Effectiveness of the ladder check evaluation in the ward rounds record input assistance of the doctor office work adjunct

Abstract

The responsibility of ward rounds aid provided by assistants at the physicians' offices (referred to as “doctor aids [DAs]” at this hospital) at the Funabashi Municipal Medical Center includes not only making records of the hospital round details, but also maintaining records of changes in admission instructions, treatment and examination details, and conference details. However, the quality of the content entered by different DAs varies because the characteristics of the disease being handled and details of treatment given at the time of hospital rounds are different in each hospital department. Therefore, to ensure quality of tasks, we established an educational system for rounds assistance in the form of ladder check evaluations for new assistants (DAs responsible for assisting in making records of the rounds for the first time). According to our system, teams of two persons (new DA and DA responsible for rounds) conduct rounds as a part of on-the-job training (OJT), and after a fixed period, the DA responsible for rounds conducts ladder check evaluation of the new DA. The evaluation is conducted in three steps, and as per the comprehensive evaluation criteria, the new DA is considered capable of working independently and ready for rounds upon receiving a passing mark (i.e., scoring more than 50% in each item). Implementation of ladder check evaluations for tasks was found to be useful as it allows the new DAs to understand the level they have attained and objectively view their progress. Physicians expect DAs to be involved with a larger variety of tasks while ensuring high quality.