scholarly journals Audit of methods used to contact the duty doctor - Abraham Cowley Unit

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S349-S350
Author(s):  
Ivan Shanley ◽  
Jessica Thomas
Keyword(s):  
House Officer ◽  
Junior Doctors ◽  
Ward Staff ◽  
Timely Manner ◽  
Post Intervention ◽  
Initial Outcome ◽  
Standard Set ◽  
Inpatient Psychiatric Unit ◽  
Initial Results ◽  
Subsequent Intervention

AimsThe aim of this audit was to determine whether the duty doctor of a 4 ward inpatient psychiatric unit is contacted safely, effectively and in a manner that can be monitored. This is in line with trust protocol and the method stated is via switchboard. Should a deficit be found it was the aim to make an appropriate intervention.BackgroundIn the Abraham Cowley Unit, there is a Senior House Officer ‘on-call’ duty doctor 24/7. The shifts are 2 x 12.5 hours daily and at all times the duty doctor should be contacted via switchboard. Contacting via switchboard is important to ensure there is an audit trail of calls made. Issues that arise from using other methods of contact, e.g. calling direct extensions, include miscommunication and the doctor not being reached in a timely manner. This had been identified as an issue anecdotally by junior doctors on call and also highlighted following an untoward incident.MethodThe method by which the on call doctor was contacted was recorded in Excel for 5 consecutive 12.5 hour shifts in October 2019. The standard set for calls via switchboard was 80%. Following the initial results and the subsequent intervention, a repeat audit was performed using the same method.ResultInitial OutcomeInitially it was found that only 25% of calls received where through the appropriate channel (5 out of 20 calls). This fell far below the 80% standard and an intervention was therefore devised.InterventionIn order to ensure that all ward staff were aware of the trust policy posters were created and placed above all ward telephones and the telephone in the assessment suite office. This information was also handed over to the nurses in charge directly in order for it to be filtered through to other staff during handover.Post Intervention OutcomeFollowing the intervention 88% of calls received where through the appropriate channels (7 out of 8 calls) and the 80% standard was achieved.ConclusionThere has been a demonstrable improvement in the adherence to trust policy when contacting the duty doctor, with the percentage of calls made through the appropriate channel rising from 25% to 88%. This has now met the agreed standard of 80% and will improve the trust's ability to monitor contact of the duty doctor effectively.

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.

A multifaceted intervention package to improve the diagnosis and management of delirium

2014 ◽  
Vol 27 (2) ◽  
pp. 337-342 ◽  
Author(s):  
J. Fleet ◽  
S. Chen ◽  
F.C. Martin ◽  
T. Ernst
Keyword(s):  
Confusion Assessment Method ◽  
Assessment Method ◽  
Multifaceted Intervention ◽  
Junior Doctors ◽  
Intervention Package ◽  
Post Intervention ◽  
Convenience Sample ◽  
Pharmacological Management ◽  
Hospital Patients ◽  
The Impact

ABSTRACTBackground:Delirium is a major cause of morbidity and mortality amongst hospital patients. Previous studies have shown that it is often poorly recognized and managed. We wanted to assess the impact of a multifaceted intervention on delirium management.Methods:A pre/post-intervention design was used. The local hospital delirium guideline was adapted into A7 sized cards and A3/A2 posters. Cards were distributed to junior doctors and teaching sessions were held. Computer screen savers were displayed and delirium promotion days held. The pre/post-intervention data were used to audit the following: delirium knowledge through questionnaires, documented use of the confusion assessment method (CAM) and identification and management of eight common precipitating factors. Re-audit was four months post baseline with interventions within this period. χ2 tests were used for statistical analysis.Results:A convenience sample of randomly selected doctors in postgraduate training posts completed 100 questionnaires and 25 clinical notes were selected via retrospective identification of delirium. Results from questionnaires demonstrated significant improvements in: recognizing CAM as the diagnostic tool for delirium (24% vs. 71%, p < 0.01); identifying haloperidol as first line in pharmacological management (55% vs. 98%, p <0.01) and its correct dose (40% vs. 67%, p <0.01). In clinical practice, there was significant improvement in documentation of CAM for inpatient delirium assessments (0% vs. 77%, p <0.01). Trainees found the delirium card “very helpful” (82%) and carried it with them at all times (70%).Conclusion:This multifaceted intervention increased CAM use in delirium recognition and improved the knowledge of pharmacological management. The delirium card was highly popular.

Contingency Management to Induce Exercise Among College Students

2013 ◽  
Vol 30 (2) ◽  
pp. 84-95 ◽  
Author(s):  
Jessica G. Irons ◽  
Derek A. Pope ◽  
Allyson E. Pierce ◽  
Ryan A. Van Patten ◽  
Brantley P. Jarvis
Keyword(s):  
Undergraduate Students ◽  
External Validity ◽  
Contingency Management ◽  
Multiple Baseline ◽  
Activity Levels ◽  
Post Intervention ◽  
Baseline Phase ◽  
Changing Criterion ◽  
Subsequent Intervention

Objective: The effects of contingency management to induce physical activity levels were examined in seven non-obese physically inactive undergraduate students by providing monetary payments using a multiple baseline, changing-criterion procedure. Methods: Participants attended a baseline phase, a subsequent intervention phase consisting of three exercise sessions per week for 4 weeks, and a follow-up session 2 weeks post intervention. A total of $145 was available for attendance and exercise contingency payments. Results: Results indicate that all participants significantly increased exercise during intervention from inactivity at baseline to exercising three 30-minute sessions per week. Participants maintained some gains during follow-up. Limitations: The study employed a small and homogenous sample size and required participants to exercise in a lab setting thus limiting external validity. Conclusions: These findings suggest that incentive-based interventions are an effective and viable means for inducing exercise.

scholarly journals EP.FRI.1023 Clinical Portal: a clinician-led IT solution to the ‘surgical list’

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Cait Bleakley ◽  
Chloe Wright ◽  
Rola Salem ◽  
Kirk Bowling
Keyword(s):  
Patient Information ◽  
Single Point ◽  
Direct Consequence ◽  
Direct Access ◽  
Accurate Information ◽  
Junior Doctors ◽  
Post Intervention ◽  
It Systems ◽  
The Creation ◽  
The Impact

Abstract Aim Burnout amongst junior doctors is an emotive topic, with time pressures during busy on-call shifts negatively impacting efficiency and morale. Historically, within busy surgical firms the most junior team members commonly worked beyond scheduled hours. It has been highlighted within our trust that our IT systems significantly contributed to this. Thus leading to the creation of a clinician-led IT solution, enabling direct access to accurate information at a single point.  This study aims to measure the impact of the systems introduction on efficiency and shift experience of our junior doctors.  Methods 'Clinical Portal’ was introduced in August 2019. This IT system enables all patient information to be collated in one place, with the added benefit of simplifying the creation of patient lists. Number and duration of Exception Reports (ER) by on-call surgical juniors were measured for two months pre and post intervention. A qualitative survey was also distributed to this cohort to measure satisfaction and experience during on-call shifts within this period.  Results Following introduction of 'Clinical Portal', the total length of time included in ERs reduced. Surgical juniors expressed an improvement in their on-call experience, most notably dedicating less time to collating patient information and ward list formation. The overall experience improved despite time required to become proficient at using the new system.  Conclusions Streamlining of IT systems used during on-call shifts demonstrates improved efficiency amongst juniors reflected in a reduction of ERs. A direct consequence of these implemented changes is significant improvement in morale amongst our juniors. 

scholarly journals An approach to improve early detection of sternal wound infection

2009 ◽  
Vol 35 (1) ◽  
pp. 11-14 ◽  
Author(s):  
Mohammad H. Howlader ◽  
John S. Smith ◽  
Brendan Madden
Keyword(s):  
Reliable Method ◽  
Median Sternotomy ◽  
House Officer ◽  
Ward Round ◽  
Recording System ◽  
The Other ◽  
Medical Practitioners ◽  
Cardiac Procedures ◽  
Rubber Stamp ◽  
Initial Results

We developed a reproducible and reliable method of using a rubber stamp prospectively to document appearances of the sternal wound. 395 consecutive patients undergoing median sternotomy for cardiac procedures were studied over a period of four months. Data were collected by the Senior House Officer during the ward round for all patients at Day 3 and Day 7 post-operatively. Data were entered for 303 patients using the rubber stamp. 78 patients had no stamp entered in their case notes. 21 patients were recorded as having abnormal wounds, 11 of whom confirmed positive microbiological growth.  On the other hand, 282 patients were recorded to have normal wounds, 10 of which had positive bacterial growth. Our initial results have been encouraging with almost 80% compliance and 96% specificity. A simple recording system consisting of proven signs of infection known to medical practitioners was our tool. Keywords: Detection; Infection; Sternal woundOnline: 21 May 2009DOI: 10.3329/bmrcb.v35i1.1815Bangladesh Med Res Counc Bull 2009; 35: 11-14

scholarly journals Developing a policy to deal with sexual assault on psychiatric in-patient wards

2009 ◽  
Vol 33 (3) ◽  
pp. 108-111 ◽  
Author(s):  
Tara Lawn ◽  
Elizabeth McDonald
Keyword(s):  
Sexual Assault ◽  
Sexual Harassment ◽  
Psychiatric Ward ◽  
Junior Doctors ◽  
Ward Staff ◽  
Capacity To Consent ◽  
The Media ◽  
Face Complex ◽  
Ongoing Concern

Sexual harassment and assault on psychiatric wards is an ongoing concern. A number of incidents have been reported in the media. This paper focuses on a policy drafted to deal with allegations of sexual assault or rape on an in-patient psychiatric ward. We aimed to produce a practical, easy-to-follow guide for junior doctors and ward staff who may face complex and possibly contentious issues surrounding consent, capacity to consent and police involvement.

Are Foundation Year Assessors Adequately Trained?

2010 ◽  
Vol 92 (10) ◽  
pp. 1-4
Author(s):  
JML Williamson ◽  
AG Martin
Keyword(s):  
Medical Education ◽  
Postgraduate Medical Education ◽  
Variable Number ◽  
House Officer ◽  
Junior Doctors ◽  
Specialty Training ◽  
Senior House Officer ◽  
Medical Education And Training ◽  
Competency Based ◽  
And Training

In 2005 the career path, training and assessment of UK junior doctors was fundamentally altered. The traditional progression from a pre-registered house officer year (immediately after graduation) to a senior house officer (SHO) grade (for a variable number of years) has been streamlined into two foundation years (FYs) and then entry into either a core training (CT) or specialty training (ST) programme. The foundation assessment programme (FAP) has developed a competency-based curriculum for training FYs 1–2 based on the Postgraduate Medical Education and Training Board's (PMETB's) standards.

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