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Dr Toolbox

 A project run in North West Foundation School 


Related themes

  • Rotas and scheduling

Background

Trainees often find themselves frustrated by the lack of easily accessible information needed to complete administrative tasks, such as how to make referrals, book investigations or contact other professionals in their hospital. Much of the knowledge gained by doctors throughout the year is lost when they move to a different firm or another hospital. This identified an unmet need for retaining this knowledge in order to facilitate better patient care during periods of transition for doctors in training.
The Toolbox has been designed for doctors in training, by doctors in training to address the issues that the Dr Toolbox team encountered during their time as trainees.

Project objectives

  • To provide specific and local information on how to get things done and complete administrative tasks in hospitals
  • To improve efficiency (and the learning environment) of trainee doctors by increasing time for training
  • To improve patient safety by facilitating a handover
  • To boost the morale of trainees by facilitating quality improvement projects
  • To be environmentally sustainable by reducing the need for paper based induction documentation

How they did it

The Dr Toolbox online directory was set up and run by trainee doctors to provide up-to-date, relevant information and ‘survival guides’ for each of the firms and/or hospitals.
Unlike traditional paper based guides, Dr Toolbox has been created uniquely for the intranet, internet and smart phone platforms and uses a ‘wiki’ format meaning simple updates are possible in minutes. These updates are made by ‘editors’; trainees at individual trusts who build on the toolbox as part of their own safety project.
The website was made into an offline app which automatically synchronised information uploaded by editors making it available offline on all smartphones.
Dr Toolbox is currently active in over 30 hospitals with over 100 doctors contributing, resulting in measurable improvements in efficiency.  You can view a demo here: http://www.daps.org.uk/doctors/toolbox/.

Who was involved

The project team were responsible for planning and executing this project. It consisted of a project manager and a variable number of project team members, who were brought in to deliver tasks according to the project schedule.
The below table lists members of staff who had a role to play, or were involved on the project team. The majority of these positions were not full time and were shared roles, and not necessarily new established roles.

Project Role Working Role Whole Time Equivalent (WTE)
Senior Responsible Owner Senior Clinician 1 hours p/w
App editor Doctor in training 5 hours p/w
IT representative   1 hours p/w
Medical Education Manager   1 hours p/w

Outcomes

  • Dr Toolbox was announced the winner at the prestigious 2014 HSJ Value in Healthcare Award in the Value and Improvement in Communication category. This was a great, national recognition of the impact Dr Toolbox is having
  • The Dr Toolbox website has currently has over 60 hospitals registered with over 200 registered editors and three leadership programmes
  • Dr Toolbox has provided a tried and tested way of sharing useful information with other trainees and facilitating quality improvement or patient safety projects
  • Dr Toolbox provides an opportunity for MDT linking including a tab that provides a link and portal to wider hospital teams and services. The app can also be used by members of the wider MDT to help deliver care in the community setting
  • A survey of F1s at trusts using Dr Toolbox found that the mean time saved per doctor per day was 39 minutes
  • The Dr Toolbox template provided an educational tool for doctors in training to educate themselves about hospital services in a self-directed manner.

What they’ve said

“I am excited by the development of the Dr Toolbox. It is an excellent innovation which I feel will significantly transform the perennial issues faced by junior doctors and hospitals in general.

“I am also particularly encouraged by the inclusion of patient safety as both a driving principle and an explicit consideration in the Toolbox itself. I strongly endorse this initiative and encourage you to get involved at your hospital.” 

Professor Sir Bruce Keogh- NHS Medical Director

“Very happy for you to say that I think it is great – excellent for helping best practice and good patient care.”Prof Parveen Kumar, Former President of the Royal Society of Medicine

‘Massive potential for all juniors on a firm’ 

Sarah Hammond, Consultant Anesthetist

“I wish I had this when I started!” 

F2, NW Thames Deanery

 “The whole toolbox buzz at St Georges Hospital really put the topic of handover on the table.” 

Ryan Pedley, F1 St Georges Hospital, London

“I love it and can really see how it can help with some problems in healthcare.”  

Rob Bethune, Surgical Registrar, Bristol

Toolkit

Please look at the materials in the related documents section below. The top tips and business cases have been developed by the BTBC team to support organisations to implement these changes and the case studies and project resources have been developed and approved by the project teams.

The top tips include lessons learnt that have been identified throughout the project. The business case will guide you through the management principles and communications and engagement activities. The case studies provide a detailed overview of the project. Feel free to adapt these resources to suit your projects.
Your organisation may have its own materials and templates that you can use or you may find the NHS Improving Quality (NHS IQ) learning handbook useful too.

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