Rolling handOVER Rolling handOVER

(ROVER) – (ROVER) –

Enhancing Junior Doctors’ Enhancing Junior Doctors’

Orientation to New RotationsOrientation to New Rotations

Dr Caitlin TaylorDr Caitlin Taylor

Realising the Need for ROVERRealising the Need for ROVER

New Academic Year in undesirable events– “July Phenomenon”

October BMJ, Retrospective Cohort Study1

– Up to 82% in errors– Regardless of trainee’s level of experience

1. Haller G, Myles S, Taffe P, Perneger T, Wu C. Rate of undesirable events at beginning of academic year: retrospective cohort study. BMJ 2009; 339:1-8.

Realising the Need for ROVERRealising the Need for ROVER

Factors Contributing to Errors1

– New environment– Breakdown in communication & teamwork– Poor handovers– Lack of supervision

Realising the Need for ROVERRealising the Need for ROVER

Strategies Proposed to Errors– Improve orientation1

– Increase supervision1

– Written protocols1

– Simulation training1

– Verbal handovers– Mentors

Development of ROVERDevelopment of ROVER

Important Aspects of Intern Orientation Identified– Head of unit, registrar, resident– Intern handover– Unit orientation package

Insufficient Unit Orientation Packages–Verbose, outdated–Not intern-specific–Availability, accessibility poorly promoted

Initially Discussed at ANZMET 2007

What is ROVER?What is ROVER?

Orientation Document– Concise– Demystifies– Quick reference– Easily accessible– Up-to-date – Complements other orientation guides

Written by Junior Doctors Approved by Education Supervisors

What is ROVER?What is ROVER?

Essential Information– Staff members, meetings– Common medical conditions– Roles, responsibilities, tips

Additional Information– Familiarity with certain symptoms/signs– Common medications, procedures, referrals– Useful intranet documents, websites

Implementation of ROVER Implementation of ROVER

Production– End of 1st rotation

Implementation–Commencement of 2nd rotation

Result–Comparison b/w 1st & 2nd/3rd rotations– 2/3rds of interns had useful unit orientations– ROVER useful & complimented unit info

ROVER a SuccessROVER a Success

2009 Interns Feedback About ROVER– Most beneficial & preferred orientation tool

– Eased transition– Reduced anxiety– Highlighted expectations allowing reflection– Focused appropriate revision– Easily accessible– Concise

ROVER a SuccessROVER a Success

Head of Dept & Supervisors Feedback– “Great document”– “Very useful addition to the unit orientation

package”

Further DevelopmentFurther Development

2010 Intern Orientation Week– ‘Intern Learning’ workshops

– Identifying opportunistic learning on the job– ROVERs assist in:

– Identifying informal learning opportunities– Developing learning objectives

– Promoted with unit orientation packages,ACF HMO2 ROVERs Statewide Rollout