Trainee doctor or daughter?

BMJ ◽  
2003 ◽  
Vol 326 (Suppl S3) ◽  
pp. 030384
Author(s):  
Wendy Brown
Keyword(s):  
Trainee Doctor

scholarly journals The quality of handover on an inpatient psychiatric unit - information is key!

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S183-S183
Author(s):  
Emma Davies ◽  
Ijeoma Enemo-Okonkwo
Keyword(s):  
Patient Safety ◽  
Nursing Staff ◽  
Current Issue ◽  
Improve Patient Safety ◽  
Quality Care ◽  
Limited Information ◽  
Psychiatric Unit ◽  
Trainee Doctor ◽  
Inpatient Psychiatric Unit

AimsTo study the quality of handover, between nursing staff and doctors, on an inpatient psychiatric unit.Effective handover between professionals is vital to ensure the accurate transfer of useful information to enable quality care and patient safety.Implementation of a handover tool has been shown to improve patient safety, especially when used to structure communication over the phone.Feedback at trainee doctor forums highlighted insufficient handover from nursing staff whilst on-call, a problem which prompted further exploration.MethodStandards were developed for the expected quality of handover, consisting of a set of criteria for the minimum information required to ensure a safe and effective handover, stemming from the SBAR (Situation, Background, Assessment, Recommendation) approach, with adequate identification of patients, clear communication of the current situation and relevant details.In an inpatient psychiatric setting, telephone calls to the on-call doctor were recorded for a two-week period, documenting whether key information was communicated.ResultTotal number of calls to on-call doctor recorded: 68. The patients name was given in 49% and the ID number in just 10%. Both relevant diagnosis/history and NEWS score was provided in 18%. However, the current issue and recommendation was given in 90% and 95% respectively.ConclusionThe results thus far demonstrate a lack of structure and often limited information delivered in handover from nursing staff to the on-call doctor. This leads to difficulties in prioritisation, identifying the urgency of the situation and inefficiencies, as time is spent requesting further information which is not readily available.After nursing colleagues were made aware, results from a further two-week period, from 65 total calls, demonstrated some improvement. Patient name given in 51%, ID number in 18%, relevant diagnosis/history in 12%, NEWS score in 17%, current issue in 92% and recommendation in 51%. It is clear that with marginal improvement, there remains a problem which we aim to address by collaborating further with senior nursing leads whilst implementing a succinct handover proforma. It is likely that with COVID-19 as the priority on the agenda this past year, quality improvement projects such as this has not been the main focus. We hope that we will be able to implement these changes in the coming months.

Training for Child Psychiatry

2016 ◽  
pp. 299-308
Author(s):  
Donald W. Winnicott
Keyword(s):  
Child Psychiatry ◽  
Emotional Health ◽  
Trainee Doctor ◽  
Child Psychiatrists

In this contribution to a symposium on the training for child psychiatry—a new specialty in medicine at this time—Winnicott proposes that doctors who have trained in paediatrics and psychoanalysis should also train as child psychiatrists. Becoming an adult psychiatrist who then trains in child psychiatry is not advisable because the trainee doctor will have missed the development of child physical and emotional health during its maturation.

A Shropshire Surgeon

2016 ◽  
pp. 57-58
Author(s):  
Donald W. Winnicott
Keyword(s):  
Point Of View ◽  
Trainee Doctor

A Shropshire Surgeon is a poem in which Winnicott parodies the famous poem A Shropshire Lad by A. E. Houseman, from the point of view of a trainee doctor.

scholarly journals Improving access to the physical health clinic in a community first-episode psychosis service

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S224-S224
Author(s):  
Zena Tansley-Ahmed ◽  
Wei Han Lim
Keyword(s):  
Health Outcomes ◽  
Physical Health ◽  
Health Clinic ◽  
First Episode ◽  
Successful Implementation ◽  
Trainee Doctor ◽  
Improvement Project ◽  
User Input ◽  
Physical Health Outcomes ◽  
Early Intervention In Psychosis

AimsPhysical health outcomes are poor for patients with severe mental illness as demonstrated by the significant mortality gap present globally.[1] Access to and engagement with care is a key factor underpinning this disparity.[2] The Early Intervention in Psychosis service works with young people from 14-35 experiencing a first episode of psychosis in the community. Within the service, difficulties in engagement have been reflected in the high ‘no-show’ rates observed in the Foundation Year 2 trainee doctor-led physical health clinic. This quality improvement project aimed to reduce the ‘did not attend’ (DNA) rate in the physical health clinic by 20% in order to improve patient outcomes, particularly in the context of their physical health.MethodThe project took place between September and November 2020, over the course of 10 weeks. A driver diagram was constructed to identify key influencing factors and subsequent change ideas. In order to implement each of these changes, three cycles within the Plan, Do, Study, Act (PDSA) ramp framework were completed. These consisted of phone reminders within 48 hours of appointments, a teaching session for staff alongside the distribution of an accompanying information leaflet and increased flexibility in clinic times with opportunistic appointments. The change ideas were cumulative with each cycle lasting a duration of seventeen days.ResultThe baseline DNA rate was calculated based on the preceding month and found to be 55%. Following cycle one of the project, there was a significant reduction in DNA rates to 30% although this remained relatively stable at 33% after cycle two. By the end of cycle three when all interventions had been introduced, the DNA rate had dropped to 22%. As such, a total drop in DNA rate of over 30% was achieved which surpassed the initial aim of the project.ConclusionThe outcomes of this project demonstrate that the introduction of even simple measures can lead to positive change. Successful implementation of these changes requires teamwork and a culture of openness and flexibility. Feedback from team members, particularly care coordinators, also indicated better resulting engagement of clients with the service overall, suggesting potential for both improved mental and physical health outcomes. Next steps for this project may involve not only continued implementation of established changes but also service user input and scope for virtual consultations particularly in light of current COVID-19 restrictions.

Managing the trainee doctor in difficulty

2018 ◽  
pp. 165-176
Author(s):  
Elisabeth Paice ◽  
Victor Orton
Keyword(s):  
Trainee Doctor

scholarly journals Using student doctor or trainee doctor may be helpful

BMJ ◽  
2003 ◽  
Vol 327 (7423) ◽  
pp. 1110-a-1110 ◽  
Author(s):  
H. G. El-Sayeh
Keyword(s):  
Trainee Doctor

scholarly journals Oxford Textbook of the Psychiatry of Intellectual Disability

2020 ◽  
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Developmental Disorders ◽  
Mental Health Problems ◽  
Evidence Base ◽  
Health Problems ◽  
Multiple Choice Questions ◽  
Language Therapy ◽  
Trainee Doctor ◽  
Single Response

Intellectual Disability (ID), a lifelong condition characterized by an impairment of intellectual functioning and deficits in adaptive skills is part of a spectrum of developmental disorders which also includes other conditions like autism and ADHD. While psychiatric problems are three to four times more common in those with ID, diagnosing it can be fraught with difficulties due to associated communication problems, atypical presentations, overlap with physical conditions, and experience of marginalization and abuse. In addition, treatment approaches may be different and the potential for treatment-related side effects greater. With a range of international experts authoring its chapters and providing the up-to-date evidence base in assessment, diagnosis, and treatment of mental health problems in people with ID, this book will be useful not just for the trainee doctor in psychiatry, but also for those in allied professions like general practice, nursing, psychology, speech and language therapy, social work, and occupational therapy as well as family members and carers and all those involved in any way with organizing or delivering care and treatment for people with intellectual disability and mental health problems. Throughout, the book addresses issues that are of relevance to those on the frontline and hence most chapters offer examples of clinical issues that come up in day to day practice. There are also a number of single response multiple choice questions that will serve as an aid to learning.

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