No CrossRef data available.
We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
Published online by Cambridge University Press: 20 June 2025
Aims: To ensure fair workload distribution and faster patient care, SWLSTG follows a cross-cover policy, grouping wards into clusters based on proximity. Each ward has designated cross-cover doctors responsible for daytime medical advice and patient reviews in absence of the ward doctors.
A duty-doctor covers all the wards, handling emergencies, urgent reviews, and mandatory tasks if no cross-cover doctor is available. Duty-doctors carry the duty phone which is a dedicated mobile phone for urgent but non-life-threatening situations. However, in practice, ward staff often bypass the protocol and contact the duty-doctor directly, leading to:
Increased workload for a single doctor.
Delays in patient care due to unnecessary escalations.
Interruptions in emergency response.
This project aims to reinforce adherence to the cross-cover protocol, ensuring appropriate ward doctors are contacted first before escalating to the duty-doctor, reducing unnecessary workload and improving efficiency of patient care.
Methods: Pre-Intervention Data Collection: Distribute feedback forms to trainees to assess the frequency and impact of unnecessary duty-doctor calls.
New System Implementation: Set up an automatic voicemail on the duty phone using the Teams, reminding callers to contact their cross-cover doctor first (operating 9 am–5 pm on weekdays, except bank holidays). The Teams system also allows call tracking by displaying missed call numbers, unlike the previous system, which only showed “unknown number”.
Educational Intervention: Develop a leaflet and ward posters outlining the correct protocol, emphasising contacting cross-covering doctors first unless in a medical emergency.
Implementation: Circulate materials to nursing staff and ward teams, reinforcing adherence through staff meetings.
Collaboration with Ward Managers: Engage ward managers to reinforce adherence and ensure staff compliance.
Post-Intervention Evaluation: Conduct a follow-up survey to measure changes in behaviour and impact on patient care.
Results: The expected Results:
Faster response times for non-emergency reviews as cross-cover doctors are located closer to wards and responsible for fewer patients.
Improve efficiency of patient care by providing continuity.
Increase awareness among ward staff regarding the importance of cross-covering doctors.
Greater clarity and adherence to the protocol among staff.
Reduction in unnecessary escalation to duty-doctors.
Conclusion: Implementing a structured approach to protocol adherence improves workload distribution, reduces unnecessary escalations, and enhances efficiency of patient care. An automated voice message serves as a constant reminder, reinforcing the correct escalation process. However, Teams system carries potential downtime risk, so the old duty phone number will remain as a backup. Future steps include ongoing reinforcement, monitoring reliability, and periodic re-evaluation to sustain improvements.
Abstracts were reviewed by the RCPsych Academic Faculty rather than by the standard BJPsych Open peer review process and should not be quoted as peer-reviewed by BJPsych Open in any subsequent publication.
You have
Access
Open access
eLetters
No eLetters have been published for this article.