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84 Reducing waste and improving patient safety: introduction of the on-call doctor’s bag
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  1. Matthew Stahl,
  2. Alok Prasad,
  3. Ekta Vasita,
  4. Neil Patel,
  5. Sassoon Levi
  1. Frimley Health NHS Foundation Trust, UK

Abstract

We introduced an on-call doctors bag for the Foundation Year One (FY1) doctor’s on-call medical ward cover at Wexham Park Hospital. These on-call shifts are extremely busy with the FY1 covering 14 different wards. Time is wasted locating essential equipment on unfamiliar wards. Literature over the last 5 years has calculated that junior doctors spend on average 29 hours accessing treatment room and approximately 4 working days collecting equipment over a year.1 These delays can compromise patient safety in emergencies as well as contributing to daily inefficiency and lower job satisfaction.

A pre-intervention questionnaire using a 5-point Likert Scale identified 90% of FY1 respondents (n=22) at felt that significant time was wasted looking for equipment on unfamiliar wards.

A paramedic sling-bag (£90) was purchased as an on-call doctors bag. The bag was stocked with the relevant equipment and was made available to all FY1s for their medical on-call. The bag was restocked by the ward manager at the end of each shift.

A post-intervention questionnaire was distributed to FY1 doctors. 100% of respondents (n=20) agreed the on-call bag helped them to be more efficient. 100% of respondents agreed less time was spent collecting equipment on the wards with the bag. 95% of respondents stated that they will continue to use the on-call bag.

10 simulated trials were performed comparing the time taken to collect equipment on 8 different wards. 6 volunteer final year medical students unfamiliar with the hospital environment were asked to collect equipment for four common on-call tasks (ABGs, cannulas, phlebotomy and blood cultures) on 8 different wards with and without the on-call bag. In every trial performed, the student with the on-call bag obtained the equipment faster than the student without the bag. The median time saved across all procedures and wards was 3 min 26 s (range 57 s – 7 min 29 s).

The on-call doctor’s bag is invaluable in reducing waste and increasing the number of on-call jobs that can be completed per shift. It reduces the time wasted in collecting essential equipment when treating the unwell or deteriorating patient.

Reference

  1. Karapinar Y, Habib A, Sawyerr H. Improving time efficiency gathering equipment in the treatment room. BMJ Open Quality 2017;6.

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