Foundation Faculty Sharing Good Practice James Houston, Will Barker dr-toolbox.com March 2016

“It’s 0930 on Day 2 into working here and the Consultant already seems cross with me… The SpR is in clinic and I need to book an endoscopy for an upper GI bleed, a Contrast CT, refer to the respiratory team and get a critical care review… I can’t remember any of this from induction!”

study identified 6% increase in mortality in August [1] ‘The intention is to end the so-called killing season. This is good news for patients – we recognise the change-over period in August puts patients at risk’

Starting in a Hospital as a Junior Doctor is a bewildering and stressful period Published increase in mortality around August changeover Common tasks are often more difficult than they should be and include: –Requesting many different tests –Making referrals to many different specialities –Using hospital guidelines that are difficult to find More time (and stress) is often spent finding out how to do such tasks rather than actually doing the tasks themselves.

Provide specific, local information on how to get things done in hospitals Improve the efficiency (and learning environment) of junior doctors. Increasing time for training Improve patient safety by facilitating a better handover between rotating doctors

Handover guides for all F1/F2 firms Bleeps of doctors & MDT Extension numbers for wards, secretaries How to make speciality referrals –within the hospital How to request specific investigations –within the hospital Reference guides specific to the hospital A resource for teaching –And post graduate medical education

Password protected Easily updatable Specific to Junior Doctors working at individual hospitals Available on –a mobile phone –hospital intranet or –a home computer

Set-up and run by Junior Doctors in each trust as part of their own QUIPs Sustainable via the use of local “Toolbox Champions” and support of Foundation Schools Simple to set up for other NHS trusts Scalable to other members of the MDT

Trust Survey: 81.0% of F1s surveyed have used it Of those users: –93.8% found it a useful way to access information –100% felt it saved them time Self reported time saved: –Mean = 39 minutes per doctor per day Statistically significant in changing actions –F1s are less likely to contact senior for help on basic tasks (p < 0.05) Analytics: Approx 2000 page views per month at single Trust ‘Not only the junior doctors, but also nursing and administration staff, registrars and consultants have seen the site and have been very impressed’ ‘I re-audited the Toolbox, and it show increased awareness, usage and satisfaction… ‘I have shown [the Toolbox] to every new member of staff as well as locums, and I am aware that it is being used by the MDT at all levels’

65 Dr Toolbox sites –40 new sites over the last year –Over 200 Doctors involved in programme Endorsement by NHS Medical Director Health Education England –Inspire Improvement BTBC –£15,000 to develop an app Education and Training –NW Thames Leadership Programme –South Thames Leadership Programme

Most people overestimate what they can do in one year… and underestimate what they can do in ten years

A local solution to a national problem Readily scalable to your Trust Quicker, safer, less stressed doctors We need you! Take it back to your Trusts Set up for changeover Get involved

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