Evaluating a Structured Workflow Guide to Improve Junior Doctor Preparedness for Vascular Surgery Late Shifts: A...

Area of Science:

• Medical Education
• Surgical Training
• Healthcare Workflow Optimization

Background:

• Junior doctors in vascular surgery often manage complex late shifts with limited formal induction.
• Key responsibilities include admissions, post-operative reviews, medication reconciliation, investigations, and complication escalation.
• Inadequate preparedness can impact patient care and junior doctor well-being.

Purpose of the Study:

• To evaluate the impact of a structured workflow guide on junior doctors' preparedness and confidence during vascular surgery late shifts.
• To assess if the guide improves efficiency and reduces reliance on senior staff.

Main Methods:

• Prospective paired pre-post interventional study involving eight Foundation Year 1 (FY1) doctors.
• A structured workflow guide was developed and implemented during departmental induction.
• Pre- and post-intervention questionnaires assessed preparedness, confidence, clerking time, and escalation frequency using Likert scales.

Main Results:

• Significant improvements were observed across all ten preparedness and confidence domains post-intervention (p = 0.0078).
• Composite preparedness/confidence scores increased substantially from 19.5 to 46.0.
• Self-reported average clerking time decreased from 1.8 to 1.2 hours, and escalations to senior colleagues reduced from 5.25 to 3.5 per shift.

Conclusions:

• A structured workflow guide effectively enhances junior doctors' self-reported preparedness and confidence in vascular surgery late shifts.
• The guide appears to streamline workflows, reducing clerking times and the frequency of senior staff escalation.
• This intervention offers a practical solution for improving junior doctor training and support in surgical settings.