Impact of a structured intern education programme on clinical documentation in the emergency department

McLean, Andrew, Lawlor, Jenine, Mitchell, Rob, Kault, David, O'Kane, Carl, and Lees, Michelle (2015) Impact of a structured intern education programme on clinical documentation in the emergency department. Emergency Medicine Australasia, 27 (1). pp. 29-34.

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OBJECTIVES: To evaluate the impact of More Learning for Interns in Emergency (MoLIE) on clinical documentation in the ED of a large regional hospital.

METHODS: MoLIE was implemented at The Townsville Hospital (TTH) in 2010, and has since provided ED interns with structured off-floor teaching and a dedicated clinical supervisor. A pre- and post-intervention study was conducted using retrospective medical record review methodology. Charts were selected by identifying all TTH ED patients seen by interns in the period 2008-2011. Two hundred pre-intervention records (2008-2009) and 200 post-intervention records (2010-2011) were reviewed. These were randomly selected following an initial screen by an ED staff specialist. The quality of clinical documentation for five common ED presentations (asthma, chest pain, lacerations, abdominal pain and upper limb fractures) was assessed. For each presentation, documentation quality was scored out of 10 using predefined criteria. An improvement of two or more was thought to be clinically significant. Mean scores for each group were compared using a Student's t-test for independent samples.

RESULTS: Mean documentation scores (and 95% confidence intervals) were 5.55 (5.17-5.93) in 2008, 5.42 (4.98-5.86) in 2009, 6.37 (5.99-6.75) in 2010 and 6.08 (5.71-6.45) in 2011. There was a statistically but not clinically significant improvement in scores pre- and post-intervention (P ≤ 0.001).

CONCLUSION: The introduction of MoLIE was associated with a small but statistically significant improvement in documentation, despite an 80% increase in intern placements. These results suggest that structured training programmes have potential to improve intern performance while simultaneously enhancing training capacity. The impact on quality of care requires further evaluation.

Item ID: 42889
Item Type: Article (Research - C1)
ISSN: 1742-6723
Keywords: education; emergency; medical; medicine
Date Deposited: 22 Feb 2016 02:47
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110305 Emergency Medicine @ 50%
13 EDUCATION > 1302 Curriculum and Pedagogy > 130209 Medicine, Nursing and Health Curriculum and Pedagogy @ 50%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920205 Health Education and Promotion @ 100%
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