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P-174 Hospice GP trainee induction – better prescribing, fewer incidents
  1. Ros Marvin and
  2. Sarah Bell
  1. Garden House Hospice Care, Letchworth Garden City, UK


An increase in hospice clinical incidents was identified during the pandemic in 2020. Investigation of medical team incidents demonstrated the requirement for additional education of new GP trainees on four-monthly hospice placements, specifically targeting prescribing. GP trainees learn key palliative medicine and hospice processes in a single day of induction. Previously, induction focussed on medical care, with the processes, including prescribing, largely learnt ‘on the job’. Analysis of the incidents identified key areas for increased education: lack of experience at prescribing anticipatory medications; errors due to using an unfamiliar prescription chart; and the complex process of ordering discharge medications from the local hospital pharmacy.

A new, interactive prescribing practice induction session was created: prescribing anticipatory medications; error identification on hospice prescription charts; and discharge prescribing on TTO forms. This was delivered to two consecutive groups of new GP trainees. Contemporaneous feedback on prescribing was given to trainees during the session.

Numerical comparison of medical team clinical incidents demonstrated 21 incidents in the 12 months prior to the new induction (average 1.75 incidents per month), versus six incidents in the six months post new induction (average 1 per month), a reduction of over 40%.

Feedback from trainees regarding the induction session has been universally positive (8/8 trainees), with one trainee commenting ‘excellent… detailed training in using the system and … medications [for patients] to take home’. The resulting reduction in incidents demonstrates improved patient care and safety.

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