Can patient safety be improved by reducing the volume of “inappropriate prescribing tasks” handed over to out-of-hours junior doctors?

Figures & data

Table 1 Questionnaire responses from pre-intervention survey of FY1s

	Strongly Agree	Agree	Neither Agree Nor Disagree	Disagree	Strongly Disagree
Do you receive jobs while on-call that should have been done by the day team?	4	7	1	1	0
Are you regularly asked to rewrite drug charts?	3	5	3	2	0
Are you regularly asked to dose warfarin?	4	7	2	0	0
Are you regularly asked to continue a therapeutic Tinzaparin prescription?	1	4	5	3	0
Do you think a checklist given out to ward teams on Fridays would help reduce inappropriate prescribing tasks?	7	4	2	0	0
Do you often attend patients during on-calls and find an inadequate summary/management plan/ceiling of care documented in the notes?	1	4	5	3	0

Abbreviation: FY1s, first-year junior doctors.

Table 2 Comparison of “inappropriate” prescribing tasks submitted during individual pre-intervention weekends with the post-intervention weekends

	Pre-intervention			Post-intervention
	16/12/16 to 19/12/16	30/12/16 to 2/1/17	6/1/17 to 9/1/17	13/1/17 to 16/1/17	20/1/17 to 23/1/17	27/1/17 to 30/1/17
Anticoagulation prescription	20	24	33	16	3	8
Drug chart rewrite	8	5	7	6	3	5
Other “inappropriate” prescribing task	9	17	15	8	15	10
Total inappropriate	37	46	55	30	21	23
Total tasks	274	363	333	333	278	317
Inappropriate tasks as percentage of total	13.6%	12.7%	18.6%	9.0%	7.8%	7.3%

Figure 1 Bar graph comparing the number of inappropriate prescribing tasks handed over in pre-intervention weekends with post-intervention weekends.

Table 3 Standard deviation calculation for the mean number of inappropriate prescribing tasks as a percentage of total prescribing in pre- and post-intervention weekends

	Weekend	Inappropriate prescribing tasks as a percentage of total prescribing tasks	Mean	(Score – mean)^Citation2	SD (√total of previous column)
Pre-intervention	1	13.6%		1.88
Pre-intervention	2	12.7%		5.15
Pre-intervention	3	18.6%	14.97%	13.18	4.50
Post-intervention	4	9.0%		0.94
Post-intervention	5	7.8%		0.05
Post-intervention	6	7.2%	8.03%	0.53	1.23

Abbreviation: SD, standard deviation.

Figure S1 Checklist designed to decrease inappropriate prescribing handed over to junior doctors during out-of-hours.

RabanMZWalterSRDouglasHEStrumpmanDMackenzieJWest-brookJIMeasuring the relationship between interruptions, multitasking and prescribing errors in an emergency department: a study protocolBMJ Open2015510e009076

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