| Paediatric team assistants to help with administrative duties | Monitoring time spent by medical staff on administrative tasks before and after the intervention | Decrease in time spent on administrative tasks by SHOs (65%) and SpRs (62%) |
| Refining and improving efficiency of handovers | Audit cycle of handover punctuality, duration and satisfaction. | Percentage starting on time increased from 0% to 50%. Timeliness of evening shift SpR improved from 60% to 100% |
| Introduction of education weeks for specialty trainees years 2–3 | Qualitative trainee responses | Highly valued as enabled clinic attendance |
| Introduction of new junior doctor rotas following rota mapping exercise | Diary card monitoring | Compliance |
| Email hotline for GPs to encourage appropriate management in the community | Retrospective review of enquiries to email address | Poor uptake of this new service |
| Introduction of a Paediatric Short Stay Unit to increase ambulation and optimise management of high turnover cases during daytime hours | Audit of factors contributing to delays in discharge | Average 4.5 h delay from decision to discharge to time of discharge |
| Introduction of GP into emergency department to optimise management by primary care where appropriate | Audit number of bleeps from emergency department to SpR on-call Monitor proportions of patients seen by GP and number of returns | Decrease in weekend morning bleeps GPs saw 33% of all attendances with a 5% return rate |
| Introduction of clinical site practitioners to support the out-of-hours medical and nursing teams | New intervention | New intervention |