The ‘August Effect’ – Orientations for doctors

27 August 2014

New doctor orientations can save lives this August

The 'August Effect' - Orientations for doctors

It is well known that going to hospital can often be more harmful to your health than staying out of it. All the more so during the changeover period for doctors in August. This is when new foundation house doctors arrive to hospitals for their rotations. A new working environment, new clinical challenges and, often, a change of accommodation and location for doctors can result in greatly diminished performance levels. This is known as the ‘August effect’.

A review from Birkbeck University in the UK says that new doctor orientations could reduce the August effect when patient mortality rises by a staggering 12%. Birkbeck’s Department of Organizational Psychology undertook the study and has shown the increased efficacy of doctors post-induction. Her study has been published in the journal of the Royal College of Physicians, Clinical Medicine.

Dr Kamau calls for the introduction of clinical skills orientations (orientations) before doctors’ first day at work. The average efficiency in hospitals declines considerably, by up to 7.2%, after newly qualified doctors start work. Clinical procedures take longer and time is taken by other staff to provide guidance. The spill-over effects are lower patient safety and a greater risk of patient death. Dr Kamau’s research shows that, whereas 96% of uninducted new doctors fail one or more clinical procedure tests, the failure rate was reduced substantially after the doctors were orientated. Improvements spanned a range of vital clinical skills including intravenous line insertion and drug administration, certifying death, prescribing and catheterisation.

Dr Kamau said, “There is value in scheduling orientations before doctors report for their first day on the job. Doing this can help solve the hospital efficiency problem that is responsible for the ‘August effect’.”

Some departments of UK hospitals already have attempted to address the clinical skills shortfall of arriving doctors. In the areas of surgery and A&E there is a need to make sure that everyone is up to speed to avoid catastrophic results. However, even at the base level of ward round skills such as catheterisation and inserting cannulas there is a pressing need for staff orientations. Provision can easily be built in to the arrival process of new doctors whether it is face-to-face or via online orientations using video.

Dr. Kamau continues, “The NHS and health organizations in other countries should reconsider the timing and content of clinical skills orientations. Orientations before day one on the job could save lives.”

If you or your organisation feel your staff and new arrivals may benefit from orientation procedures to cover skills shortfalls, health and safety training and, indeed, just general company information.

Sonya Sikra

Sonya is the Brand Strategy Manager at GoContractor. She specializes in communicating how implementing tech in construction can drive productivity and profit.

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