| Title |
Can patient safety be improved by reducing the volume of “inappropriate prescribing tasks” handed over to out-of-hours junior doctors?
|
|---|---|
| Published in |
International Journal of General Medicine, March 2018
|
| DOI | 10.2147/ijgm.s153227 |
| Pubmed ID | |
| Authors |
Samuel Martin Amis, Tobin Henry Edgar Osicki |
| Abstract |
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. Three weekends were initially audited to quantify the number of "inappropriate prescribing tasks" using data from the hospital's computerized task assigning system. On three subsequent weekends, a checklist was handed out to the ward teams on Friday mornings. This checklist was designed to encourage the day teams to check that drug charts would not need oral anticoagulation or rewriting over the weekend. An overall reduction in "inappropriate prescribing tasks" of 46% with a specific reduction in inappropriate oral anticoagulation prescribing of 65% was observed. Inappropriate drug chart rewrites were reduced by 30%. The reduction in the mean number of pre-intervention inappropriate prescribing tasks (as a percentage of total prescribing tasks) and the post-intervention mean was 6.94% (95% confidence interval -0.54 to 14.42, p-value=0.062). Improved job satisfaction and a perceived reduced workload were noted from post-intervention qualitative surveys. While improved patient safety directly resulting from this intervention is more difficult to establish, and the observed reduction in inappropriate prescribing was only approaching statistical significance, our colleagues commented in post-intervention feedback that they felt they had more time, and felt less pressured, while attending patients. The workload of junior doctors can exert a significant effect on patient care, and simple measures can alleviate this burden. Furthermore, computerized hospital task management systems are an underutilized source of data for audit and quality improvement. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 35 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 35 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Postgraduate | 5 | 14% |
| Student > Ph. D. Student | 5 | 14% |
| Student > Bachelor | 4 | 11% |
| Student > Master | 3 | 9% |
| Other | 3 | 9% |
| Other | 5 | 14% |
| Unknown | 10 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 7 | 20% |
| Pharmacology, Toxicology and Pharmaceutical Science | 4 | 11% |
| Nursing and Health Professions | 3 | 9% |
| Business, Management and Accounting | 2 | 6% |
| Arts and Humanities | 1 | 3% |
| Other | 4 | 11% |
| Unknown | 14 | 40% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 April 2018.
All research outputs
#15,503,317
of 23,039,416 outputs
Outputs from International Journal of General Medicine
#652
of 1,467 outputs
Outputs of similar age
#211,657
of 331,172 outputs
Outputs of similar age from International Journal of General Medicine
#6
of 13 outputs
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