Call it the Jewish mother in me, but I always carry emergency snacks in my bag. Amongst my stethoscope, hospital badge and the just-in-case paracetamol, you will find multiple cereal and protein bars. It was no wonder that, with the introduction of emergency rotas due to the coronavirus pandemic and the possibility of last-minute long days or night shifts, one of my first thoughts was, “But what will I (and other trainees) do about food?”
It was this that made me suggest a box of snacks during a meeting between rota managers and trainees at Birmingham Children’s Hospital. The concept was well received by trainees, and with the postgraduate team we got together to create the Hospital-on-Call or HOC-BOX.
With financial backing from the postgraduate department, I, colleagues from the general paediatric department and postgraduate administrators sourced supplies from local supermarkets. Once we had enough stock, an email was circulated to trainees. The HOC-BOX was launched in April 2020, consisting of two boxes - one for food and drink, the other for toiletry essentials - and placed where the night team gather for the virtual handover.
To ensure the HOC-BOX was meeting trainee expectations, quantitative and qualitative feedback was completed at time of use, and to date we have had 174 feedback responses from trainees.
The project has been an overwhelming success. It has positively impacted upon staff wellbeing, with all respondents feeling more supported and 92% of users saying their mental wellbeing has improved on both long days and night shifts. Eighteen months later, the boxes continue to be in daily use and have now become a permanent fixture for the out-of-hours team.
I've reflected on the success of HOC-BOX and its impact on wellbeing, and here are my thoughts on why it has worked.
An idea can sometimes involve thinking within the box
The idea behind the HOC-BOX was one influenced by one of my old registrar’s ‘Hangry Box’. A box full of goodies is not an original concept, but in my eyes what makes the HOC-BOX stand out is that we have created a project on a hospital-wide scale, with input from the postgraduate department and directly overseen by hospital administrators, managers, and consultants.
It is easily reproducible
The best wellbeing initiatives are those that can be used in any setting. The HOC-BOX is just that. So far, we have created a second box in the NICU at Birmingham Women’s Hospital, and we are currently working on creating a third box in the Emergency Department at Birmingham Children’s Hospital.
Teamwork does indeed make the dreamwork
Creating, running and managing this project is not a one-person job. The input of the postgraduate administrators has been vital to this project. It is they who put the boxes out at 4pm every day and restock the boxes when resources are low. We have also created management roles for other trainees with an interest in wellbeing, to support the running of the project, particularly the HOC-BOX on a separate hospital site. With the ongoing financial backing of the postgraduate team, we (the postgraduate administrators, trainees and I) buy the supplies from the supermarket around once or twice a month to meet stock demand. To date we have spent £4 per day to replenish the boxes.
Projects addressing basic needs have the biggest impact
Using St Emelyn’s Hierarchy of Wellbeing (see image below), we must first address our physiological needs at work before we can address other aspects of wellbeing. The HOC-BOX does just this with 96% of respondents agreeing that, “The HOC-BOX is important to staff wellbeing and morale”. And it's now a foundation for other initiatives to support trainee wellbeing.
We need to listen to trainees
As a College, we are getting better at listening and supporting trainee wellbeing. It is becoming increasingly well known how supporting trainees directly impacts on how they work and interact with patients. Being able to work in a role that impacts on trainee experience and wellbeing is something I accidentally fell into, but now I am invested in, no matter on what scale. For instance, who knew that stocking Aldi’s version of Cadbury chocolate in the HOC-BOX would cause such uproar amongst West Midlands’ trainees?! But then what do you expect from trainees who have the Cadbury factory down the road?