White L, Beckingham E, Calman F, Deehan C
Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, UK.
Clin Oncol (R Coll Radiol). 2007 May;19(4):213-22. doi: 10.1016/j.clon.2007.01.442. Epub 2007 Mar 6.
To analyse extended hours working patterns within UK cancer centres and to assess alternatives to the normal 9.00 am to 5.00 pm working day.
Questionnaires were sent to 62 radiotherapy managers in June and July 2005 to survey where extended hours working had been implemented, the objectives for using a longer working day and how departments organised their service issues, including staffing levels, costs and patients. This was followed by visits to six departments that were working extended hours. A second questionnaire sent to 60 radiotherapy physics managers in September 2005 requested information for the hours of daily, monthly and annual megavoltage machine servicing and quality assurance (QA). A third questionnaire was distributed to all radiotherapy outpatients from four departments who attended on a single day of survey in 2005. It looked at patient preference for treatment hours.
In total, 57 (92%) radiotherapy managers responded. Thirty-one departments (55%) were working extended hours, 22 (39%) had short-term experience and three (5%) departments had no experience. Increasing capacity to reduce waiting lists was the main reason for working extended hours. The additional hours were predominantly worked by radiographers, with little or no support from the other department disciplines. The servicing and QA spreadsheet was returned by 53% (n=32) of physicists. The average amount of servicing and Quality Assurance (QA) work being scheduled out of hours in each department was 35% (0-100%). The patient questionnaire was completed by 470 patients. When asked if patients would want to come to a reasonable appointment time outside of the normal working day, 29% (n=136) said 'yes' and 12% (n=55) were unsure.
It was concluded that two shifts covering an 11.5 h working day is a robust alternative to the normal working day, taking into consideration efficient use of radiographers and patient preference for out of hours appointments.
分析英国癌症中心的延长工作时间模式，并评估正常上午9点至下午5点工作日的替代方案。
2005年6月和7月向62名放射治疗管理人员发放问卷，以调查延长工作时间的实施地点、采用更长工作日的目标以及各部门如何组织服务问题，包括人员配备水平、成本和患者情况。随后走访了6个延长工作时间的部门。2005年9月向60名放射治疗物理管理人员发放了第二份问卷，要求提供每日、每月和每年兆伏级机器维修及质量保证（QA）的时间信息。第三份问卷发放给了2005年调查当日来自四个部门的所有放射治疗门诊患者，了解患者对治疗时间的偏好。
共有57名（92%）放射治疗管理人员回复。31个部门（55%）正在延长工作时间，22个部门（39%）有短期经验，3个部门（5%）没有经验。增加能力以减少等候名单是延长工作时间的主要原因。额外的工作时间主要由放射技师承担，其他部门人员很少或没有提供支持。53%（n = 32）的物理学家返回了维修和QA电子表格。每个部门安排在非工作时间的维修和质量保证（QA）工作平均量为35%（0 - 100%）。470名患者完成了患者问卷。当被问及患者是否愿意在正常工作日之外的合理预约时间就诊时，29%（n = 136）表示“愿意”，12%（n = 55）不确定。
考虑到放射技师的高效利用和患者对非工作时间预约的偏好，得出结论认为，涵盖11.5小时工作日的两班制是正常工作日的有力替代方案。
