Abstract:

Background:
Accessibility of junior doctor page numbers in hospitals is important to enable ward staff (e.g. nurses) to contact the correct doctor for a patient easily when needed, especially when a patient’s clinical condition is unstable. However increasingly often in team-based departments ward staff cannot simply contact any junior doctor working on the ward and have to correctly identify the correct junior doctor looking after a given patient and page them. This is often difficult for ward staff because junior doctors work shift patterns and rotate through specialties every few months making it difficult for ward staff to learn which junior doctor to contact for a given consultant. Educating ward staff every few months as to which junior doctors are working for each consultant-led team has proved challenging in the past by having to learn the names of each set of new junior doctors at the beginning of each rotation and also the limited time ward staff have to dedicate to additional learning.

Aims:
1) Educate ward staff which junior doctors to contact using a newly devised passive learning programme to help nurses and other ward staff to contact the correct junior doctor by page.
2) Evaluate the impact of the passive leaning programme by comparing junior doctor page number accessibility before and after implementation of the learning programme.

Methods:
1) A new passive learning programme was devised by putting a ‘junior doctor photograph identification card’ on the wall of each ward of an orthopaedic department in a district general hospital. Each ‘ID card’ has the name, photograph and pager number of each doctor and the consultant they worked for.
2) A cross-sectional survey of 35 ward staff was taken before and two weeks after implementation of the learning programme to evaluate the impact of the learning programme.

Results:
- In a random on-the-spot test, only 22.5% of ward staff knew which consultant a presented junior doctor worked for before the learning programme compared to 75% after the learning programme. (p value <0.01)
- 95% of ward staff noticed a marked improvement in contacting the correct junior doctor after implementation of the learning programme.
- The average time ward staff felt it took to identify the correct page number for the correct junior doctor was over four times quicker after implementation of the learning programme. A reduction of 75 seconds to 18 seconds. (p value < 0.01).

Conclusions:
We have demonstrated that our novel devised passive learning programme for ward staff increases the accessibility of junior doctors. This has implications for ward efficiency and improves limitations that come with a team-based department. Furthermore this is likely to have positive implications for patient safety in an environment where accessibility and communication is key. This novel learning programme can be readily adopted to other clinical departments facing the limitations of a team based structure.

Keywords:

Junior doctors, photographic identification, accessibility, team-baed, passive learning.