1. Rolling handOVER (ROVER) – Enhancing Junior Doctors’ Orientation to New Rotations Dr Caitlin Taylor

2. Realising the Need for ROVER  New Academic Year –  in undesirable events –“July Phenomenon”  October BMJ, Retrospective Cohort Study 1 –Up to 82%  in errors –Regardless of trainee’s level of experience 1. Haller G, Myles S, Taffe P, Perneger T, Wu C. Rate of undesirable events at beginning of academic year: retrospective cohort study. BMJ 2009; 339:1-8.

3. Realising the Need for ROVER  Factors Contributing to  Errors 1 –New environment –Breakdown in communication & teamwork –Poor handovers –Lack of supervision

4. Realising the Need for ROVER  Strategies Proposed to  Errors –Improve orientation 1 –Increase supervision 1 –Written protocols 1 –Simulation training 1 –Verbal handovers –Mentors

5. Development of ROVER  Important Aspects of Intern Orientation Identified –Head of unit, registrar, resident –Intern handover –Unit orientation package  Insufficient Unit Orientation Packages –Verbose, outdated –Not intern-specific –Availability, accessibility poorly promoted  Initially Discussed at ANZMET 2007

6. What is ROVER?  Orientation Document –Concise –Demystifies –Quick reference –Easily accessible –Up-to-date –Complements other orientation guides  Written by Junior Doctors  Approved by Education Supervisors

7. What is ROVER?  Essential Information –Staff members, meetings –Common medical conditions –Roles, responsibilities, tips  Additional Information –Familiarity with certain symptoms/signs –Common medications, procedures, referrals –Useful intranet documents, websites

8. Implementation of ROVER  Production – End of 1 st rotation  Implementation – Commencement of 2 nd rotation  Result – Comparison b/w 1 st & 2 nd /3 rd rotations –2/3rds of interns had useful unit orientations –ROVER useful & complimented unit info

9. ROVER a Success  2009 Interns Feedback About ROVER –Most beneficial & preferred orientation tool – Eased transition – Reduced anxiety – Highlighted expectations allowing reflection – Focused appropriate revision – Easily accessible – Concise

10. ROVER a Success  Head of Dept & Supervisors Feedback –“Great document” –“Very useful addition to the unit orientation package”

11. Further Development  2010 Intern Orientation Week –‘Intern Learning’ workshops –Identifying opportunistic learning on the job –ROVERs assist in: –Identifying informal learning opportunities –Developing learning objectives –Promoted with unit orientation packages,ACF  HMO2 ROVERs  Statewide Rollout