites and you may get lucky and see the absolutely gigantic wedge tailed eagle on the road.
There are a number of small town museums in the area worth checking out if interested in history.
💡If you want to look at more about how to use the in-app editing features, check out our other help articles here: