The negative impact of shift working is an issue that affects most doctors and can have an impact on patient safety. Therefore, it is important to design a good rota system that will help provide 24/7 service cover, minimize risks for staff (doctors cutters) and patients and increase service delivery efficiency.
Various studies have provided evidence that shift work can have multiple short-term and long-term effects on physicians. A Japanese study at a university hospital suggests that continuous study and an increase in the number of patients is associated with medical errors. Short-term effects may include fatigue, needle stick injuries, irritable bowel syndrome, and post-shift accidents (RTAs). Long-term side effects include increased risk of cardiovascular disease, myocardial infarction, stroke, sleep duration, and neurological disorders. The effects of long shifts are felt not only on health, but also on personal relationships.
A survey on peri-operative mortality was conducted by the UK CEPOD which linked medical errors to fatigue and shortness of breath. He also identified risks in relation to the number of shifts worked. The reported adverse events increased to 6 per cent in the second night shift, 17 per cent in the third and 36 per cent in the fourth night shift. The cost of this neglect is also very high.
The key to reducing risks is to create a good rota system for doctors on rotas to avoid overwork. Providing good working conditions and resting facilities during shifts can also help improve performance. The night call room should be available to the night-working staff and provide adequate rest and relaxation after the call. In addition, hospitals should have a fatigue risk management system that guarantees care and support to doctors and other medical personnel.
The support of hospital management, Rota Masters and senior doctors is needed and each of them can have their own opinion on this. Due to the large number of medical emergencies, epidemics (swine flu) and natural disasters such as earthquakes, floods, the effective functioning of the rota system can be difficult. Of patients. Doctors and other medical personnel will have to re-jog their fixed schedule. Doctors will need to be more flexible with their working methods. Patients may have problems and may not be comfortable with other doctors during certain shifts. (“I want to see my doctor.”)
Requirement: 24 hours service delivery due to increasing demand in hospital practice. The shift structure is prone to intensive workloads and therefore reduces fatigue and performance. A good rota design can reduce the chances of fatigue. Customer service can be enhanced and improved, it will bridge the gap.
Customers: doctors, local patients, visiting patients and other medical personnel.
Costs: The NHS Litigation Authority in England paid 76 69,769 million for clinical negligence claims in 2008/09, compared to 63 3,633 million in 2007/08. Reduce such costs. Being cost effective by giving value for money. The overall costs incurred in establishing the policy will be much less than the costs incurred to cover clinical negligence claims.
Competition: Private professionals, traditional healers, etc. Medical workers who do not have fixed shift shifts and are flexible.
Adequate evidence is now present that concludes that shift work is particularly detrimental to shift work doctors; Even in the short term and can have a negative impact on patient safety. As a result, many recommendations can be made: the length of the shift should be as short as possible, rest breaks should be facilitated, and doctors should be encouraged to rest as much as possible during night shifts; And shift workers and employers need to be educated on how to change the circadian rhythm, and thus maximize work, minimizing risks for employees, patients and society as a whole.
A good rota design that provides 24/7 service cover, optimizes training opportunities and minimizes adverse effects should be adopted. To minimize the harmful effects of long shifts and reduce medical errors, it is proposed to design a good rota system using a constructive approach. Rota system design, there will be a shift of 4 – 8 hours, followed by a night shift of 1-7 hours and then a rest period of 2 days. The shift of the cutter is arranged accordingly to provide 24 hours services. Avoid shifts of more than 12 hours. The traditional 24 hour no-call rota model should be adopted for some features.
The support of hospital management, Rota Masters and senior doctors will be required and accepted by everyone within the system. Encourage accurate and honest monitoring of rotas. Effectiveness can be monitored using charts and line diagrams to assess its function. Feedback from doctors, management and patients is required. This correction should be made available as soon as possible and put into practice immediately.