Short Communication
Sarah Bouayyad and William Tsa
Abstract
Aim: High workload during on-calls has been linked to burnout and reduced patient safety. Cross-covering otolaryngology is common practice during on-calls and often involves providing services in unfamiliar surroundings with potentially life threatening conditions. The necessity and dangers of cross-cover amongst all surgical specialities was assessed and a free-to-download app was developed in response. Methods: A national survey of a Foundation, core and speciality trainees’ experiences of cross-covering during on-calls was conducted. The app cross-cover buddy (CCB) was created in response to results. It was evaluated with a second questionnaire evaluating accessibility and content. Focus group and individual consultant feedback also contributed to the design. Results: The initial questionnaire yielded 54 respondents, with 67% having had experience of cross-cover. Over 77% of trainees felt that patient safety was jeopardised by cross-cover, and 60% stated they did not have access to easily accessible resources. Key feedback explaining these findings included lack of knowledge of management, red flag symptoms, specialty specific complications, and time pressure. Ten consultants from various specialties were approached regarding the findings. There was majority agreement that cross-covering is necessary for service provision and education. The app was well received with 85% of a second group of trainees who trialed the app felt that CCB would improve confidence in patient safety, and 60% felt that CCB would help reduce stress when on-call. Conclusion: Cross-covering on-calls is a necessary part of modern NHS service provision, but may jeopardise patient safety. CCB was created as a secondary, quick access reference guide with key information regarding specialties requiring cross-cover. The app received outstanding feedback from consultants and trainees of all levels, with consistent recommendations to be incorporated into local/national systems.