Introducing an Emergency Department Electronic Handbook to Junior Doctors New to Emergency Medicine.

ABSTRACT

Background The transition of junior doctors into working in the emergency department (ED) in the United Kingdom often poses challenges in adapting to new hospital systems and protocols. To address this issue at Queen Elizabeth Hospital, King's Lynn (QEHKL), a quality improvement project (QIP) was undertaken to develop an electronic ED handbook with the primary aim of enhancing the confidence and knowledge of newly appointed doctors during their ED rotation. This electronic handbook serves as a comprehensive repository for vital medical protocols, guidelines, and trust referral pathways, offering an easily accessible resource for junior doctors. Objectives The primary objective of this study was to determine whether there was an improvement in the confidence and knowledge of ED junior doctors following the introduction of the Electronic ED Handbook. The secondary objectives were to determine whether introducing the ED Handbook increased the overall satisfaction rating of the content of the ED Junior Doctor Induction program and assess the level of recommendation for the ED Handbook among the doctors for inclusion in future ED inductions. Method The QIP was designed using the Model for Improvement framework, Plan, Do, Study, Act (PSDA). The aims were designed to be Specific, Measurable, Achievable, Relevant, and Time-bound (SMART). Pre- and post-intervention surveys were conducted for comparison before and after the ED Handbook was introduced. Results Regarding the confidence of junior doctors to proceed into their new roles, the responses of "quite confident" or "very confident" increased from 77.8% (before) to 100% (after the ED Handbook introduction). One hundred percent of the responders found the ED Handbook to be either "very useful" or "extremely useful" in increasing their confidence and knowledge in the first month of their ED rotation. The satisfaction rating of "excellent" for the content of the ED Junior Doctor Induction program increased from 55.5% to 66.7%. One hundred percent of the responders recommended the inclusion of the ED Handbook for future inductions. Conclusion and recommendations Comparing the results from the pre- and post-intervention surveys shows a significant improvement in the confidence and knowledge of ED junior doctors following the introduction of the Electronic ED Handbook. The handbook was formally endorsed by the ED clinical governance team as an integral component of the ED induction process, aiding junior doctors in making a seamless transition into their new roles in emergency medicine. This study emphasizes the importance of utilizing digital resources to improve the confidence and knowledge of junior doctors and recommends the continued use of the handbook in future induction programs.