40 Transforming training with rota design

Background The Simpson Centre for Reproductive Health is a tertiary Obstetrics and Gynaecology unit. The trainee rotas were complex and conflicted between service provision and training. Following a Deanery visit a Trainee’s Committee was set up and rotas became trainee-led. The impact of rota design change has been followed closely since then. Drivers for Change Patient safety concerns and reduced quality of care • Senior issues accessing advanced training • Undermining behaviour • Juniors felt anonymous • No team structure • Deanery ‘red flags’ Objectives • Improve access to training opportunities • Improve satisfaction with training • Positively influence departmental moral How did we implement change? A trainee driven rota working group was established with senior support. Though this, provisional rota options were formulated and co-designed. Based on trainee feedback the following points were essential in the design: • Rota template identical for all tiers creating ‘rota buddies’ • Emergency teams with all on call work in blocks • Formation of elective teams given continuity of consultant trainers • Senior trainees running senior rota • Consultant responsibility for junior rota Results The Scottish training survey (STS) was utilised as a validated tool to measure outcomes. Team Culture Teaching Educational environment KEY 2016 2017 2016 2017 2016 2017 -†‘/-†“ 95% significant change in mean score =no significant change in mean score -†“ performing poorly/-†‘performing well above for this indicator Foundation iƒa iƒ© iƒa iƒ© = GPST = = = = = = O and G ST = iƒ© iƒ© = iƒ© = Lessons Learnt • The team structure gave a sense of belonging, and trainees felt valued. • There was a change of culture away from undermining behaviours and towards shared training goals. • Access to training opportunities was made equitably, and increased continuity between trainees and trainers. • It has measurably improved training and departmental culture which has impacted positively on the delivery of care.