Junior doctor changeover likely to drive August reduction in quality and safety of patient care

New research suggests that failure by junior doctors in their annual changeover period to identify deteriorating patients and poor prioritisation skills are likely to drive a reduction in the quality and safety of patient care. Next Wednesday 7 August thousands of newly qualified doctors will take up their first hospital jobs and junior doctors will become a grade more senior. This period is associated with worse clinical outcomes than the rest of the year. Researchers writing in JRSM Short Reports, the open-access offshoot to the Journal of the Royal Society of Medicine, found that there was a significant increase in the number of urgent medical tasks after changeover, but that new junior doctors completed routine tasks quicker than their more experienced predecessors. The researchers analysed data from the wireless system for the management of out-of-hours workflow at City Hospital and the Queen's Medical Centre, Nottingham.

Leading the research team, Dr John Blakey of the Liverpool School of Tropical Medicine, said: "The to the provision of care by junior doctors who are inexperienced, or who are less experienced for their level of seniority, presents clear potential for a reduction in the quality and safety of patient care." Referred to as the 'August effect', the situation causes great concern amongst the , especially in the light of reports suggesting medical students are poorly prepared for their first post.

The researchers found there was no change in the overall volume of work requested of junior doctors but that there was a significant increase in the volume of requests for more urgent and serious problems. "This amounts to a considerable cumulative duration of unresolved patient risk per month", said Dr Blakey. He added: "New junior doctors also completed more quickly than their predecessors. This is because they appear to work through tasks based more on their proximity rather than how urgent they are."

The new study lends empirical evidence to qualitative research investigating whether are prepared for the practicalities and complexities of their first posting, say the researchers. They suggest improved training, supervision and quality control could reduce omissions, errors, failure to recognise deterioration and poor task prioritisation skills.

More information: What drives the 'August effect'? An observational study of the effect of junior doctor changeover on out of hours work ( DOI: 10.1177/2042533313489823 ) will be published online by JRSM Short Reports on Wednesday 31 July 2013.

add to favorites email to friend print save as pdf

Related Stories

Huge potential of NHS junior doctors being ignored

Jan 27, 2012

Junior doctors in the NHS are willing and able to help improve health services, but they don't feel valued or heard, reveals the results of a regional survey published online in BMJ Quality and Safety.

Restricted working hours have had little effect in US

Mar 22, 2011

Reducing doctors' working hours from over 80 a week does not seem to have adversely affected patient safety and has had limited impact on postgraduate training in the United States, finds a study published in the British ...

Recommended for you

Young Aussie women now fatter but fitter

56 minutes ago

Young Australian women are fatter, fitter and more frazzled today than they were nearly 20 years ago, according to Australian Longitudinal Study on Women's Health researchers.

Healthy relationships help foster healthy eating habits

1 hour ago

There are few subjects more personal than an individual's weight. And for those people who are considered overweight, whether this is a scientifically accurate measurement or a personal assessment, the battle ...

Gov't website for doc payments not up to snuff

5 hours ago

The government's new "Open Payments" website is intended to let you find out whether your doctor is getting freebies, travel or other financial benefits from drug companies and medical device manufacturers. But it doesn't ...

User comments