Implementing mobile devices to reduce non-rostered workload for junior doctors

There is a large body of evidence demonstrating the detrimental effect of long work hours on the performance, mood, and job satisfaction of junior doctors. By extension these effects carry over into the realm of patient safety, compromising the quality of care provision. House officers in the general surgery department of Tauranga Hospital, New Zealand are often required to arrive at work well before their rostered start time of 7.30am to hand write the results of clinical investigations on their patient lists. Baseline measurement demonstrated that each house officer was spending an average of 28 minutes a day of non-rostered time completing this task, increasing to 33 minutes on post-acute days. This quality improvement project trialed the use of a mobile device for accessing clinical results in real-time on surgical ward rounds with the ultimate aim of reducing non-rostered workload by one hour per house officer, per week. A sustainable reduction to a median of 15 minutes non-rostered work per day for each house officer was achieved, translating into 75 minutes less non-rostered work for each house officer every week. Importantly, this result was sustained for more than seven working weeks and spanned a changeover in house officer rotation. Furthermore, the use of the devices was associated with a perceived improvement in the accuracy and timeliness of access to clinical results with no perceived detriment to the speed or flow of the ward round.