The aim was to assess junior doctors' understanding of their role in the Major Incident Contingency Plan at their hospital, and to evaluate the effectiveness of a teaching intervention on increasing awareness.
In this audit, ‘junior doctor’ refers to the first 2 years of work after qualifying from medical school. Once a major incident is confirmed, junior doctors should go to their ward, contact the senior nurse in charge and compile a list of the patients who could safely be discharged from the hospital. This action is standard across NHS Trusts in Wales.
A questionnaire was given to 89 junior doctors across three NHS Trusts in Wales. It involved general aspects of a major incident, as well as ascertaining perceptions of their role as junior doctors. They then received formal teaching by Emergency Planning Faculty. Following this, a repeat questionnaire was completed.
91% felt they did not know what would be expected of them during a major incident; 47% would initially go to the Emergency Department; 27% were unclear where to go; 31% were unaware who to contact on hearing of a major incident; and 16% would telephone switchboard. Junior doctors believe their primary role would be triage (16%); clerking in the emergency department (36%); clerking in Medical Assessment Unit/Surgical Assessment Unit (17%); and practical work (15%). Only 3% would first go to their ward; 12% believe their primary role would involve patients on the ward; and only 1% would list patients for discharge. 90% of completed questionnaires included a request for teaching. Following teaching, 97% knew who to call, where to go and what to do during a major incident.
Junior doctors' awareness of major incidents within Wales was near absent prior to teaching. This teaching is vital to help ensure smooth running of the hospital on the day.
Are junior doctors aware of their role during a major incident?
How effective is a teaching intervention on improving awareness?
This audit is the first of its kind to assess the understanding of major incident roles within Wales.
Awareness of major incidents was near absent prior to teaching.
Teaching is highly effective, and the vast majority of junior doctors wish to learn about it.
Strengths and limitations of this study
Three of the seven NHS Trusts in Wales were included in the audit. These Trusts were located in both the north and the south of Wales, giving a good reflection of major incident awareness across the country.
A limitation of the audit was that the second questionnaire was completed within one day of the teaching; it did not assess the longer-term retention of this knowledge.