Improving compliance with requirements on junior doctors' hours.
| Autor: | Cass HD; Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH. cassh@gosh.nhs.uk, Smith I, Unthank C, Starling C, Collins JE |
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| Jazyk: | angličtina |
| Zdroj: | BMJ (Clinical research ed.) [BMJ] 2003 Aug 02; Vol. 327 (7409), pp. 270-3. |
| DOI: | 10.1136/bmj.327.7409.270 |
| Abstrakt: | Problem: Compliance with UK regulations on junior doctors' working hours cannot be achieved by manipulating rotas that maintain existing tiers of cover and work practices. More radical solutions are needed. Design: Audit of change. Setting: Paediatric night rota in large children's hospital. Key Measures for Improvement: Compliance with regulations on working hours assessed by diary cards; workload assessed by staff attendance on wards; patient safety assessed through critical incident reports. Strategies for Change: Development of new staff roles, followed by change from a partial shift rota comprising 11 doctors and one senior nurse, to a full shift night team comprising three middle grade doctors and two senior nurses. Effects of Change: Compliance with regulations on working hours increased from 33% to 77%. Workload changed little and was well within the capacity of the new night team. The effect on patient care and on medical staff requires further evaluation. Lessons Learnt: Reduction of junior doctors' working hours requires changes to roles, processes, and practices throughout the organisation. |
| Databáze: | MEDLINE |
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