Quantitative and qualitative analysis of exception reporting at a district general hospital

Author(s):  
Charlotte G Underwood ◽  
Qamrunnisa U Yunus ◽  
Alexander B Gibson

Background/aims Exception reporting is a function by which junior doctors report when their work has varied from expected. This study analysed the reporting at the authors' hospital. Methods The authors analysed 204 reports submitted across 12 months to investigate the nature and pattern of the exception reports. Results The majority of reports (86%) were for ‘hours and rest’, 5% for education and 9% for both. On average doctors reported an additional 1.32 hours of work per report. The most common response was time off in lieu, but 13% of reports were never responded to. Qualitative analysis showed the most common reasons for reporting were ‘work outside of rostered hours’, ‘workload’ and ‘staffing issues’. Over 10% of the reports discussed an educational issue. Conclusions The data were not specific and there was fewer than one report per junior doctor in the period analysed. It is therefore unlikely that the reports submitted represent the additional work done by junior doctors at the hospital. Guardians should investigate local attitudes to exception reporting and educate both seniors and juniors on the importance of submitting accurate exception reports.

2015 ◽  
Vol 86 (11) ◽  
pp. e4.97-e4
Author(s):  
Jonathan Bedford ◽  
David Whiteside ◽  
Pooja Dassan

Junior doctors are primarily responsible for prescribing medications for patients with parkinsonism attending a district general hospital. We assessed levels of confidence and knowledge of appropriate prescribing in a variety of circumstances among 30 junior doctors at Ealing Hospital, using a 5 part questionnaire. Only 10% felt confident in prescribing a regimen for patients with parkinsonism who are unable to take their usual medications orally. 60% could not select a suitable anti-emetic, and just 2 respondents answered all assessment questions correctly. Confidence in prescribing improved with seniority but overall scores in the assessment section did not.We have designed a protocol to assist doctors when managing patients with parkinsonism on the ward, and are conducting teaching sessions to improve understanding. The impact of these interventions will be assessed and presented at the Annual Meeting.


Dementia ◽  
2015 ◽  
Vol 15 (2) ◽  
pp. 263-272 ◽  
Author(s):  
Iain Wilkinson ◽  
Anna Coates ◽  
Sophie Merrick ◽  
Chooi Lee

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
P Nemchand ◽  
D Hassan ◽  
A Steel

Abstract Our project was conducted in a district general hospital across five acute geriatric wards. Our team included consultants, registrars, and ward matrons. The project focused on improvement of care for geriatric inpatients, with moderate to severe frailty. Advanced care planning (ACP) columns are displayed on white boards. They indicate whether ACPs are required/initiated for each patient. When previously utilised, ACPs were initiated for 78% of appropriate patients [1]. Following a change in staff and reduction in awareness/education, the ACP column use reduced with fewer ACPs established. Our goals were to ensure completion of the ACP column, encourage junior doctor/nurse involvement and trigger a greater number of appropriate ACPs initiated Improvement in ACP practice was addressed by daily board round review of appropriate patients for ACP, increasing awareness of ACP triggers and education around discussion content. Interventions consisted of: 1, a flow-chart adjacent to white boards prompting “Do not attempt resuscitation (DNAR)” and ACP processes. This signposted staff to information on ACP triggers and “how to start a conversation”. 2 Involving registrar “champions” on each ward. We explained our intervention to all team members to encourage engagement. Data from the ACP columns were audited prior to intervention, 2 weeks and 6 weeks after intervention. There was a 54% increase in ACP documentation after 6 weeks across the wards. The improvement in the use of the ACP column correlated with a greater number of ACPs initiated. This facilitated an increase in consideration of patient wishes towards the end of life. Increasing use of a daily ACP prompts on board rounds triggers an increase in ACP implementation for appropriate patients. Sustainability was achieved by recruitment of ward “ACP champions”. Junior doctors/matrons were more empowered to discuss ACPs. Results were presented at departmental teaching to reinforce the positive impact of the intervention.


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