Barriers to the implementation of exception reporting at a busy district general hospital

Hassan, Dana; Maggs, Fenella

doi:10.7861/futurehealth.6-2-s28

Cited by 2 publications

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References 1 publication

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“…This appears to be consistent among other trusts. 4 Due to the novelty of the ER system, there is a scarcity of data identifying the reasons behind this. At the district general hospital where this study was executed, 76% of junior doctors had not submitted a report between August 2017 and June 2018.…”

Section: Introductionmentioning

confidence: 99%

Exception reporting: an effective way to increase compliance leading to improvements in working conditions for junior doctors

Senn

Mawella

Ganeshananthan

2021

Future Healthcare Journal

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Background In 2016, the new junior doctors contract introduced exception reporting (ER) to monitor extra hours worked, report patient safety, rostering and training concerns. Unfortunately, from discussions with foundation doctors, there seems to be a reluctance to engage with ER. Objectives This quality improvement project aims to identify reasons for reluctance among foundation doctors to engage with ER and implement changes to address these barriers with a view to improve rates of ER. Methods Questionnaires regarding ER were distributed to all foundation doctors at a district general hospital. Following this, a leaflet was created and disseminated to all doctors providing guidance on ER and addressing several issues highlighted by the questionnaire. Foundation doctors were re-surveyed to assess for improvement. Results We found a significant improvement (p<0.05) in proportion of overtime exception reports filled from 20.3% to 33.9%. The most common barriers identified were apprehension of meeting with the consultant to discuss reports, insufficient senior encouragement and fear of appearing inefficient. Conclusions An increased awareness and understanding of ER through the leaflet achieved an improvement in rates of ER. The insight gained from this quality improvement report can be applied across other trusts to improve compliance with the ER system nationwide, in order to safeguard staff wellbeing and thereby improve patient safety.

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Section: Introductionmentioning

confidence: 99%

Exception reporting: an effective way to increase compliance leading to improvements in working conditions for junior doctors

Senn

Mawella

Ganeshananthan

2021

Future Healthcare Journal

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Quantitative and qualitative analysis of exception reporting at a district general hospital

Underwood

Yunus

2021

Br J Hosp Med

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Background/aims Exception reporting is a function by which junior doctors report when their work has varied from expected. This study analysed the reporting at the authors' hospital. Methods The authors analysed 204 reports submitted across 12 months to investigate the nature and pattern of the exception reports. Results The majority of reports (86%) were for ‘hours and rest’, 5% for education and 9% for both. On average doctors reported an additional 1.32 hours of work per report. The most common response was time off in lieu, but 13% of reports were never responded to. Qualitative analysis showed the most common reasons for reporting were ‘work outside of rostered hours’, ‘workload’ and ‘staffing issues’. Over 10% of the reports discussed an educational issue. Conclusions The data were not specific and there was fewer than one report per junior doctor in the period analysed. It is therefore unlikely that the reports submitted represent the additional work done by junior doctors at the hospital. Guardians should investigate local attitudes to exception reporting and educate both seniors and juniors on the importance of submitting accurate exception reports.

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Barriers to the implementation of exception reporting at a busy district general hospital

Cited by 2 publications

References 1 publication

Exception reporting: an effective way to increase compliance leading to improvements in working conditions for junior doctors

Exception reporting: an effective way to increase compliance leading to improvements in working conditions for junior doctors

Quantitative and qualitative analysis of exception reporting at a district general hospital

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