Introducing an Emergency Department Electronic Handbook to Junior Doctors New to Emergency Medicine
Background The transition of junior doctors into working in the emergency department (ED) in the United Kingdom often poses challenges in adapting to new hospital systems and protocols. To address this issue at Queen Elizabeth Hospital, King's Lynn (QEHKL), a quality improvement project (QIP) w...
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Published in | Curēus (Palo Alto, CA) Vol. 16; no. 8; p. e66313 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
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Cureus Inc
06.08.2024
Cureus |
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Abstract | Background The transition of junior doctors into working in the emergency department (ED) in the United Kingdom often poses challenges in adapting to new hospital systems and protocols. To address this issue at Queen Elizabeth Hospital, King's Lynn (QEHKL), a quality improvement project (QIP) was undertaken to develop an electronic ED handbook with the primary aim of enhancing the confidence and knowledge of newly appointed doctors during their ED rotation. This electronic handbook serves as a comprehensive repository for vital medical protocols, guidelines, and trust referral pathways, offering an easily accessible resource for junior doctors. Objectives The primary objective of this study was to determine whether there was an improvement in the confidence and knowledge of ED junior doctors following the introduction of the Electronic ED Handbook. The secondary objectives were to determine whether introducing the ED Handbook increased the overall satisfaction rating of the content of the ED Junior Doctor Induction program and assess the level of recommendation for the ED Handbook among the doctors for inclusion in future ED inductions. Method The QIP was designed using the Model for Improvement framework, Plan, Do, Study, Act (PSDA). The aims were designed to be Specific, Measurable, Achievable, Relevant, and Time-bound (SMART). Pre- and post-intervention surveys were conducted for comparison before and after the ED Handbook was introduced. Results Regarding the confidence of junior doctors to proceed into their new roles, the responses of "quite confident" or "very confident" increased from 77.8% (before) to 100% (after the ED Handbook introduction). One hundred percent of the responders found the ED Handbook to be either "very useful" or "extremely useful" in increasing their confidence and knowledge in the first month of their ED rotation. The satisfaction rating of "excellent" for the content of the ED Junior Doctor Induction program increased from 55.5% to 66.7%. One hundred percent of the responders recommended the inclusion of the ED Handbook for future inductions. Conclusion and recommendations Comparing the results from the pre- and post-intervention surveys shows a significant improvement in the confidence and knowledge of ED junior doctors following the introduction of the Electronic ED Handbook. The handbook was formally endorsed by the ED clinical governance team as an integral component of the ED induction process, aiding junior doctors in making a seamless transition into their new roles in emergency medicine. This study emphasizes the importance of utilizing digital resources to improve the confidence and knowledge of junior doctors and recommends the continued use of the handbook in future induction programs. |
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AbstractList | Background
The transition of junior doctors into working in the emergency department (ED) in the United Kingdom often poses challenges in adapting to new hospital systems and protocols. To address this issue at Queen Elizabeth Hospital, King’s Lynn (QEHKL), a quality improvement project (QIP) was undertaken to develop an electronic ED handbook with the primary aim of enhancing the confidence and knowledge of newly appointed doctors during their ED rotation. This electronic handbook serves as a comprehensive repository for vital medical protocols, guidelines, and trust referral pathways, offering an easily accessible resource for junior doctors.
Objectives
The primary objective of this study was to determine whether there was an improvement in the confidence and knowledge of ED junior doctors following the introduction of the Electronic ED Handbook. The secondary objectives were to determine whether introducing the ED Handbook increased the overall satisfaction rating of the content of the ED Junior Doctor Induction program and assess the level of recommendation for the ED Handbook among the doctors for inclusion in future ED inductions.
Method
The QIP was designed using the Model for Improvement framework, Plan, Do, Study, Act (PSDA). The aims were designed to be Specific, Measurable, Achievable, Relevant, and Time-bound (SMART). Pre- and post-intervention surveys were conducted for comparison before and after the ED Handbook was introduced.
Results
Regarding the confidence of junior doctors to proceed into their new roles, the responses of “quite confident” or “very confident” increased from 77.8% (before) to 100% (after the ED Handbook introduction). One hundred percent of the responders found the ED Handbook to be either “very useful” or “extremely useful” in increasing their confidence and knowledge in the first month of their ED rotation. The satisfaction rating of “excellent” for the content of the ED Junior Doctor Induction program increased from 55.5% to 66.7%. One hundred percent of the responders recommended the inclusion of the ED Handbook for future inductions.
Conclusion and recommendations
Comparing the results from the pre- and post-intervention surveys shows a significant improvement in the confidence and knowledge of ED junior doctors following the introduction of the Electronic ED Handbook. The handbook was formally endorsed by the ED clinical governance team as an integral component of the ED induction process, aiding junior doctors in making a seamless transition into their new roles in emergency medicine. This study emphasizes the importance of utilizing digital resources to improve the confidence and knowledge of junior doctors and recommends the continued use of the handbook in future induction programs. Background The transition of junior doctors into working in the emergency department (ED) in the United Kingdom often poses challenges in adapting to new hospital systems and protocols. To address this issue at Queen Elizabeth Hospital, King's Lynn (QEHKL), a quality improvement project (QIP) was undertaken to develop an electronic ED handbook with the primary aim of enhancing the confidence and knowledge of newly appointed doctors during their ED rotation. This electronic handbook serves as a comprehensive repository for vital medical protocols, guidelines, and trust referral pathways, offering an easily accessible resource for junior doctors. Objectives The primary objective of this study was to determine whether there was an improvement in the confidence and knowledge of ED junior doctors following the introduction of the Electronic ED Handbook. The secondary objectives were to determine whether introducing the ED Handbook increased the overall satisfaction rating of the content of the ED Junior Doctor Induction program and assess the level of recommendation for the ED Handbook among the doctors for inclusion in future ED inductions. Method The QIP was designed using the Model for Improvement framework, Plan, Do, Study, Act (PSDA). The aims were designed to be Specific, Measurable, Achievable, Relevant, and Time-bound (SMART). Pre- and post-intervention surveys were conducted for comparison before and after the ED Handbook was introduced. Results Regarding the confidence of junior doctors to proceed into their new roles, the responses of "quite confident" or "very confident" increased from 77.8% (before) to 100% (after the ED Handbook introduction). One hundred percent of the responders found the ED Handbook to be either "very useful" or "extremely useful" in increasing their confidence and knowledge in the first month of their ED rotation. The satisfaction rating of "excellent" for the content of the ED Junior Doctor Induction program increased from 55.5% to 66.7%. One hundred percent of the responders recommended the inclusion of the ED Handbook for future inductions. Conclusion and recommendations Comparing the results from the pre- and post-intervention surveys shows a significant improvement in the confidence and knowledge of ED junior doctors following the introduction of the Electronic ED Handbook. The handbook was formally endorsed by the ED clinical governance team as an integral component of the ED induction process, aiding junior doctors in making a seamless transition into their new roles in emergency medicine. This study emphasizes the importance of utilizing digital resources to improve the confidence and knowledge of junior doctors and recommends the continued use of the handbook in future induction programs. Background The transition of junior doctors into working in the emergency department (ED) in the United Kingdom often poses challenges in adapting to new hospital systems and protocols. To address this issue at Queen Elizabeth Hospital, King's Lynn (QEHKL), a quality improvement project (QIP) was undertaken to develop an electronic ED handbook with the primary aim of enhancing the confidence and knowledge of newly appointed doctors during their ED rotation. This electronic handbook serves as a comprehensive repository for vital medical protocols, guidelines, and trust referral pathways, offering an easily accessible resource for junior doctors. Objectives The primary objective of this study was to determine whether there was an improvement in the confidence and knowledge of ED junior doctors following the introduction of the Electronic ED Handbook. The secondary objectives were to determine whether introducing the ED Handbook increased the overall satisfaction rating of the content of the ED Junior Doctor Induction program and assess the level of recommendation for the ED Handbook among the doctors for inclusion in future ED inductions. Method The QIP was designed using the Model for Improvement framework, Plan, Do, Study, Act (PSDA). The aims were designed to be Specific, Measurable, Achievable, Relevant, and Time-bound (SMART). Pre- and post-intervention surveys were conducted for comparison before and after the ED Handbook was introduced. Results Regarding the confidence of junior doctors to proceed into their new roles, the responses of "quite confident" or "very confident" increased from 77.8% (before) to 100% (after the ED Handbook introduction). One hundred percent of the responders found the ED Handbook to be either "very useful" or "extremely useful" in increasing their confidence and knowledge in the first month of their ED rotation. The satisfaction rating of "excellent" for the content of the ED Junior Doctor Induction program increased from 55.5% to 66.7%. One hundred percent of the responders recommended the inclusion of the ED Handbook for future inductions. Conclusion and recommendations Comparing the results from the pre- and post-intervention surveys shows a significant improvement in the confidence and knowledge of ED junior doctors following the introduction of the Electronic ED Handbook. The handbook was formally endorsed by the ED clinical governance team as an integral component of the ED induction process, aiding junior doctors in making a seamless transition into their new roles in emergency medicine. This study emphasizes the importance of utilizing digital resources to improve the confidence and knowledge of junior doctors and recommends the continued use of the handbook in future induction programs.Background The transition of junior doctors into working in the emergency department (ED) in the United Kingdom often poses challenges in adapting to new hospital systems and protocols. To address this issue at Queen Elizabeth Hospital, King's Lynn (QEHKL), a quality improvement project (QIP) was undertaken to develop an electronic ED handbook with the primary aim of enhancing the confidence and knowledge of newly appointed doctors during their ED rotation. This electronic handbook serves as a comprehensive repository for vital medical protocols, guidelines, and trust referral pathways, offering an easily accessible resource for junior doctors. Objectives The primary objective of this study was to determine whether there was an improvement in the confidence and knowledge of ED junior doctors following the introduction of the Electronic ED Handbook. The secondary objectives were to determine whether introducing the ED Handbook increased the overall satisfaction rating of the content of the ED Junior Doctor Induction program and assess the level of recommendation for the ED Handbook among the doctors for inclusion in future ED inductions. Method The QIP was designed using the Model for Improvement framework, Plan, Do, Study, Act (PSDA). The aims were designed to be Specific, Measurable, Achievable, Relevant, and Time-bound (SMART). Pre- and post-intervention surveys were conducted for comparison before and after the ED Handbook was introduced. Results Regarding the confidence of junior doctors to proceed into their new roles, the responses of "quite confident" or "very confident" increased from 77.8% (before) to 100% (after the ED Handbook introduction). One hundred percent of the responders found the ED Handbook to be either "very useful" or "extremely useful" in increasing their confidence and knowledge in the first month of their ED rotation. The satisfaction rating of "excellent" for the content of the ED Junior Doctor Induction program increased from 55.5% to 66.7%. One hundred percent of the responders recommended the inclusion of the ED Handbook for future inductions. Conclusion and recommendations Comparing the results from the pre- and post-intervention surveys shows a significant improvement in the confidence and knowledge of ED junior doctors following the introduction of the Electronic ED Handbook. The handbook was formally endorsed by the ED clinical governance team as an integral component of the ED induction process, aiding junior doctors in making a seamless transition into their new roles in emergency medicine. This study emphasizes the importance of utilizing digital resources to improve the confidence and knowledge of junior doctors and recommends the continued use of the handbook in future induction programs. BackgroundThe transition of junior doctors into working in the emergency department (ED) in the United Kingdom often poses challenges in adapting to new hospital systems and protocols. To address this issue at Queen Elizabeth Hospital, King’s Lynn (QEHKL), a quality improvement project (QIP) was undertaken to develop an electronic ED handbook with the primary aim of enhancing the confidence and knowledge of newly appointed doctors during their ED rotation. This electronic handbook serves as a comprehensive repository for vital medical protocols, guidelines, and trust referral pathways, offering an easily accessible resource for junior doctors.ObjectivesThe primary objective of this study was to determine whether there was an improvement in the confidence and knowledge of ED junior doctors following the introduction of the Electronic ED Handbook. The secondary objectives were to determine whether introducing the ED Handbook increased the overall satisfaction rating of the content of the ED Junior Doctor Induction program and assess the level of recommendation for the ED Handbook among the doctors for inclusion in future ED inductions.MethodThe QIP was designed using the Model for Improvement framework, Plan, Do, Study, Act (PSDA). The aims were designed to be Specific, Measurable, Achievable, Relevant, and Time-bound (SMART). Pre- and post-intervention surveys were conducted for comparison before and after the ED Handbook was introduced.ResultsRegarding the confidence of junior doctors to proceed into their new roles, the responses of “quite confident” or “very confident” increased from 77.8% (before) to 100% (after the ED Handbook introduction). One hundred percent of the responders found the ED Handbook to be either “very useful” or “extremely useful” in increasing their confidence and knowledge in the first month of their ED rotation. The satisfaction rating of “excellent” for the content of the ED Junior Doctor Induction program increased from 55.5% to 66.7%. One hundred percent of the responders recommended the inclusion of the ED Handbook for future inductions.Conclusion and recommendationsComparing the results from the pre- and post-intervention surveys shows a significant improvement in the confidence and knowledge of ED junior doctors following the introduction of the Electronic ED Handbook. The handbook was formally endorsed by the ED clinical governance team as an integral component of the ED induction process, aiding junior doctors in making a seamless transition into their new roles in emergency medicine. This study emphasizes the importance of utilizing digital resources to improve the confidence and knowledge of junior doctors and recommends the continued use of the handbook in future induction programs. |
Author | Sarvesh, Bhaskar Malik, Ayesha Giubileo, Angelo Wickramanayake, Udara Arrayeh, Ahmed Nwankpa, Charles Hewagamage, Ravindu Arulvasan, Venoth |
AuthorAffiliation | 1 Emergency Medicine, Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, GBR 2 Medicine, University of East Anglia, King's Lynn, GBR 3 Information Technology, Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, GBR |
AuthorAffiliation_xml | – name: 1 Emergency Medicine, Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, GBR – name: 2 Medicine, University of East Anglia, King's Lynn, GBR – name: 3 Information Technology, Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, GBR |
Author_xml | – sequence: 1 givenname: Udara surname: Wickramanayake fullname: Wickramanayake, Udara organization: Emergency Medicine, Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, GBR – sequence: 2 givenname: Ahmed surname: Arrayeh fullname: Arrayeh, Ahmed organization: Emergency Medicine, Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, GBR – sequence: 3 givenname: Venoth surname: Arulvasan fullname: Arulvasan, Venoth organization: Medicine, University of East Anglia, King's Lynn, GBR – sequence: 4 givenname: Bhaskar surname: Sarvesh fullname: Sarvesh, Bhaskar organization: Emergency Medicine, Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, GBR – sequence: 5 givenname: Charles surname: Nwankpa fullname: Nwankpa, Charles organization: Emergency Medicine, Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, GBR – sequence: 6 givenname: Ravindu surname: Hewagamage fullname: Hewagamage, Ravindu organization: Information Technology, Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, GBR – sequence: 7 givenname: Ayesha surname: Malik fullname: Malik, Ayesha organization: Emergency Medicine, Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, GBR – sequence: 8 givenname: Angelo surname: Giubileo fullname: Giubileo, Angelo organization: Emergency Medicine, Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, GBR |
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Cites_doi | 10.1093/intqhc/mzaa070 10.1136/bmjquality.u203210.w1579 10.1136/bmjquality.u209167.w3822 10.1111/tct.12104 10.1136/postgradmedj-2016-133973 10.1186/s12909-017-0859-6 10.1136/bmjoq-2020-000970 10.3109/0142159X.2014.947929 10.1111/j.1365-2923.2011.04048.x 10.1371/journal.pone.0007103 10.7861/futurehosp.6-2s-s17 |
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References | Thomas N (ref8) 2019; 6 ref14 Thomson H (ref4) 2014; 11 ref7 ref9 Dave MS (ref10) 2020; 32 Van Hamel C (ref3) 2015; 37 ref6 Ross D (ref13) 2016; 5 Miles S (ref2) 2017; 17 Davies M (ref11) 2015; 4 Clare K (ref12) 2020; 9 Mcmillan L (ref16) 2023; 108 Kilminster S (ref5) 2011; 45 O'Keeffe C (ref1) 2017; 93 Jen MH (ref15) 2009; 4 |
References_xml | – volume: 32 year: 2020 ident: ref10 article-title: Improving knowledge and confidence in foundation doctors during specialty changeover publication-title: Int J Qual Health Care doi: 10.1093/intqhc/mzaa070 contributor: fullname: Dave MS – volume: 4 year: 2015 ident: ref11 article-title: The Handbook: an end to 'I wish I had known that before I started' publication-title: BMJ Qual Improv Rep doi: 10.1136/bmjquality.u203210.w1579 contributor: fullname: Davies M – ident: ref6 – ident: ref7 – volume: 5 year: 2016 ident: ref13 article-title: Introduction of a junior doctors' handbook: an essential guide for new doctors publication-title: BMJ Qual Improv Rep doi: 10.1136/bmjquality.u209167.w3822 contributor: fullname: Ross D – volume: 11 year: 2014 ident: ref4 article-title: Effective foundation trainee local inductions: room for improvement? publication-title: Clin Teach doi: 10.1111/tct.12104 contributor: fullname: Thomson H – volume: 93 year: 2017 ident: ref1 article-title: The value of emergency medicine placements for postgraduate doctors: views of foundation year 2 doctors and training leads in the emergency department (ED) publication-title: Postgrad Med J doi: 10.1136/postgradmedj-2016-133973 contributor: fullname: O'Keeffe C – volume: 17 year: 2017 ident: ref2 article-title: Medical graduates' preparedness to practice: a comparison of undergraduate medical school training publication-title: BMC Med Educ doi: 10.1186/s12909-017-0859-6 contributor: fullname: Miles S – volume: 9 year: 2020 ident: ref12 article-title: Creating more than a directory: improving handover of information by renovating the induction app for University Hospital Wishaw publication-title: BMJ Open Qual doi: 10.1136/bmjoq-2020-000970 contributor: fullname: Clare K – ident: ref9 – volume: 37 year: 2015 ident: ref3 article-title: Prepared for practice? a national survey of UK foundation doctors and their supervisors publication-title: Med Teach doi: 10.3109/0142159X.2014.947929 contributor: fullname: Van Hamel C – volume: 45 year: 2011 ident: ref5 article-title: Preparedness is not enough: understanding transitions as critically intensive learning periods publication-title: Med Educ doi: 10.1111/j.1365-2923.2011.04048.x contributor: fullname: Kilminster S – volume: 4 year: 2009 ident: ref15 article-title: Early in-hospital mortality following trainee doctors' first day at work publication-title: PLoS One doi: 10.1371/journal.pone.0007103 contributor: fullname: Jen MH – volume: 108 year: 2023 ident: ref16 article-title: Implementing a practical induction programme in a tertiary teaching hospital publication-title: Arch Dis Child contributor: fullname: Mcmillan L – volume: 6 year: 2019 ident: ref8 article-title: Junior doctor-designed induction booklet to improve future junior doctor experience in a new post publication-title: Future Healthc J doi: 10.7861/futurehosp.6-2s-s17 contributor: fullname: Thomas N – ident: ref14 |
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Snippet | Background The transition of junior doctors into working in the emergency department (ED) in the United Kingdom often poses challenges in adapting to new... BackgroundThe transition of junior doctors into working in the emergency department (ED) in the United Kingdom often poses challenges in adapting to new... Background The transition of junior doctors into working in the emergency department (ED) in the United Kingdom often poses challenges in adapting to new... |
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SubjectTerms | Emergency medical care Emergency Medicine Handbooks Hospitals Medical Education Medical referrals Patient safety Physicians Polls & surveys Quality Improvement Smartphones |
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Title | Introducing an Emergency Department Electronic Handbook to Junior Doctors New to Emergency Medicine |
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