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17 July 2018
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Evidence: The value of junior doctor engagement

Throughout their training, junior doctors rotate through numerous departments and trusts. This provides them with a unique exposure to a variety of practices across individual healthcare providers, observing pockets of excellence, as well as incidences where there is room for improvement. Trainees bring a fresh perspective to the traditional clinical practice of institutions and can be flag bearers for innovation and change (Firth-Cozen, 2001). Organisations which employ junior doctors have an opportunity to mobilise agents for change if they can signpost these employees to a productive, influential group which offers development opportunities. (Winthrop, et al., 2013) They are also in a position to identify high performers to retain outside of formal training structures through dedicated leadership or quality improvement positions.  

Junior doctor engagement in quality improvement (QI) and patient safety (PS) endeavours results in a healthier transparent learning culture, reduced medical errors, and improved organisational performance. When employee time and organisational resources are correctly assigned value, QI/PS work demonstrates a significant return on investment for healthcare organisations (Roueche & Hewitt, 2012). Individual QI initiatives led by junior doctors have resulted in organisational savings of over £300 000 due to improved use of resources and more effective deployment of staff (Palmer et al, 2013). Meaningful junior doctor engagement also results in significant reductions in clinical errors as well as improvements to patient care outcomes (Prins et al, 2010).

Conversely, without dedicated engagement initiatives, junior doctors often selectively disclose errors informally (Kroll, et al., 2008) and clinical error reporting becomes primarily nurse-driven (Evans, et al., 2006) exacerbating inter-professional silos. At an organisational level, the invariable result of poor junior doctor engagement is disengaged, disenchanted cynical senior clinicians (Wathes & Spurgeon, 2016). A King’s Fund report on medical engagement recently stated:

 “medical engagement should not be an optional extra, but rather an integral element of the culture of any health organisation and system.”

                      - Clark & Nath (2014)

Employees identify strongly with an organisation they feel empowers them to deliver positive change. They will derive greater professional satisfaction after understanding and improving the systems they work in. These aspects are the basis of high-performance work systems and have a strong positive correlation with increased performance outcomes (Messersmith, et al., 2011).

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