"That was a good shift": Interprofessional collaboration and junior doctors' learning and development on overtime shifts

Anya Johnson, Helena Nguyen, Sharon K. Parker, Markus Groth, Steven Coote, Lin Perry, Bruce Way

Research output: Contribution to journalArticle

Abstract

Purpose - The purpose of this paper is to investigate a boundary spanning, interprofessional collaboration between advanced practice nurses (APNs) and junior doctors to support junior doctors' learning and improve patient management during the overtime shift.

Design/methodology/approach - A mixed methods evaluation of an intervention in an adult tertiary referral hospital, to enhance interprofessional collaboration on overtime shifts. Phase 1 compared tasks and ward rounds on 86 intervention shifts with 106 "regular" shifts, and examined the effect on junior doctor patient management testing a model using regression techniques. Phase 2 explored the experience of the intervention for stakeholders. 91 junior doctors participated (89 percent response rate) on 192 overtime shifts. Junior doctors, APNs and senior medical professionals/administrators participated in interviews.

Findings - The intervention was associated with an increase in self-initiated ward rounds by junior doctors, partially explained by junior doctors completing fewer tasks skilled nurses could also complete. The intervention significantly reduced doctors' engagement in tasks carried over from day shifts as well as first year (but not more experienced) junior doctors' total tasks. Interviews suggested the initiative reduced junior doctors' work pressure and promoted a safe team climate, situation awareness, skills, confidence, and well-being.

Originality/value - Junior doctors overtime shifts (5 p.m. to 11 p.m.) are important, both for hospitals to maintain patient care after hours and for junior doctors to learn and develop independent clinical decision making skills. However, junior doctors frequently report finding overtime shifts challenging and stressful. Redesigning overtime shifts to facilitate interprofessional collaboration can improve patient management and junior doctors' learning and well-being.

Original languageEnglish
Pages (from-to)471-486
Number of pages16
JournalJournal of Health, Organization and Management
Volume31
Issue number4
DOIs
Publication statusPublished - 2017

Cite this

Johnson, Anya ; Nguyen, Helena ; Parker, Sharon K. ; Groth, Markus ; Coote, Steven ; Perry, Lin ; Way, Bruce. / "That was a good shift" : Interprofessional collaboration and junior doctors' learning and development on overtime shifts. In: Journal of Health, Organization and Management. 2017 ; Vol. 31, No. 4. pp. 471-486.
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abstract = "Purpose - The purpose of this paper is to investigate a boundary spanning, interprofessional collaboration between advanced practice nurses (APNs) and junior doctors to support junior doctors' learning and improve patient management during the overtime shift.Design/methodology/approach - A mixed methods evaluation of an intervention in an adult tertiary referral hospital, to enhance interprofessional collaboration on overtime shifts. Phase 1 compared tasks and ward rounds on 86 intervention shifts with 106 {"}regular{"} shifts, and examined the effect on junior doctor patient management testing a model using regression techniques. Phase 2 explored the experience of the intervention for stakeholders. 91 junior doctors participated (89 percent response rate) on 192 overtime shifts. Junior doctors, APNs and senior medical professionals/administrators participated in interviews.Findings - The intervention was associated with an increase in self-initiated ward rounds by junior doctors, partially explained by junior doctors completing fewer tasks skilled nurses could also complete. The intervention significantly reduced doctors' engagement in tasks carried over from day shifts as well as first year (but not more experienced) junior doctors' total tasks. Interviews suggested the initiative reduced junior doctors' work pressure and promoted a safe team climate, situation awareness, skills, confidence, and well-being.Originality/value - Junior doctors overtime shifts (5 p.m. to 11 p.m.) are important, both for hospitals to maintain patient care after hours and for junior doctors to learn and develop independent clinical decision making skills. However, junior doctors frequently report finding overtime shifts challenging and stressful. Redesigning overtime shifts to facilitate interprofessional collaboration can improve patient management and junior doctors' learning and well-being.",
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author = "Anya Johnson and Helena Nguyen and Parker, {Sharon K.} and Markus Groth and Steven Coote and Lin Perry and Bruce Way",
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"That was a good shift" : Interprofessional collaboration and junior doctors' learning and development on overtime shifts. / Johnson, Anya; Nguyen, Helena; Parker, Sharon K.; Groth, Markus; Coote, Steven; Perry, Lin; Way, Bruce.

In: Journal of Health, Organization and Management, Vol. 31, No. 4, 2017, p. 471-486.

Research output: Contribution to journalArticle

TY - JOUR

T1 - "That was a good shift"

T2 - Interprofessional collaboration and junior doctors' learning and development on overtime shifts

AU - Johnson, Anya

AU - Nguyen, Helena

AU - Parker, Sharon K.

AU - Groth, Markus

AU - Coote, Steven

AU - Perry, Lin

AU - Way, Bruce

PY - 2017

Y1 - 2017

N2 - Purpose - The purpose of this paper is to investigate a boundary spanning, interprofessional collaboration between advanced practice nurses (APNs) and junior doctors to support junior doctors' learning and improve patient management during the overtime shift.Design/methodology/approach - A mixed methods evaluation of an intervention in an adult tertiary referral hospital, to enhance interprofessional collaboration on overtime shifts. Phase 1 compared tasks and ward rounds on 86 intervention shifts with 106 "regular" shifts, and examined the effect on junior doctor patient management testing a model using regression techniques. Phase 2 explored the experience of the intervention for stakeholders. 91 junior doctors participated (89 percent response rate) on 192 overtime shifts. Junior doctors, APNs and senior medical professionals/administrators participated in interviews.Findings - The intervention was associated with an increase in self-initiated ward rounds by junior doctors, partially explained by junior doctors completing fewer tasks skilled nurses could also complete. The intervention significantly reduced doctors' engagement in tasks carried over from day shifts as well as first year (but not more experienced) junior doctors' total tasks. Interviews suggested the initiative reduced junior doctors' work pressure and promoted a safe team climate, situation awareness, skills, confidence, and well-being.Originality/value - Junior doctors overtime shifts (5 p.m. to 11 p.m.) are important, both for hospitals to maintain patient care after hours and for junior doctors to learn and develop independent clinical decision making skills. However, junior doctors frequently report finding overtime shifts challenging and stressful. Redesigning overtime shifts to facilitate interprofessional collaboration can improve patient management and junior doctors' learning and well-being.

AB - Purpose - The purpose of this paper is to investigate a boundary spanning, interprofessional collaboration between advanced practice nurses (APNs) and junior doctors to support junior doctors' learning and improve patient management during the overtime shift.Design/methodology/approach - A mixed methods evaluation of an intervention in an adult tertiary referral hospital, to enhance interprofessional collaboration on overtime shifts. Phase 1 compared tasks and ward rounds on 86 intervention shifts with 106 "regular" shifts, and examined the effect on junior doctor patient management testing a model using regression techniques. Phase 2 explored the experience of the intervention for stakeholders. 91 junior doctors participated (89 percent response rate) on 192 overtime shifts. Junior doctors, APNs and senior medical professionals/administrators participated in interviews.Findings - The intervention was associated with an increase in self-initiated ward rounds by junior doctors, partially explained by junior doctors completing fewer tasks skilled nurses could also complete. The intervention significantly reduced doctors' engagement in tasks carried over from day shifts as well as first year (but not more experienced) junior doctors' total tasks. Interviews suggested the initiative reduced junior doctors' work pressure and promoted a safe team climate, situation awareness, skills, confidence, and well-being.Originality/value - Junior doctors overtime shifts (5 p.m. to 11 p.m.) are important, both for hospitals to maintain patient care after hours and for junior doctors to learn and develop independent clinical decision making skills. However, junior doctors frequently report finding overtime shifts challenging and stressful. Redesigning overtime shifts to facilitate interprofessional collaboration can improve patient management and junior doctors' learning and well-being.

KW - Team working

KW - Boundary spanning

KW - Learning and development

KW - Nurse

KW - Interprofessional collaboration

KW - Junior doctors

KW - Patient management

KW - HOUSE OFFICERS

KW - WORK

KW - PERFORMANCE

KW - DESIGN

KW - NURSES

KW - COMMUNICATION

KW - EXPERIENCES

KW - MEDICINE

KW - OUTCOMES

KW - QUALITY

U2 - 10.1108/JHOM-01-2017-0008

DO - 10.1108/JHOM-01-2017-0008

M3 - Article

VL - 31

SP - 471

EP - 486

JO - Journal of Health, Organization and Management

JF - Journal of Health, Organization and Management

SN - 0268-9235

IS - 4

ER -