Abstract
Introduction
The weekend on-call team attends ward emergencies and front door new assessments. The extra routine ward work results in delay in the new assessments and add further exhaustion for the on-call team, impacting on junior doctor’s well-being and patient safety.
Objective
Aim to improve patient safety by facilitating the continuity of patient care over the weekend
Method
Group discussions among junior doctors, nurses, pharmacists, and ward managers were done to understand the challenges that impact communication. The average time spent on a ward by on-call team was 60 minutes. Plan-do-study-act (PDSA) cycles were introduced. The key measurement used was the time taken to complete the ward task.
Results
Team agreed to focus on improving communication over weekends based on the number of times nurses contacted junior doctors
Friday morning ward round was made mandatory for every patient and a check-list sticker was introduced to test the change for 15 patients. Results were assessed and showed 3 patients did not require review and saved 6 minutes of on-call team over the weekend.
The second PDSA included 30 patients which showed 11 minutes of time saved. But change was not sustained. Awareness sessions were introduced, and the plan was to add A4 sheet titled Mandatory Friday Round (MFR). Next PDSA cycles showed saving on-call team but not all the on-call team and nurses reviewed MFR.
The team reviewed the results of the 5th PDSA cycle and agreed to use the green colour MFR A4 sheet and included prompts for the team to complete all the usual tasks. This saved about 28 minutes of on-call team.
Discussion
28 minutes saved from one ward were used for the new assessment. The team feels extending the good practice to all 5 elderly care wards will save approximately 2 hours
Conclusion
Effective communication using MFR has enabled on-call team to assess extra new patients and have adequate rest.