scholarly journals 985 Improving the Accessibility and Quality of Junior Doctor's Rotas During the Covid19 Pandemic

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Gowda ◽  
K Smith
Keyword(s):  
Work Force ◽  
Working Life ◽  
Junior Doctors ◽  
Medical Speciality ◽  
Surgical Department ◽  
Working Lives ◽  
Pdsa Cycle ◽  
Force Planning ◽  
At Home

Abstract Introduction Rotas are an important part of a Junior Doctors working life. Having an up to date and accessible rota is important in enhancing Junior Doctor’s working lives in addition to being vital for work force planning and patient safety. During the Covid19 pandemic, rotas have changed several times making it difficult to track changes. Prior to our project, Junior Doctors found it neither difficult nor easy to access rotas at work (2.84 out of 5), found it fairly difficult to access rotas at home (2.38 out of 5) and the rotas they had access to were only average in being up to date (2.69 out of 5). Our project looked to improve this. Method Data was collected by surveys sent to Junior Doctors in the surgical department. PDSA Cycle 1 involved implementing surgical rotas on Microsoft Teams. PDSA Cycle 2 involved having other speciality rotas on Microsoft Teams. Our aims were to improve accessibility of rotas both at home and in the workplace whilst improving how up to date the available rota is. Results After the surgical rotas were on Microsoft Teams, rotas were easy to access at work (4.64 out of 5), fairly easy to access at home (4.24 out of 5) and were mostly up to date (4.41 out of 5). This has led to an improved satisfaction amongst Junior Doctors. Conclusions Currently the surgical department in Derby is using our solution for rotas. Medical staffing is in the midst of implementing this in the Medical speciality.

Work-at-Home and the Quality of Working Life

1985 ◽  
Vol 10 (3) ◽  
pp. 455 ◽  
Author(s):  
Boas Shamir ◽  
Ilan Salomon
Keyword(s):  
Working Life ◽  
Quality Of Working Life ◽  
Work At Home ◽  
At Home

scholarly journals Exceptional prison conditions and the quality of prison life: Prison size and prison culture in Norwegian closed prisons

2011 ◽  
Vol 8 (6) ◽  
pp. 515-529 ◽  
Author(s):  
Berit Johnsen ◽  
Per Kristian Granheim ◽  
Janne Helgesen
Keyword(s):  
Quality Of Life ◽  
Working Life ◽  
Senior Management ◽  
Positive Relationships ◽  
Prison Life ◽  
Working Lives ◽  
Prison Culture ◽  
The Relationship ◽  
Positive Results

This paper discusses the quality of prison life and prison size in relation to the notion of ‘Scandinavian exceptionalism’. Using the questionnaires ‘Measuring the Quality of Prison Life’ (MQPL) for prisoners and ‘Staff Measuring the Quality of Prison Life’ (SQL) for staff, data were collected from all 32 closed prisons in Norway. Based on the assumption that prison officers’ working lives, their perspectives and their values influence prisoners’ quality of life, the main focus in the paper is on the officers. Small prisons (fewer than 50 prisoners) obtain more positive results than medium-sized (50–100) and large (more than 100) prisons, on several dimensions measured. The relationship between officers and prisoners seems to be of better quality in small prisons than in medium-sized and large prisons. Officers in small prisons also report more positive relationships with senior management than their colleagues in medium-sized and large prisons. The results are discussed in light of previous studies on officers and prison working life dynamics.

scholarly journals Improving driving advice provided to cardiology patients on discharge

2018 ◽  
Vol 7 (1) ◽  
pp. e000162
Author(s):  
Amoolya Vusirikala ◽  
Mark Backhouse ◽  
Sarah Schimansky
Keyword(s):  
Hard Copy ◽  
Junior Doctors ◽  
Improvement Project ◽  
The Third ◽  
Driving Restrictions ◽  
Pdsa Cycle ◽  
Before And After ◽  
Ability To Drive ◽  
Discharge Summaries

Certain cardiac conditions can limit patients’ ability to drive. It remains the doctors' responsibility to advise patients of any driving restrictions and is particularly important after certain diagnoses or procedures. We identified that the quality of documented advice was variable and frequently no written driving advice was recorded on discharge. It was apparent that there was a lack of awareness and knowledge of the current Driving and Vehicle Licensing Agency (DVLA) guidance among junior doctors.We therefore designed a quality improvement project using Plan–Do–Study–Act (PDSA) methodology to improve the provision of driving advice on discharge from a cardiology ward by focusing on staff education. After collecting baseline data, we created a template with cardiology-specific DVLA advice. During the second PDSA cycle, we improved the electronic template and also introduced a hard copy on the ward. During the third PDSA cycle, we incorporated information on DVLA guidance in the specialty induction session. We also evaluated junior doctors’ confidence of providing driving advice before and after this intervention.Baseline measurements showed that 10% (9/92) of all discharge summaries included driving advice. This improved to 49% (34/69) after the third PDSA cycle. Importantly, after receiving information on driving advice in the induction, junior doctors felt more confident in providing driving advice to cardiology patients on discharge. In conclusion, the provision of driving advice on discharge is an important element of patient safety. However, clinicians’ knowledge and awareness of current DVLA guidance is often limited. We demonstrated a significant increase in the provision of driving advice by introducing a standardised template.

scholarly journals Improving the quality of assessment and management of nasal trauma in a major trauma centre (MTC): Queen Elizabeth Hospital, Birmingham

2019 ◽  
Vol 8 (4) ◽  
pp. e000632
Author(s):  
Apoorva Khajuria ◽  
Max Sallis Osborne ◽  
Lisha McClleland ◽  
Sandip Ghosh
Keyword(s):  
Airway Obstruction ◽  
Queen Elizabeth Hospital ◽  
Facial Trauma ◽  
Junior Doctors ◽  
Trauma Patients ◽  
Nasal Airway ◽  
Pdsa Cycle ◽  
Major Trauma Centre ◽  
Nasal Trauma

BackgroundNasal fractures present in 39% of patients with facial trauma. These patients are assessed in the emergency department followed by outpatient review in the senior house officer-led emergency ear, nose and throat (ENT) clinic. Inadequate treatment of nasal trauma can result in debilitating functional and aesthetic problems. Inexperienced junior doctors may be apprehensive in assessing nasal trauma resulting in time pressured clinics and suboptimal management.MeasuresA retrospective review of clinical noting over 3 months was carried out to gauge the extent of the problem. Three baseline measurements for satisfactory quality of assessments included: (1) 3/5 key symptoms elicited by the clinician (epistaxis, rhinorrhoea, nasal airway obstruction, dental malocclusion and diplopia). (2) Presence/absence of ‘septal haematoma’ (SH) and ‘deviated nasal septum’ (DNS) documented. (3) Patient follow-up within 2 weeks after the initial injury. Three Plan-Do-Study-Act (PDSA) cycles were conducted with implementation of interventions (proforma, clinic poster, patient information leaflet and training) as visualised in our ‘driver diagram’.ResultsThe quality of nasal trauma assessments improved following each intervention. There was an increase from 86% to 100% patients being seen within 2 weeks of the injury. There was an improvement in quality of assessments following the teaching as two-thirds (PDSA cycle 2) followed by 100% (PDSA cycle 3) of clinical documentation included ‘rhinorrhoea’ and 83% (PDSA cycle 2) to 100% (PDSA cycle 3) included ‘nasal airway obstruction’. Similarly, two thirds (PDSA cycle 2) followed by 100% (PDSA cycle 3) examined and documented the presence/absence of SH and DNS. A 100% improvement in trainee confidence was reported. We are now conducting more comprehensive assessments of nasal trauma patients.ConclusionThe need to provide relevant training and support to ENT junior doctors is crucial in their development, as well as to ensure delivery of high-quality patient-centred care.

Work-At-Home and the Quality of Working Life

1985 ◽  
Vol 10 (3) ◽  
pp. 455-464 ◽  
Author(s):  
Boas Shamir ◽  
Ilan Salomon
Keyword(s):  
Working Life ◽  
Quality Of Working Life ◽  
Work At Home ◽  
At Home

Quality of working life in genitourinary medicine

2003 ◽  
Vol 14 (8) ◽  
pp. 524-525 ◽  
Author(s):  
D Bansal ◽  
V Griffiths ◽  
E M Carlin
Keyword(s):  
Working Life ◽  
Care Staff ◽  
Health Care Staff ◽  
Quality Of Working Life ◽  
Staff Members ◽  
Work Related ◽  
Working Lives ◽  
Related Quality ◽  
Genitourinary Medicine

Quality issues are becoming increasingly relevant to the working lives of health care staff. We sought to assess the perceived work-related quality of life of staff working in a genitourinary medicine (GUM) department using a self-administered anonymous questionnaire focusing on areas from the Trust's staff charter. Over two-thirds (69%) of the staff members participated. Perceptions of working life were generally good within GUM. In particular staff felt valued as a resource with free expression of ideas, involvement in decision making, fair treatment and respect. Weaker areas were identified enabling a plan to be developed to address these. It is important to address quality in working life in order to achieve improvements.

scholarly journals 187 Improving Awareness of Managing Post-Operative Haemorrhage in Patients Undergoing Thyroid and Parathyroid Surgery: The SCOOP Protocol

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Bhattacharya ◽  
J Jegadeeson ◽  
J Ramsingh ◽  
P Truran
Keyword(s):  
Nursing Staff ◽  
Simulation Training ◽  
Clinical Signs ◽  
Skin Wound ◽  
Junior Doctors ◽  
Parathyroid Surgery ◽  
Surgical Department ◽  
Life Threatening ◽  
Clinical Questions ◽  
Life Threatening Complication

Abstract Introduction Post-operative haemorrhage is a rare but potentially life-threatening complication of thyroid surgery and occurs in 1 in 100 patients. Our aim was to assess current levels of awareness of post-operative haemorrhage in the surgical department and to improve confidence in managing this. Method Questionnaires with a combination of clinical questions were distributed amongst nurses, foundation doctors, senior house officers and registrars in the surgical department. Results There was a clear gap in awareness in all grades. The British Association of Endocrine and Thyroid surgeons (BAETS) have guidance on the management of these patients and in particular the acronym SCOOP (Steristrips removed, Cut subcuticular sutures, Open skin wound, Open strap muscles, Pack wound). 18/24 of participants had not heard of the SCOOP protocol. Most nurses (6/12) all junior doctors (8/8) showed lack of confidence in managing patients with suspected bleeding. Conclusions An informative poster was created for relevant clinical areas as per the BAETS recommendation. These posters outlined the steps in the SCOOP acronymas well as the main clinical signs of haemorrhage. BAETS recommend that all first responders, including nursing staff, junior doctors and the crash team should be aware of the SCOOP protocol. Simulation training sessions are in progress for these members of staff.

Cognitive determinants of community functioning and quality of life in homeless adults with mental illness: 6-year follow-up from the At Home/Chez Soi Study Toronto site

2021 ◽  
pp. 1-9
Author(s):  
K. M. Gicas ◽  
C. Mejia-Lancheros ◽  
R. Nisenbaum ◽  
R. Wang ◽  
S. W. Hwang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Functional Outcomes ◽  
Verbal Learning ◽  
Subjective Quality ◽  
Subjective Quality Of Life ◽  
Homeless Adults ◽  
Community Functioning ◽  
At Home

Abstract Background High rates of physical and mental health comorbidities are associated with functional impairment among persons who are homeless. Cognitive dysfunction is common, but how it contributes to various functional outcomes in this population has not been well investigated. This study examines how cognition covaries with community functioning and subjective quality of life over a 6-year period while accounting for the effects of risk and protective factors. Methods Participants were 349 homeless adults (mean age = 39.8) recruited from the Toronto site of the At Home/Chez Soi study, a large Canadian randomized control trial of Housing First. Participants completed up to four clinical evaluations over 6 years. Factor scores were created to index verbal learning and memory (vLM) and processing speed-cognitive flexibility (PSCF). The primary outcomes were community functioning and subjective quality of life. Risk factors included lifetime homelessness, mental health diagnoses, medical comorbidity, and childhood adversity. Linear mixed-effects models were conducted to examine cognition-functional outcome associations over time, with resilience as a moderator. Results Better vLM (b = 0.787, p = 0.010) and PSCF (b = 1.66, p < 0.001) were associated with better community functioning, but not with quality of life. Resilience conferred a protective effect on subjective quality of life (b = 1.45, p = 0.011) but did not moderate outcomes. Conclusions Our findings suggest a need to consider the unique determinants of community functioning and quality of life among homeless adults. Cognition should be prioritized as a key intervention target within existing service delivery models to optimize long-term functional outcomes.

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