Chaponda M, Borra M, Beeching N J, Almond D S, Williams P S, Hammond M A, Price V A, Tarry L, Taegtmeyer M
Infectious Diseases and Clinical Pharmacology, Royal Liverpool University Hospital, Liverpool.
Clin Med (Lond). 2009 Aug;9(4):323-6. doi: 10.7861/clinmedicine.9-4-323.
This prospective observational study assessed the impact of the changes in junior doctors' working hours and waiting-time initiatives on teaching and learning opportunities for junior doctors in acute medicine. An audit cycle of post-take ward rounds including all medical admissions to an urban teaching hospital was conducted. During two seven-day periods in July 2006 and 2008, 317 and 354 patients were admitted respectively. In the two-year interval a number of changes were implemented resulting in a significant increase in patients reviewed by a consultant within 24 hours of admission. Target waiting times were being met but there were many missed learning opportunities for junior staff. Senior doctors continue to perform the majority of post-take reviews in the absence of the doctors who had admitted the patient. Similar patterns are likely to be found in other hospitals attempting to balance training with government targets for waiting times and junior doctors' working hours.
这项前瞻性观察性研究评估了初级医生工作时间的变化以及等待时间举措对急症医学中初级医生教学与学习机会的影响。对一家城市教学医院所有内科住院患者进行了查房后审计周期。在2006年7月和2008年的两个七天时间段内，分别有317名和354名患者入院。在这两年期间实施了多项变革，使得顾问医生在患者入院24小时内进行复查的患者数量显著增加。目标等待时间得到了满足，但初级员工有许多学习机会被错过。在负责收治患者的医生不在场的情况下，高级医生继续进行大部分查房后复查。在其他试图在培训与政府设定的等待时间和初级医生工作时间目标之间取得平衡的医院，可能也会发现类似模式。
