11 How can we improve induction to the paediatric and neonatal intensive care units?

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BackgroundGOSH PICU & NICU care for 1,700 critically unwell children a year. Medical staffing is provided by senior paediatric and anaesthetic trainees, and by overseas fellows from diverse professional backgrounds, starting at several different points throughout the year, completing rotations of 3 – 12 months. The current induction programme is one day of talks followed in most cases by one day of shadowing prior to starting clinical duties. Anecdotal feedback from both doctors and nursing staff has suggested that many doctors do not start work feeling fully equipped for such a high intensity role and there remains a steep learning curve.MethodsAn online survey was disseminated to doctors, assessing both their experiences of the induction they had received and their ideas for how the programme could be made more effective. A separate survey was sent to nurses for their thoughts on how the transition could be improved.ResultsOf 19 doctors who participated, 26% felt the current induction format covered everything they needed to know to do their job effectively. 47% felt they had a good idea of what their job would be when they started but only 32% felt they had understood how the units worked. 68% found the shadowing period useful. 42 nurses contributed and only 14% felt new doctors started work with all the information they needed to do their jobs. Both staff groups identified several key areas where additional information was needed, and provided useful 'top tips' for new starters (summarised in Table 1).ConclusionBoth professional groups felt the induction programme needed improvement. In response, an induction website has been created, addressing knowledge gaps highlighted by the surveys; doctors are given access to this in advance of their face to face sessions. The surveys will be repeated in future to determine whether this measure has helped ease the transition of new doctors joining ICU.

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