Creating more than a directory : improving handover of information by renovating the induction app for University Hospital Wishaw

Clare, Kathleen and Cathcart, Jennifer and Patel, Manish (2020) Creating more than a directory : improving handover of information by renovating the induction app for University Hospital Wishaw. BMJ Open Quality, 9 (4). pp. 1-6. e000970. ISSN 2399-6641 (

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Starting in a new hospital can be an overwhelming experience for any grade of doctor. There is a vast amount of information that needs to be learnt immediately to function in the new environment. There is an annual changeover of doctors between hospitals in August nationwide and most junior doctors rotate specialties every 4–6 months. Evidence shows that doctors feel this transition has a negative impact on patient care and indicates that inpatient mortality rises during the August changeover. In our hospital, we noted problems with access to guidelines, referral information and investigations by junior doctors, especially at changeover. In an initial questionnaire, 100% of doctors had experienced difficulties with referring to a specialty and 96% felt time was wasted doing so. Furthermore, 87.5% of doctors had difficulties with ordering laboratory investigations and 100% of survey participates expressed difficulty accessing guidelines. To tackle this issue, we created guidelines on how to refer to different specialties, order investigations and general running of the hospital. We then used a free app platform called induction and uploaded the guidelines as well as formal hospital guidelines to the app. After use of the app, we assessed these problems via further questionnaires. Doctors reporting problems with finding how to refer to specialties reduced from 100% to 0% in the final survey. Problems finding how to request investigations fell from 100% to 14.3% after 1 month to 7.7% after 3 months. Finally, problems finding guidelines fell from 100% to 15.4%. Further, 100% of doctors felt the app saved time. Use of the induction app to access guidelines saves time and reduces problems accessing information needed to carry out tasks. This an easily replicated project with low running costs which proved to help with the universal problems around induction to a new hospital environment.