Decision-Making

Give junior doctors a break – but let’s also equip them better

By Peter Bonis – chief medical officer, Wolters Kluwer Health, Clinical Effectiveness

Every August, thousands of newly qualified junior doctors start work in UK hospitals. As they begin their careers, the first Wednesday of the month is often referred to as ‘Black Wednesday’ because of the possible risk of having so many inexperienced medics on the wards. The fuss around Black Wednesday focuses attention on the daunting job junior doctors face in today’s over-stretched NHS.

Never before have junior doctors been under more pressure to do more, with less time and fewer resources. No wonder the pressure of seeing patients for the first time can lead to some mistakes, stirring up an inevitable debate about patient safety.

One of the biggest problems is many new doctors don’t feel they have enough time for training or for spending with a consultant – as evidenced in a survey by the GMC.

A project piloted at Leicester General Hospital highlighted some of the effects of this. It found that newly qualified junior doctors make prescribing errors at up to twice the rate of other health professionals.

If tried and trusted models of training, and even sufficient time with a consultant are lacking, how else can we help junior doctors navigate their first years of treating and caring for patients? Surely we need to equip them better?

Technology could provide an answer, particularly mobile tech that the young doctor can access just at the time they need it – on the front line, when an accurate decision matters most.

Clinical Decision Support (CDS) technology is being used increasingly by doctors to support their decisions with evidence-based information regarding diagnoses, treatment recommendations, or drug prescriptions. Accessible on a smartphone or tablet, it allows them to quickly access accurate and authoritative information.

The pilot project at Leicester Hospital used a range of technology options to see how they could help junior doctors in their decision-making. It included clinical simulations, feedback, computer-based prescribing tasks and the world’s most-used clinical decision support tool, UpToDate. UpToDate is used by over 1.1 million health professionals, providing evidence-based recommendations on over 10,500 conditions across 24 specialities.

The results of the Leicester study speak for themselves. There was a 50% reduction in prescribing errors. Most serious errors were eradicated and doctors felt better supported. The potential cost saving from avoiding medication errors was £300,000 and the junior doctors reported they were more confident and enthusiastic throughout their work.

Maybe technology like this can help alleviate some of the pressure heaped on junior doctors, leading to fewer mistakes as they launch into a hopefully long and rewarding career in medicine, and better care for all of us.



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