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      Recognizing junior doctors' potential contribution to patient safety and health care quality improvement

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          Abstract

          Purpose

          The purpose of this paper is to reframe perceptions surrounding junior doctors' capacity to contribute to patient safety and quality improvement.

          Designmethodologyapproach

          A targeted literature review was conducted followed by individual telephone interviews and a halfday forum involving junior doctor representatives and selected leaders in the sector.

          Findings

          Junior doctors' entry into health care is an ideal time to cultivate practitioners' interest and expertise in improving the health system for better patient care. Junior doctors are more likely to bring or embrace new ideas, and recognize the importance of transparency and integration of technology into healthcare systems. Engaging with junior doctors in collaborative processes, rather than focusing on their more senior colleagues, may create a more effective culture.

          Originalityvalue

          The attributes of junior doctors as they are in the absence of specific quality improvement or leadership training that are currently underutilized in patient safety and quality improvement are explored, along with the factors limiting and facilitating the utilization of these attributes.

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          Most cited references24

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          The Quality of Care

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            Pharmacist participation on physician rounds and adverse drug events in the intensive care unit.

            Pharmacist review of medication orders in the intensive care unit (ICU) has been shown to prevent errors, and pharmacist consultation has reduced drug costs. However, whether pharmacist participation in the ICU at the time of drug prescribing reduces adverse events has not been studied. To measure the effect of pharmacist participation on medical rounds in the ICU on the rate of preventable adverse drug events (ADEs) caused by ordering errors. Before-after comparison between phase 1 (baseline) and phase 2 (after intervention implemented) and phase 2 comparison with a control unit that did not receive the intervention. A medical ICU (study unit) and a coronary care unit (control unit) in a large urban teaching hospital. Seventy-five patients randomly selected from each of 3 groups: all admissions to the study unit from February 1, 1993, through July 31, 1993 (baseline) and all admissions to the study unit (postintervention) and control unit from October 1, 1994, through July 7, 1995. In addition, 50 patients were selected at random from the control unit during the baseline period. A senior pharmacist made rounds with the ICU team and remained in the ICU for consultation in the morning, and was available on call throughout the day. Preventable ADEs due to ordering (prescribing) errors and the number, type, and acceptance of interventions made by the pharmacist. Preventable ADEs were identified by review of medical records of the randomly selected patients during both preintervention and postintervention phases. Pharmacists recorded all recommendations, which were then analyzed by type and acceptance. The rate of preventable ordering ADEs decreased by 66% from 10.4 per 1000 patient-days (95% confidence interval [CI], 7-14) before the intervention to 3.5 (95% CI, 1-5; P<.001) after the intervention. In the control unit, the rate was essentially unchanged during the same time periods: 10.9 (95% CI, 6-16) and 12.4 (95% CI, 8-17) per 1000 patient-days. The pharmacist made 366 recommendations related to drug ordering, of which 362 (99%) were accepted by physicians. The presence of a pharmacist on rounds as a full member of the patient care team in a medical ICU was associated with a substantially lower rate of ADEs caused by prescribing errors. Nearly all the changes were readily accepted by physicians.
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              Workplace bullying in junior doctors: questionnaire survey.

              Lyn Quine (2002)
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                Author and article information

                Contributors
                Journal
                jhom
                10.1108/jhom
                Journal of Health Organization and Management
                Emerald Publishing
                1477-7266
                17 May 2013
                : 27
                : 2
                : 273-286
                Affiliations
                Monash University, Melbourne, Australia
                Monash University, Melbourne, Australia
                Monash University, Melbourne, Australia
                Irish Centre for Patient Safety, NUI Galway, Galway, Ireland
                Article
                0250270208.pdf 0250270208
                10.1108/14777261311321824
                23802403
                56b20fe8-ad1f-4469-8abb-48e974ef069e
                © Emerald Group Publishing Limited
                History
                Categories
                e-viewpoint, Viewpoint
                cat-HSC, Health & social care
                cat-HMAN, Healthcare management
                Custom metadata
                yes
                yes
                included

                Health & Social care
                Quality improvement,Doctors,Patient care,Competences,Medical personnel
                Health & Social care
                Quality improvement, Doctors, Patient care, Competences, Medical personnel

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