60 seconds with Arvind Singhal, Specialty Training Registrar (SBH) discussing Results Endorsement
What is your role here at Barts Health NHS Trust and what does it involve?
I’m a Cardiology Registrar, currently working at St Bartholomew’s Hospital. As a middle-grade doctor it’s a good mix of decision-making, training and supervising juniors
How long have you been at the trust?
I have been at the Trust for almost 2 years. I worked at the Royal London Hospital last year.
What is results endorsing and why do clinicians need to do it/ why is it important?
Results endorsing is a new(ish) name for something doctors have always had to do – check the results of the tests they request! Obviously, all results need to be checked to make sure significant findings are acted upon. Before electronic results, doctors had to write in bloods folders and go through a stack of papers in their inboxes. Thankfully now it’s much easier to check results, but it is also a legal requirement that all requesters endorse a result to confirm it has been checked. Most of all, it is a key patient safety issue to make sure nothing slips through the net.
Why do you think there is an issue with clinicians not endorsing results?
I think many clinicians are unaware it exists, or how easy it is to do once you get used to it. I think there’s also a lot of inertia to starting, but I think once people clear their inboxes it’s much easier thereafter (and safer!)
Tell us about the changes to the endorse function in Millennium:
The Clinical Informatics team has added a large “Endorse” button to Millennium, so you can’t miss it. The change was made based on feedback to make it much more visable and accessible.
All tests requested by a clinician go to both their results inbox and the inbox of the Consultant in charge of the patient. This is viewable through the “Message Centre” button at the top of the screen, or on the “Results” tab on the left of the home screen. Clicking on either of these will show all your results that are pending endorsement.
How has this improved/ made the process easier?
This actually saves time rather than creating work. I used Millennium when I was an F1 at Charing Cross Hospital and I used to check all my results through my inbox – it was much quicker than going through each patient’s results. When I request a test from clinic now the result comes straight to my inbox which is great for when a decision is pending – I don’t have to keep checking on test results. It's also super quick and easy to endorse the result with the new "Endorse" button.
Congratulations – your team has one of the highest endorsement percentages in the entire trust. Why do you think that’s the case?
Probably because I’ve just been badgering people! I’ve tried to show people on the ward how to endorse, and why it’s important.
What is the number one thing that you would like to see change in the next 12 months to improve endorsement across our hospitals?
I’d like to see a culture shift. We need to embrace endorsing because it saves us time and it is safer. I don’t think anyone wants to see a change back to bloods folders! I think we need to accept responsibility for tests we request. Hopefully Consultants can encourage their juniors to endorse and get that figure much higher.
What is the biggest lesson/s you’ve learnt while being at Barts Health?
I’ve learnt that there’s a lot of passion at the work place from all levels of staff, and there’s a great culture of trying to improve
What is your favourite part of your job?
I love teaching, and being on the ward.
Are there any other stats about endorsement that you’d like to share?
Some departments have shown that it really is possible to achieve high endorsement rates. The Rheumatology team endorse >80% of their results because they know how important it is. The rest of us are lagging behind and I’d love to see Cardiology catch them up next!
Who can staff get in touch with if they have questions or ideas for improving the endorsement rate at our trust?
Please get in touch with me or Yang Chen and we’d be happy to help!