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junior doctor quality improvement

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
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...
February 8, 2018: International Journal of Surgery
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)...
February 9, 2018: Journal of Neurology
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
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
Ali Sibtain Farooq Sheikh, Mona Adel Mohamed
No abstract text is available yet for this article.
January 16, 2018: Hospital Practice (Minneapolis)
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
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
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
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
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
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
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
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
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
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 1, 2017: Journal of the Royal Society of Medicine
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
Elizabeth Shermon, Laura Munglani, Sarah Oram, Linda William, Julian Abel
INTRODUCTION: Do Not Attempt Resuscitation (DNAR)decisions have traditionally formed the basis of ceiling of care discussions. However, poor quality discussions can lead to high patient and relative dissatisfaction, generating hospital complaints. Treatment escalation plans (TEPs) aim to highlight the wider remit of treatment options with a focus on effective communication. We aimed to improve TEP discussions and documentation at Weston General Hospital by introducing a standardised form...
2017: BMJ Open Quality
Madhusudan Deepak Thalitaya, Claire Reynolds
BACKGROUND: Nationally, there is a drive to rotate more Foundation and GP Trainee Doctors through Psychiatry posts. In East London Foundation Trust (ELFT) in Bedfordshire, doctors from Core Psychiatry, Foundation and GP training programmes come to train in Psychiatry. Many will not have worked in Psychiatry before and have little experience of patients with ID. The prevalence of people with ID is increasing with improved life expectancy. They are a complex and vulnerable group with considerable wider legal, ethical and social issues...
September 2017: Psychiatria Danubina
Laura Mk Pannell, Jonathan Tyrrell-Price
Background Up to date patient data is a cornerstone of optimal safety and care, so admission to hospital requires transfer of data held in the community to secondary care. Despite the advent of electronic medical record systems such as Connecting Care and EMIS, the telephone remains the mainstay of communication. Methods A prospective cross-sectional quality improvement project was conducted to assess the time taken in telephone communication between primary and secondary care doctors and determine if access to the electronic shared system, Connecting Care, would improve efficiency...
August 2, 2017: British Journal of Hospital Medicine
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