儿童医院的住院医师工作时间变化：对人员配置模式和劳动力需求的影响。

Resident work hour changes in children's hospitals: impact on staffing patterns and workforce needs.

机构信息

Child Health Evaluation and Research (CHEAR) Unit, University of Michigan, 300 North Ingalls Building, Room 6E08, Ann Arbor, MI 48109-0456, USA.

出版信息

Pediatrics. 2012 Oct;130(4):700-4. doi: 10.1542/peds.2012-1131. Epub 2012 Sep 10.

DOI:10.1542/peds.2012-1131

PMID:22966029

Abstract

BACKGROUND AND OBJECTIVE

Changes to the structure and nature of resident duty hour assignments can create compensatory workforce needs in hospital or outpatient settings to ensure appropriate patient care. The objective of this study was to understand what, if any, adjustments children's hospitals have made in staffing and assignments of specific duties during the past 2 years as a result of residency duty hour changes, and what changes are anticipated in the upcoming 2 years.

METHODS

Mail survey to chief executive officers and chief operating officers of 114 freestanding children's hospitals or children's hospitals within a larger hospital.

RESULTS

Response rate was 65.4%. Respondents from more than half of hospitals (57%, N = 36) reported increasing the overall full-time equivalent (FTE) of hospitalists in response to the 2011 resident work hour changes. Forty-eight percent (N = 30) increased the overall FTE of pediatric nurse practitioners (PNPs), and 42% (N = 27) increased the FTE of neonatal nurse practitioners (NNPs). Most hospitals plan to increase the number of hospitalists (69%, N = 44), PNPs (59%, N = 37), or pediatric attending physicians (56%, N = 35) over the next 2 years. Forty-three percent (N = 27) of hospitals plan to increase the number of NNPs over the next 2 years, and a quarter plan to increase physician assistants (25%, N = 16) or pediatric house staff (24%, N = 15).

CONCLUSIONS

Changes in work hours for pediatric residents appear to have an impact on workforce planning within pediatric hospitals. Decreases in available resident work hours will create an increasing demand, primarily for nonresident physicians, PNPs, and NNPs.

摘要

背景与目的

住院医师值班时间结构和性质的变化可能会在医院或门诊环境中产生补偿性的劳动力需求，以确保患者得到适当的护理。本研究的目的是了解过去 2 年中，由于住院医师值班时间的变化，儿童医院在人员配备和特定职责分配方面进行了哪些调整（如果有的话），以及未来 2 年内预计会进行哪些调整。

方法

对 114 家独立儿童医院或大型医院内儿童医院的首席执行官和首席运营官进行邮件调查。

结果

回复率为 65.4%。超过一半的医院（57%，N=36）的受访者报告称，为应对 2011 年住院医师工作时间的变化，增加了医院医生的总全职等效人数（FTE）。48%（N=30）增加了儿科执业护士（PNP）的总 FTE，42%（N=27）增加了新生儿执业护士（NNP）的 FTE。大多数医院计划在未来 2 年内增加医院医生（69%，N=44）、PNP（59%，N=37）或儿科主治医生（56%，N=35）的数量。43%（N=27）的医院计划在未来 2 年内增加 NNP 的数量，四分之一的医院计划增加医师助理（25%，N=16）或儿科住院医师（24%，N=15）。