Quality improvement report: setting up a hospital at night service, limitations of bleep filtering and using an electronic task management system

BMJ Open Quality

article

Aaisha Saqib¹  Kevin Cairney¹  Karen Mcintyre¹  Emma Coutts¹  Tamara Stephens¹  Lesley Roberts¹  Sandip Banerjee¹ 

[1] Specialist Medicine Directorate , Medway Maritime Hospital

关键词: hospital medicine;    duty hours/work hours;    interruptions;    teamwork;   

DOI  :  10.1136/bmjoq-2020-001007

学科分类：药学

来源: BMJ Publishing Group

【 摘 要 】

The ‘hospital at night’ concept was developed at a joint conference of the London Deanery and Clinical Staff in 2002, as an issue for education and service provision. At the start of the project, our trust had issues with both the structure of the hospital at night handover and the working practices overnight. The vision was to improve team working out of hours, expedite review of sick patients and reorganise care to seek a reduction in bleeps to medical junior doctors overnight in a way that all patients had access to the right person with the right skills for their needs at the right time. The hospital at night project at our hospital was started in 2019 by a multidisciplinary working group. We tried bleep filtering for 4 months and this was later followed on by the development of an electronic out of hour’s task list as part of our hospital at night set-up. The bleep analysis data showed an improved distribution of workload but the process was dependent on individuals. The electronic task management system was built in pre-existing online software. The system helped prioritise and review tasks requested by nurses on medical wards. But it was not without its limitations. We worked with the local information technology (IT) team to improve speed and proposed developing an IT solution that is fast and not desktop based to ensure tasks can be assigned and viewed while on the go. The project was overall a success as it demonstrated positive feedback from junior doctors, improved perception of teamwork and ability to take rest breaks. It also demonstrated a drop in ward-based cardiac arrest rates. The hospital at night project at our trust remains a work in progress, but a lot of positive changes have been delivered.hospital medicineduty hours/work hoursinterruptionsteamworkData availability statementAll data relevant to the study are included in the article or uploaded as supplementary information.http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

【 授权许可】

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