Introduction of an Electronic Handbook and Video Resource for Foundation Doctors in General Surgery

Areen Hassan Haleem, Yasmin Jessa, Kristen Medalla,Zhan Ng(Foundation Doctors)

Introduction

The transitionfrom medical student to Foundation Year One (FY 1) doctor can be challenging,especially in a fast -paced specialty as GeneralSurgery. New FY 1soften face asteeplearning curve in acquiring ward-basedknowledge while providing patient care The aim of this project was to ease thetransition period for new foundation doctors in General Surgery by creating an electronic handbook and videoresource for both learning and referencepurposes.

Results

We had a 66.7%response rate from the FY 1s for both the pre and post intervention surveys (n=6/9). The pre- implementation surveyshowed half the FY 1s ( 50% n=3/6) didnot feel prepared to work on General Surgery. One third of the FY 1s( 33.3% n=2/6)reported insufficient resources to answer common ward -basedquestions. Figure

Methodology

The QIP is designed to continue over one year Data will be collected every four months to reflect FY 1changeover. The posterhighlights data collection from the first set of FY 1s.

AIM:

To improve efficiency in completing ward-based tasks to subsequently facilitate patientmanagement.

INTERVENTION:

Created an electronic handbook and pre-recorded video to provide easy access to important ward-based information.

MEASURED OUTCOMES:

Overall FY1 confidence: using pre and post intervention feedback forms Confidence in carrying out specific ward-based tasks and ability to answer ward-based questions

Free Text feedback for suggested improvements

We ran three PDSA cycles in -order to create the resources and measure the above- mentioned outcomes ThePDSA cycles are outlined in figure3 below

PDSA Cycle 1: Identifying the improvement focus.

PDSA Cycle 2: Formal Feedback PDSA Cycle 3: Evaluating project impact.

- Night Shift Guide

-Handover List

- Daily Schedule

-Clerking Processes

- Booking a patient to theatre

- Medications

- Requesting scans

- Chasing scans

- Making Referrals

- Discharge summaries

- Common bleeps/contacts

Figure 4: Ward-based tasks assessed in pre - and post-intervention questionnaires post-guide

The pre-implementation survey was used to identify areas the FY 1shighlighted as important The topics with the highestvoteswere working a night shift (n=3), preparingahandoversheet (n=3) and the daily SAU schedule (n=3). All of thesetopics and more were included in the handbook and video.

Following the pilot introduction of the handbook a post -reference guide feedback form was sent. This showed 100% of the FY 1s had (n=4/6 agreed, n=2/6 stronglyagreed)improvedconfidence at work in all ward - based tasks assessed. An improvement in medianconfidencelevels on a5- point Likert scale was observed in all areas including: working night shifts, clerking patients, preparinghandover lists, prescribingmedication and fluids, and writing discharge summaries.

Conclusion

This QI projecthighlighted the gap in ward -based information given out to new rotating FY 1s and the benefit of having a formal resource to address the issue

We learnt the importance of the multidisciplinary teamwhendeveloping an information resource It elucidated the differentperspectives of how ward based tasks could be addressed.

Using afreetextfeedback box expanded the breadth of the qualitativedata in developing the project. Additionally, we found WhatsApp to be a more accessible platform to distribute resources and retrievefeedback.

Moving forwards there is scope to develop similar resources for otherspecialities including community-basedplacements and mandatory FY 1requirements such as the Horuse- Portfolio

This projectdeveloped our networkingabilities liaising with different members of the surgicalteam to source out information and time management skills