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junior doctor quality improvement

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https://www.readbyqxmd.com/read/29610769/improving-driving-advice-provided-to-cardiology-patients-on-discharge
#1
Amoolya Vusirikala, Mark Backhouse, Sarah Schimansky
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...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29593428/can-patient-safety-be-improved-by-reducing-the-volume-of-inappropriate-prescribing-tasks-handed-over-to-out-of-hours-junior-doctors
#2
Samuel Martin Amis, Tobin Henry Edgar Osicki
Background: First-year doctors found that during out-of-hours shifts they were being delayed and distracted from reviewing potentially sick/deteriorating patients by a high volume of prescribing tasks. This predominately consisted of oral anticoagulation prescribing and rewrites of drug charts. We hoped that if we could reduce this burden of "inappropriate prescribing tasks", we could not only improve junior doctors' job satisfaction and opportunities for training but also give them more time for patient reviews...
2018: International Journal of General Medicine
https://www.readbyqxmd.com/read/29576554/electrocardiographic-monitoring-of-psychiatric-in-patients-taking-antipsychotic-medications
#3
M M Kwan, D Gh Nguyen, R Mk Ng
OBJECTIVE: To assess the adherence to guidelines for electrocardiographic (ECG) monitoring in Hong Kong psychiatric in-patients who have been prescribed antipsychotic medications. METHODS: In-patients who had been prescribed antipsychotic drugs on hospital admission during the baseline audit period of 15 April 2015 to 16 July 2015 and the re-audit period of 28 January 2016 to 30 April 2016 were included. Quality improvement interventions were delivered after the baseline audit...
March 2018: East Asian Archives of Psychiatry: Official Journal of the Hong Kong College of Psychiatrists
https://www.readbyqxmd.com/read/29504869/an-interdisciplinary-approach-to-improve-surgical-antimicrobial-prophylaxis
#4
Oisín Conaty, Leah Gaughan, Colum Downey, Noreen Carolan, Megan Joanne Brophy, Ruth Kavanagh, Deborah A A McNamara, Edmond Smyth, Karen Burns, Fidelma Fitzpatrick
Purpose The purpose of this paper is to improve surgical antimicrobial prophylaxis (SAP) prescribing in orthopaedic surgery using the model for improvement framework. Design/methodology/approach Orthopaedic patients receiving joint replacements, hip fracture repairs or open-reduction internal-fixation procedures were included. Antimicrobial(s); dose, time of administration and duration of SAP were evaluated for appropriateness based on the local SAP guidelines. After baseline data collection, a driver diagram was constructed with interventions devised for plan-do-study-act cycles...
March 12, 2018: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/29428432/supporting-doctors-as-healthcare-quality-and-safety-advocates-recommendations-from-the-association-of-surgeons-in-training-asit
#5
C A Fleming, G Humm, J R Wild, H M Mohan, S T Hornby, R L Harries, J E F Fitzgerald, A J Beamish
BACKGROUND: As front-line healthcare staff, doctors in surgical training occupy a unique organisational space rotating through hospitals and services in which they witness first hand both good and bad practice. This puts trainees in a clear position to identify and raise patient safety issues, and to contribute to discussions regarding quality and safety improvement. However, there are a number of real and perceived barriers to trainees doing so. These include concerns about the impact on training assessments and career progression, and uncertainty about the appropriate route...
April 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29427025/telemedicine-in-general-neurology-use-of-audiovisual-consultation-for-on-call-back-up-service-in-an-acute-care-hospital
#6
Frank Janssen, Mohammed Awadallah, Awed Alhalabi, Barbara Körber, Reinhard Lang, Mateusz Scibor, René Handschu
OBJECTIVE: While telemedicine is in expanding use in acute stroke care, little is known about its use in general neurology, especially in acute care. We sought to investigate the feasibility and possible effects of a telemedicine device within the neurological back-up service of an acute care hospital. METHODS: In a 450 bed academic teaching hospital an experienced neurologist (EN) is on call to support the junior doctor at the hospital. Support was possible whether by standard telephone advice (TA) or by audiovisual consultations (AVC)...
April 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29358422/-i-did-try-and-point-out-about-his-dignity-a-qualitative-narrative-study-of-patients-and-carers-experiences-and-expectations-of-junior-doctors
#7
Camille E Kostov, Charlotte E Rees, Gerard J Gormley, Lynn V Monrouxe
OBJECTIVES: For many years, the voice of patients has been understood as a critical element for the improvement of care quality in healthcare settings. How well medical graduates are prepared for clinical practice is an important question, but one that has rarely been considered from patient and public perspectives. We aimed to fill this gap by exploring patients and carers' experiences and expectations of junior doctors. DESIGN: This comprises part of a wider study on UK medical graduates' preparedness for practice...
January 21, 2018: BMJ Open
https://www.readbyqxmd.com/read/29345405/abdominal-paracentesis-use-of-a-standardised-procedure-checklist-and-equipment-kit-improves-procedural-quality-and-reduces-complications
#8
J Fyson, L Chapman, M Tatton, Z Raos
Goals To evaluate the effect of a Standardised Procedure Checklist (PC) and Equipment Kit (EK) on procedural quality and complication rates for abdominal paracentesis. BACKGROUND: Paracentesis is a common invasive procedure performed by junior doctors. Audit of procedure conduct at two New Zealand hospitals in 2012 revealed poor performance across a range of quality measures including documentation of informed consent, excessive catheter dwell times, and inappropriate albumin prescription...
January 18, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29320310/comparison-of-current-recruitment-process-for-specialty-or-residency-training-in-uk-and-usa
#9
Ali Sibtain Farooq Sheikh, Mona Adel Mohamed
No abstract text is available yet for this article.
April 2018: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29318733/culture-change-and-mandating-quality-improvement
#10
Thomas Bartlett, Edward Hewertson, Michael Vassallo
BACKGROUND: A mandatory programme of quality improvement (QI) education was developed for newly qualified Foundation Year 1 (FY1) doctors to complete their curriculum requirements. Their perceptions were evaluated to refine the programme. METHODS: The programme delivered theoretical and experiential learning. Participants were asked to form groups and to come up with their own projects addressing the areas of need that they had identified. The 9-month group project included formal teaching and a formal presentation to the hospital...
January 10, 2018: Clinical Teacher
https://www.readbyqxmd.com/read/29282043/a-one-day-surgical-skill-training-course-for-medical-students-improved-surgical-skills-and-increased-interest-in-surgery-as-a-career
#11
Ho Seok Seo, Yong Hwa Eom, Min Ki Kim, Young-Min Kim, Byung Joo Song, Kyo Young Song
BACKGROUND: Despite many high-quality programs in basic surgical-skill education, the surgical skill of junior doctors varies widely. This, together with the waning interest in surgery as a career among medical students, is a serious issue confronted by hospitals and healthcare systems worldwide. We, therefore, developed and implemented an intensive one-day surgical-skill training course for two purposes; it would improve surgical skills and increase interest in surgery among medical students...
December 28, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29275278/increasing-compliance-with-a-clinical-practice-guideline-for-fetal-fibronectin-testing-and-the-management-of-threatened-preterm-labour-a-quality-improvement-project
#12
Lisa K Dawes, Malini Subramoney, Laura M Miller, Katie M Groom
OBJECTIVE: To increase adherence to a local hospital clinical practice guideline for the use of fetal fibronectin testing in women presenting with symptoms of threatened preterm labour. STUDY DESIGN: A quality improvement project using a multi-faceted implementation strategy. SETTING: National Women's Health, Auckland City Hospital; a tertiary referral maternity unit in Auckland, New Zealand. POPULATION: All obstetricians, junior obstetric doctors and hospital employed midwives...
February 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29192430/-clinical-application-evaluation-of-guidelines-for-diagnosis-and-treatment-of-cancer-in-traditional-chinese-medicine
#13
Nan-Nan Shi, Meng-Yu Liu, Yu-Qi Liu, Yue-Xi Wang, Li-Ying Wang, Ya Yuwen, Xue-Yao Zhao, Dong-Feng Wei, Shuang Kou, Xue-Jie Han, Yan-Ping Wang
This study aims to evaluate the adaptability and applicability of Guidelines for the Diagnosis and Treatment of Cancer in Traditional Chinese Medicine. The assessment methods included adaptability assessment and applicability assessment. The adaptability assessment was based on the questionnaire survey to evaluate the familiarity, utilization, quality, and clinical application of the Guidelines; applicability assessment was based on the prospective observation of 853 clinical cases to investigate the applicability and effect of the Guidelines, including effectiveness, economy and safety...
September 2017: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/29178213/interprofessional-collaboration-between-junior-doctors-and-nurses-in-the-general-ward-setting-a-qualitative-exploratory-study
#14
Charmaine J Tang, Wen T Zhou, Sally W-C Chan, Sok Y Liaw
AIM: To explore the collaboration experiences of junior physicians and nurses in the general ward setting. BACKGROUND: Junior physicians and nurses do not always work collaboratively and this could affect the quality of patient care. The understanding of the issues affecting junior physicians and nurses working together is needed to inform strategies to improve interprofessional collaboration. METHODS: Nineteen junior physicians and nurses were interviewed in 2012 and 2013...
January 2018: Journal of Nursing Management
https://www.readbyqxmd.com/read/29170352/55-mini-sim-innovative-bite-sized-simulation-teaching-in-a-busy-children-s-emergency-department
#15
Rachel Sunley, Karen Moloney, Jessica Parker, Christopher Arrowsmith, Kirsty Brown, Alex Wilson
: Emergency Medicine requires a highly skilled workforce who are passionate about delivering excellent patient care. Shift patterns linked with the ever increasing numbers of patients who attend Emergency Departments puts strain on educating the workforce and fostering team togetherness.Our objective in devising and instigating the 'Mini Sim' programme was to embed regular in-situ simulation training to enhance the learning of all staff within our Emergency Department team, building a highly trained workforce to deliver excellent care within the remit of our busy department...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29148172/quality-of-handwritten-surgical-operative-notes-from-surgical-trainees-a-noteworthy-issue
#16
Tatenda C Nzenza, Todd Manning, Simeon Ngweso, Marlon Perera, Shomik Sengupta, Damien Bolton, Nathan Lawrentschuk
BACKGROUND: Surgical operation notes are crucial for medical record keeping and information flow in continued patient care. In addition to inherent medical implications, the quality of operative notes also has important economic and medico-legal ramifications. Further, well-documented records can also be useful for audit purposes and propagation of research, facilitating the improvement of delivery of care to patients. We aimed to assess the quality of surgical operation notes written by junior doctors and trainees against a set standard, to ascertain whether these standards were met...
November 17, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29132638/impact-of-an-integrated-electronic-handover-tool-on-pediatric-junior-medical-staff-jms-handover
#17
Daryl R Cheng, James Liddle, Emily Mailes, Mike South
BACKGROUND: Clinical medical handover between doctors forms a critical part of the patient care process. However, with the evolution of junior medical staff (JMS) working conditions, time pressure and increasing clinical and administrative loads mean that quality clinical handover is increasingly important yet more challenging to achieve. This study evaluated the impact of a newly integrated electronic handover tool on JMS adoption and usage of the tool, as well as impacts on the quality (accuracy and redundancy) of handover data, JMS perceived workflow (time management and communication) and JMS satisfaction...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29076013/hospital-staff-views-of-prescribing-and-discharge-communication-before-and-after-electronic-prescribing-system-implementation
#18
Pamela Ruth Mills, Anita Elaine Weidmann, Derek Stewart
Background Electronic prescribing system implementation is recommended to improve patient safety and general practitioner's discharge information communication. There is a paucity of information about hospital staff perspectives before and after system implementation. Objective To explore hospital staff views regarding prescribing and discharge communication systems before and after hospital electronic prescribing and medicines administration (HEPMA) system implementation. Setting A 560 bed United Kingdom district general hospital...
December 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29035667/why-doctors-consider-leaving-uk-medicine-qualitative-analysis-of-comments-from-questionnaire-surveys-three-years-after-graduation
#19
Trevor W Lambert, Fay Smith, Michael J Goldacre
Objective To report the reasons why doctors are considering leaving medicine or the UK. Design Questionnaire survey. Setting UK. Participants Questionnaires were sent three years after graduation to all UK medical graduates of 2008 and 2012. Main outcome measures Comments from doctors about their main reasons for considering leaving medicine or the UK (or both). Results The response rate was 46.2% (5291/11,461). Among the 60% of respondents who were not definitely intent on remaining in UK medicine, 50% were considering working in medicine outside the UK and 10% were considering leaving medicine...
January 2018: Journal of the Royal Society of Medicine
https://www.readbyqxmd.com/read/28959777/improving-mrcp-paces-pass-rates-through-the-introduction-of-a-regional-multifaceted-support-framework
#20
Richard Jerrom, Tayeba Roper, Narasimha Murthy
INTRODUCTION: Practical Assessment of Clinical Examination Skills (PACES) constitutes the final part of the mandatory Royal College of Physicians exam series for progression to higher specialty training. Pass rates were lower for core medical trainees (CMTs) in Coventry and Warwickshire in comparison to other regions within the West Midlands and nationally. OBJECTIVES: Our aim was to improve pass rates in the region through the introduction of a stimulating and supportive teaching framework, designed to enhance the quality and frequency of PACES teaching...
2017: BMJ Open Quality
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