ArticleInternational journal of general medicine2018
Can patient safety be improved by reducing the volume of "inappropriate prescribing tasks" handed over to out-of-hours junior doctors?
Article in International journal of general medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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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.
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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
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The burden of the digital environment: a systematic review on organization-directed workplace interventions to mitigate physician burnout.Journal of the American Medical Informatics Association : JAMIA · 2021Pooled it
- A scoping review of work patterns of junior medical officer tasks in hospital out of hours.Internal medicine journal · 2025Article
- Effect of Organization-Directed Workplace Interventions on Physician Burnout: A Systematic Review.Mayo Clinic proceedings. Innovations, quality & outcomes · 2019Review
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Authors and funding
2 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundFirst-year doctors found that during out-of-hours shifts they were being delayed and distracted from reviewing potentially sick/deteriorating patients by a high volume of prescribing tasks. This predominately consisted of oral anticoagulation prescribing and rewrites of drug charts. We hoped that if we could reduce this burden of "inappropriate prescribing tasks", we could not only improve junior doctors' job satisfaction and opportunities for training but also give them more time for patient reviews.
methodsThree weekends were initially audited to quantify the number of "inappropriate prescribing tasks" using data from the hospital's computerized task assigning system. On three subsequent weekends, a checklist was handed out to the ward teams on Friday mornings. This checklist was designed to encourage the day teams to check that drug charts would not need oral anticoagulation or rewriting over the weekend.
resultsAn overall reduction in "inappropriate prescribing tasks" of 46% with a specific reduction in inappropriate oral anticoagulation prescribing of 65% was observed. Inappropriate drug chart rewrites were reduced by 30%. The reduction in the mean number of pre-intervention inappropriate prescribing tasks (as a percentage of total prescribing tasks) and the post-intervention mean was 6.94% (95% confidence interval -0.54 to 14.42,
conclusionImproved job satisfaction and a perceived reduced workload were noted from post-intervention qualitative surveys. While improved patient safety directly resulting from this intervention is more difficult to establish, and the observed reduction in inappropriate prescribing was only approaching statistical significance, our colleagues commented in post-intervention feedback that they felt they had more time, and felt less pressured, while attending patients. The workload of junior doctors can exert a significant effect on patient care, and simple measures can alleviate this burden. Furthermore, computerized hospital task management systems are an underutilized source of data for audit and quality improvement.
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