969 A Quality Improvement Project Centred Around the Introduction of an Exception Reporting Pathway

Abstract

Abstract Aim Exception Reporting (ER) is applicable to surgical training so can therefore be used for a variety of reasons. This Quality Improvement Project aims to positively change the attitudes and ease the process of ER. Method We conducted a qualitative survey distributed amongst medical and surgical trainees and supervisors from the Royal Liverpool and Aintree Hospitals which focused on assessing their attitudes towards ER. The second measure was a retrospective review in which we compared the number of ER from September-December in 2019 and 2020. We created a poster showing a clear pathway to ER and the repeated the cycle above including both measures. Results We received over a hundred responses to our original survey, with half being trainees and the other being supervisors. It was clear that, huge deficits were discernible in trainee and supervisor understanding of the process and its outcomes. After introducing the ER pathway, a significant improvement in understanding towards ER was noted with 98.4% (from 84.5%) of trainees and supervisors understanding what ER is and 52.8% (from 42.7%) better understanding outcomes. Despite this, there seems to be a shift in attitude toward ER with a 10.7% increase in exception reporting within a 10-month period. Conclusions Our project highlights the importance of exception reporting, and its perception between clinical staff. With the presence of COVID rotas, the introduction of new trainees to the trust, and the higher emphasis on doctor burnout and patient safety in the news, ER measures remain our closest tool to observing such dynamic attitudes and acting on them.