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Improving quality in hospital induction programmes

An effective and high quality introduction to a new place of work intuitively seems a sensible idea. Meeting new staff and finding out their individual practices and patterns of work ought to help the efficiency of the hospital and the smooth running of a department, while at the same time facilitating an untroubled handover of responsibilities and patient care. These are noble aims but they are not always satisfied. Almost every doctor will remember finding out peculiarities about a post that they wished they had known at the start of their job. Things go wrong or are delayed, staff and patients get frustrated, complaints may start, and all while the new staff are “finding their feet.” These difficulties are particularly prevalent in the NHS around August and February each year, as fresh intakes of trainees come to terms with the challenges of their new jobs. A risk management strategist or a quality control expert would have much to comment on.

An induction programme is mandatory for new preregistration house officers.1 Induction is also recommended for all other new trainees, although the programme content and format are not specified in detail.2-7 Most hospitals currently run some form of induction programme, but their length and content vary.3 It would be reassuring to think that this variety is due to a prior assessment of the differing expectations, needs, and requirements of the diverse group of trainees encountered at induction programmes, but there is little evidence to support this. More likely reasons for the diversity in programmes are differences in published lists of suggested topics,1 5 or the differing availability of local speakers, or simply tradition and political correctness. What published research there is on induction3 8 concentrates solely on preregistration house officers and does not discuss the lost and breeding tribe …