scholarly journals TP8.2.30 Bleep paralysis: preventing inefficiency on the general surgical on-call

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Helen Whitmore ◽  
Rola Salem ◽  
Kirk Bowling ◽  
Holly Clamp ◽  
Rosaline Chandra ◽  
...  
Keyword(s):  
Junior Doctor ◽  
Single Point ◽  
House Officer ◽  
Referral System ◽  
Senior House Officer ◽  
Post Intervention ◽  
Constant Intensity ◽  
Surgical Services ◽  
Surgical Workforce ◽  
The Mean

Abstract Aims The demand on surgical services is increasing. In our Trust, all surgical referrals and queries are directed through the Senior House Officer (SHO) on-call. This leads to inefficiency, with many hours spent on the telephone and away from clinical duties. Such constant intensity can cause increased stress and anxiety amongst those involved. Junior doctor burnout and stress-related sickness are increasing concerns amongst the current surgical workforce. In an attempt to alleviate these factors, we instigated an intervention to evenly distribute workload during surgical on-calls. Method The number of bleeps through the surgical SHO on-call were audited for four consecutive thirteen hour shifts. Each call was estimated to take an average of five minutes to resolve. A separate GP referral phone was introduced to reduce the volume of traffic through the SHO bleep. The number of calls through the SHO and referral phone were re-audited following this intervention. Results Before introduction of a referral phone, the mean length of time spent by the SHO per shift answering calls was 232.5 minutes, with a maximum of 330 minutes. Post intervention, the SHO spent an average of 92.5 minutes per shift answering calls and referrals through the GP phone averaged 43.75 minutes. Conclusion The introduction of a single point GP referral system has significantly reduced the volume of calls through the SHO, thus has also minimised time spent away from on-call duties. Not only does this improve efficiency within the on-call team, but also reduces risk of burnout amongst trainees.

The changing role of the otolaryngology Senior House Officer

2006 ◽  
Vol 88 (2) ◽  
pp. 66-68 ◽  
Author(s):  
AK Arya ◽  
KP Gibbin
Keyword(s):  
Patient Safety ◽  
Junior Doctor ◽  
House Officer ◽  
European Working Time Directive ◽  
Junior Doctors ◽  
Senior House Officer ◽  
European Working ◽  
Working Time Directive ◽  
Changing Role

The European Working Time Directive (EWTD) has led to a reduction in the number of hours that a junior doctor is allowed to work. The Hospital at Night project aims to reduce juniors' presence at night through more efficient working. Otolaryngology has been considered to be one of the surgical specialties in which generic junior doctors covering more than one specialty could effectively function. The hope is to reduce junior doctors' hours sufficiently without compromising their training or patient safety.

General Surgery at Rural Tennessee Hospitals: A Survey of Rural Tennessee Hospital Administrators

2011 ◽  
Vol 77 (7) ◽  
pp. 820-825
Author(s):  
Joseph B. Cofer ◽  
Tommy J. Petros ◽  
Hans C. Burkholder ◽  
P. Chris Clarke
Keyword(s):  
Rural Communities ◽  
National Survey ◽  
General Surgery ◽  
Response Rate ◽  
General Surgeon ◽  
Hospital Administrators ◽  
Surgical Services ◽  
Surgical Workforce ◽  
General Surgeons ◽  
The Mean

Rural communities face an impending surgical workforce crisis. The purpose of this study is to describe perceptions of rural Tennessee hospital administrators regarding the importance of surgical services to their hospitals. In collaboration with the Tennessee Hospital Association, we developed and administered a 13-item survey based on a recently published national survey to 80 rural Tennessee hospitals in August 2008. A total of 29 responses were received for an overall 36.3 per cent response rate. Over 44 per cent of rural surgeons were older than 50 years of age, and 27.6 per cent of hospitals reported they would lose at least one surgeon in the next 2 years. The responding hospitals reported losing 10.4 per cent of their surgical workforce in the preceding 2 years. Over 53 per cent were actively recruiting a general surgeon with an average time to recruit a surgeon of 11.8 months. Ninety-seven per cent stated that having a surgical program was very important to their financial viability with the mean and median reported revenue generated by a single general surgeon being $1.8 million and $1.4 million, respectively. Almost 11 per cent of the hospitals stated they would have to close if they lost surgical services. Although rural Tennessee hospitals face similar difficulties to national rural hospitals with regard to retaining and hiring surgeons, slightly more Tennessee hospitals (54 vs 36%) were actively attempting to recruit a general surgeon. The shortage of general surgeons is a threat to the accessibility of comprehensive hospital-based care for rural Tennesseans.

scholarly journals Effectiveness of Home-Based Occupational Therapy on COPM Performance and Satisfaction Scores in Patients with COPD

2020 ◽  
pp. 000841742097112
Author(s):  
Eleonore H. Koolen ◽  
Martijn A. Spruit ◽  
Marianne de Man ◽  
Jeanine C. Antons ◽  
Elieke Nijhuis ◽  
...  
Keyword(s):  
Occupational Therapy ◽  
Integrated Management ◽  
Performance Measure ◽  
Occupational Performance ◽  
Post Intervention ◽  
Canadian Occupational Performance Measure ◽  
Home Based ◽  
Copd Patients ◽  
The Mean ◽  
Mean Differences

Background. Occupational therapy (OT) may be an important intervention in patients with COPD, but studies show conflicting results. Purpose. To evaluate the effectiveness of home-based monodisciplinary OT in COPD patients Method. We conducted an observational clinical study. Main outcomes were the mean differences in the Canadian Occupational Performance Measure (COPM) performance and satisfaction scores, pre and post intervention. Findings. Pre- and postintervention data were obtained from 41 patients. Statistically significant increases were observed in COPM performance (5.0 ± 1.1 versus 6.9 ± 0.9; P<0.001) and satisfaction (4.6 ± 1.3 versus 6.9 ± 1.0; P<0.001). The most frequently reported occupational performance problems were found in the domains of productivity (47%) and mobility (40%), fewer in self-care (10%) and the least in leisure (3%). Implications. Home-based monodisciplinary OT can contribute significantly to the improvement of daily functioning of patients with COPD. OT should therefore be considered more often as part of the integrated management of these patients.

What is the Role of Senior House Officer or Dental Foundation Year Two Posts in Professional Careers?

2010 ◽  
Vol os17 (3) ◽  
pp. 115-122 ◽  
Author(s):  
Jennifer E Gallagher ◽  
Timothy J Bates ◽  
Harpoonam Kalsi ◽  
Aneesha Shah ◽  
Yon Jon Wang ◽  
...  
Keyword(s):  
Dental Service ◽  
House Officer ◽  
Senior House Officer ◽  
Perceived Benefits ◽  
Cross Sectional ◽  
Professional Careers ◽  
Training Post ◽  
Question Difficulty ◽  
Motivating Factor

Aims To investigate the motivations for, and perceived benefits of, undertaking senior house officer (SHO) posts, and to explore the career pathways of those who do, examining trends in successive cohorts. Method Postal cross-sectional questionnaire survey of all dental and maxillofacial SHOs (DF2s) who had worked for two South London hospitals within the previous nine years (n=137). Respondents were grouped into three cohorts to enable responses to be examined in relation to respondents’ entry to their first SHO post. Results There were responses from 83 (61%) potential participants. The most frequent motivation for carrying out SHO posts from 79 (95%) of the respondents was the desire to ‘learn from experienced clinicians’. The most common perceived benefit reported by those who had completed posts at the time of the survey was ‘an improved understanding of the role of the hospital dental service’ from 68 (97%) of those who answered this question. Difficulty in securing a job in general dental practice was not reported as a notable motivating factor, either before or after the implementation of the new dental contract. ‘Fulfil approved training post requirements for postgraduate examinations’ reduced as a motivator from 28 (88%) for the earlier cohort of SHOs to nine (36%) for the more recent cohort. Fifty-four of 78 (69%) respondents declared a definite plan to seek admission to the General Dental Council Specialist Lists in future, 24 (83%) in the first cohort, compared with 11 (46%) in the last ( P=0.05). Of the males, 13 (52%) were significantly more likely to report that they were currently working in general practice compared with 15 (27%) females ( P=0.028). Conclusion The findings suggest that multiple benefits are identified from undertaking SHO posts. However, some of the motivations for undertaking SHO posts may have changed over the nine-year period investigated. Possible influences are discussed. This paper highlights the perceived benefits of junior training posts at a time of significant transition within the profession.

The modified frailty index-11 predicts medium-term outcomes after endovascular revascularisation for chronic limb threatening ischaemia in Asian patients

Vascular ◽  
2021 ◽  
pp. 170853812098822
Author(s):  
Shereen XY Soon ◽  
Reuban D’Çruz ◽  
Charyl JQ Yap ◽  
Wei Ling Tay ◽  
Siew Ping Chng ◽  
...  
Keyword(s):  
Complication Rate ◽  
Early Recognition ◽  
Frailty Index ◽  
Arterial Disease ◽  
Unplanned Readmission ◽  
Medium Term ◽  
Post Intervention ◽  
Asian Patients ◽  
Modified Frailty Index ◽  
The Mean

Objective The aim was to evaluate the utility of frailty, as defined by the modified Frailty Index-1 1 (mFI-11) on predicting outcomes following endovascular revascularisation in Asian patients with chronic limb-threatening ischaemia (CLTI). Methods CLTI patients who underwent endovascular revascularisation between January 2015 and March 2017 were included. Patients were retrospectively scored using the mFI-11 to categorise frailty as low, medium or high risk. Observed outcomes included 30-day complication rate and unplanned readmissions, 1-, 6- and 12-month mortality, and ambulation status at 6- and 12 months post-intervention. Results A total of 233 patients (250 procedures) were included; 137 (58.8%) were males and the mean age was 69.0 (±10.7) years. 202/233 (86.7%) were diabetic and 196/233 (84.1%) had a prior diagnosis of peripheral arterial disease (PAD). The mean mFI-11 score was 4.2 (±1.5). 28/233 (12.0%), 155/233 (66.5%), and 50/233 (21.5%) patients were deemed low (mF-11 score 0–2), moderate (mFI-11 score 3–5) and high (mFI-11 score 5–7) frailty risk, respectively. High frailty was associated with an increased 12-month mortality (OR 8.54, 95% CI 1.05–69.5; p = 0.05), 30-day complication rate (OR 9.41, 95% CI 2.01–44.1; p < 0.01) and 30-day unplanned readmission (OR 5.06, 95% CI 1.06–24.2; p = 0.04). Furthermore, a high score was associated with a significantly worse 6- (OR 0.320, 95% CI 0.120–0.840; p = 0.02) and 12-month (OR 0.270, 95% CI 0.100–0.710; p < 0.01) ambulatory status. Conclusion The mFI-11 is a useful, non-invasive tool that can be readily calculated using readily available patient data, for prediction of medium-term outcomes for Asian CLTI patients following endovascular revascularisation. Early recognition of short- and mid-term loss of ambulation status amongst high-frailty patients in this challenging cohort of patients could aid decision-making for whether a revascularisation or amputation-first policy is appropriate, and manage patient and caregiver expectations on potential improvement in functional outcome.

It's Getting Better: Progress in Medical Senior House Officer Training in Scotland

2007 ◽  
Vol 52 (1) ◽  
pp. 32-35
Author(s):  
M Roberts ◽  
K McHardy ◽  
J Wakeling ◽  
E Dalgetty ◽  
A Cadzow ◽  
...  
Keyword(s):  
House Officer ◽  
Senior House Officer ◽  
Officer Training

scholarly journals COVID-19-related absence among surgeons: development of an international surgical workforce prediction model

BJS Open ◽  
2020 ◽  
Vol 5 (2) ◽  
Author(s):  
◽  
Joana F F Simoes ◽  
Elizabeth Li ◽  
James C Glasbey ◽  
Omar M Omar ◽  
...  
Keyword(s):  
Elective Surgery ◽  
Cross Sectional Study ◽  
Service Planning ◽  
Expert Elicitation ◽  
Cross Sectional ◽  
Surgical Services ◽  
Surgical Workforce ◽  
Elicitation Study ◽  
Absence Rate ◽  
Surgical Teams

AbstractBackgroundDuring the initial COVID-19 outbreak up to 28.4 million elective operations were cancelled worldwide, in part owing to concerns that it would be unsustainable to maintain elective surgery capacity because of COVID-19-related surgeon absence. Although many hospitals are now recovering, surgical teams need strategies to prepare for future outbreaks. This study aimed to develop a framework to predict elective surgery capacity during future COVID-19 outbreaks.MethodsAn international cross-sectional study determined real-world COVID-19-related absence rates among surgeons. COVID-19-related absences included sickness, self-isolation, shielding, and caring for family. To estimate elective surgical capacity during future outbreaks, an expert elicitation study was undertaken with senior surgeons to determine the minimum surgical staff required to provide surgical services while maintaining a range of elective surgery volumes (0, 25, 50 or 75 per cent).ResultsBased on data from 364 hospitals across 65 countries, the COVID-19-related absence rate during the initial 6 weeks of the outbreak ranged from 20.5 to 24.7 per cent (mean average fortnightly). In weeks 7–12, this decreased to 9.2–13.8 per cent. At all times during the COVID-19 outbreak there was predicted to be sufficient surgical staff available to maintain at least 75 per cent of regular elective surgical volume. Overall, there was predicted capacity for surgeon redeployment to support the wider hospital response to COVID-19.ConclusionThis framework will inform elective surgical service planning during future COVID-19 outbreaks. In most settings, surgeon absence is unlikely to be the factor limiting elective surgery capacity.

Factors that inform the career choice of medical students: implications for otolaryngology

2002 ◽  
Vol 116 (10) ◽  
pp. 839-841 ◽  
Author(s):  
M. Ranta ◽  
S. S. M. Hussain ◽  
Q. Gardiner
Keyword(s):  
Medical Students ◽  
Career Choice ◽  
Role Models ◽  
House Officer ◽  
Career Progression ◽  
Senior House Officer ◽  
Specialist Registrar ◽  
Training Programmes ◽  
Medical Specialities

Knowledge of the factors that inform the career choice of medical students may help plan the workforce for medical specialities. To determine which factors inform the career choice of medical students we carried out a survey of medical students at the start of their educational block in Otolaryngology. Of 202 questionnaires handed out 169 were returned (84 per cent). Students were asked to rank factors according to their importance in their career choice. The single most important factor was career progression. Other factors include on-call commitment, teachers as role models, and the interest for a particular subject. At the present time progression from senior house officer grade to specialist registrar grade in Otolaryngology is delayed. If this issue is not addressed the influx of applicants into Otolaryngology training programmes will be reduced, limiting the pool from which candidates can be chosen for a career in Otolaryngology.

scholarly journals Ten books

2010 ◽  
Vol 196 (2) ◽  
pp. 161-163
Author(s):  
Sean A. Spence
Keyword(s):  
Don Delillo ◽  
Albert Camus ◽  
House Officer ◽  
George Orwell ◽  
Senior House Officer ◽  
Graham Greene ◽  
Medical Specialties ◽  
Anthony Burgess ◽  
The Bible ◽  
Bruce Chatwin

It is difficult, if not impossible, to systematically identify ten books that have been influential over a professional lifetime, not least since many have probably exerted their influence in long-forgotten ways: part of that semantic sediment laid down by protracted reading (and conversation). However, I do know that George Orwell was the first serious writer whom I read ‘of my own free will’ and I know that I would not wish to be without the works of Anthony Burgess, Albert Camus, Bruce Chatwin, Don DeLillo, Graham Greene, Henning Mankell or W.G. Sebald. I can remember that books on Buddhism sustained me through senior house officer jobs in a number of medical specialties (trying to focus, single-mindedly, on the task in hand rather than my tiredness or distraction), and I suspect that the metaphors of my thought and speech had already been much influenced by exposure to the Bible. Here, I focus on those books that have informed the way I think about psychiatry right now and how it might be practised.

Sign in / Sign up

Export Citation Format

Share Document