ArticleJRSM short reports2013
What drives the 'August effect'? A observational study of the effect of junior doctor changeover on out of hours work.
Article in JRSM short reports, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed.
- Induction Implications: Shaping the Competence and Confidence of Junior Doctors Within Complex Medical Specialties.Cureus · 2023Article
- Exploring the 'January effect' at a university hospital in Pakistan: a retrospective cohort study investigating the impact of trainee turnover on patient care quality outcomes.BMC medical education · 2023Article
- 21st century medical education: critical decision-making guidance through smartphone/tablet applications-the Lothian pilot.BMJ simulation & technology enhanced learning · 2017Article
- NightShift simulation to train newly qualified doctors in non-technical skills: a feasibility study.Future hospital journal · 2016Article
- A survey-based cross-sectional study of doctors' expectations and experiences of non-technical skills for Out of Hours work.BMJ open · 2015Article
- Effects of experimental inductions for newly qualified doctors on competence at clinical procedures.Clinical medicine (London, England) · 2014Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate whether measurements of junior doctor on-call workload and performance can clarify the mechanisms underlying the increase in morbidity and mortality seen after junior doctor changeover: the 'August effect'.
designQuantitative retrospective observational study of routinely collected data on junior doctor workload.
settingTwo large teaching hospitals in England.
participantsTask level data from a wireless out of hours system (n = 29,885 requests) used by medical staff, nurses, and allied health professionals.
main outcome measuresNumber and type of tasks requested by nurses, time to completion of tasks by junior doctors.
resultsThere was no overall change in the number of tasks requested by nurses out of hours around the August changeover (median requests per hour 15 before and 14 after, p = 0.46). However, the number of tasks classified as urgent was greater (p = 0.016) equating to five more urgent tasks per day. After changeover, doctors took less time to complete tasks overall due to a reduction in time taken for routine tasks (median 74 vs. 66 min; p = 3.9 × 10(-9)).
conclusionThis study suggests that the 'August effect' is not due to new junior doctors completing tasks more slowly or having a greater workload. Further studies are required to investigate the causes of the increased number of urgent tasks seen, but likely factors are errors, omissions, and poor prioritization. Thus, improved training and quality control has the potential to address this increased duration of unresolved patient risk. The study also highlights the potential of newer technologies to facilitate quantitative study of clinical activity.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.