General Medicine, University Hospital Wishaw, Wishaw, UK
General Medicine, University Hospital Wishaw, Wishaw, UK.
BMJ Open Qual. 2020 Dec;9(4). doi: 10.1136/bmjoq-2020-000970.
Starting in a new hospital can be an overwhelming experience for any grade of doctor. There is a vast amount of information that needs to be learnt immediately to function in the new environment. There is an annual changeover of doctors between hospitals in August nationwide and most junior doctors rotate specialties every 4-6 months. Evidence shows that doctors feel this transition has a negative impact on patient care and indicates that inpatient mortality rises during the August changeover. In our hospital, we noted problems with access to guidelines, referral information and investigations by junior doctors, especially at changeover. In an initial questionnaire, 100% of doctors had experienced difficulties with referring to a specialty and 96% felt time was wasted doing so. Furthermore, 87.5% of doctors had difficulties with ordering laboratory investigations and 100% of survey participates expressed difficulty accessing guidelines.To tackle this issue, we created guidelines on how to refer to different specialties, order investigations and general running of the hospital. We then used a free app platform called induction and uploaded the guidelines as well as formal hospital guidelines to the app. After use of the app, we assessed these problems via further questionnaires. Doctors reporting problems with finding how to refer to specialties reduced from 100% to 0% in the final survey. Problems finding how to request investigations fell from 100% to 14.3% after 1 month to 7.7% after 3 months. Finally, problems finding guidelines fell from 100% to 15.4%. Further, 100% of doctors felt the app saved time.Use of the induction app to access guidelines saves time and reduces problems accessing information needed to carry out tasks. This an easily replicated project with low running costs which proved to help with the universal problems around induction to a new hospital environment.
对于任何级别的医生来说，在新医院工作都是一种压倒性的体验。有大量的信息需要立即学习，以便在新环境中发挥作用。全国范围内，医院之间的医生每年都会在 8 月进行轮换，大多数初级医生每隔 4-6 个月就会轮换专业。有证据表明，医生认为这种过渡对患者护理有负面影响，并表明住院患者死亡率在 8 月轮换期间上升。在我们医院，我们注意到初级医生在获取指南、转诊信息和检查方面存在问题，尤其是在交接期间。在最初的问卷调查中，100%的医生在向专科医生转诊时遇到困难，96%的医生认为这浪费了时间。此外，87.5%的医生在进行实验室检查时遇到困难，100%的调查参与者表示难以获取指南。为了解决这个问题，我们制定了如何向不同科室转诊、进行检查和管理医院的指南。然后，我们使用了一个名为 induction 的免费应用程序平台，并将指南以及医院的正式指南上传到应用程序中。在使用该应用程序后，我们通过进一步的问卷调查评估了这些问题。在最终的调查中，报告找不到如何转诊到专科的医生从 100%减少到 0%。在使用该应用程序 1 个月后，寻找如何请求检查的问题从 100%下降到 14.3%，3 个月后下降到 7.7%。最后，找不到指南的问题从 100%下降到 15.4%。此外，100%的医生认为该应用程序节省了时间。使用 induction 应用程序获取指南可以节省时间，并减少获取开展任务所需信息的问题。这是一个易于复制的项目，运营成本低，事实证明，该项目有助于解决在新医院环境下入职的普遍问题。
