Cedfeldt Andrea S, Bower Elizabeth, Flores Christine, Brunett Patrick, Choi Dongseok, Girard Donald E
A.S. Cedfeldt is education consultant, Division of Graduate Medical Education, and associate professor, Department of Medicine, School of Medicine, Oregon Health & Science University, Portland, Oregon. E. Bower is associate professor, Department of Medicine, School of Medicine, Oregon Health & Science University, Portland, Oregon. C. Flores is associate director, Division of Graduate Medical Education, School of Medicine, Oregon Health & Science University, Portland, Oregon. P. Brunett is associate dean, Division of Graduate Medical Education, and associate professor, Department of Emergency Medicine, School of Medicine, Oregon Health & Science University, Portland, Oregon. D. Choi is professor, Department of Public Health and Preventive Medicine, Department of Ophthalmology, School of Medicine, and Department of Community Dentistry, School of Dentistry, Oregon Health & Science University, Portland, Oregon. D.E. Girard is senior consultant, Divisions of Graduate Medical Education and Continuing Medical Education, J.S. Reinschmidt Professor of Medical Education, and professor, Department of Medicine, School of Medicine, Oregon Health & Science University, Portland, Oregon.
Acad Med. 2015 May;90(5):678-83. doi: 10.1097/ACM.0000000000000541.
To evaluate awareness and utilization of a new institutional policy to grant residents time off to access personal and family health care.
In 2012, two years after policy implementation, an electronic survey was sent to all 546 residents and fellows at a tertiary care academic medical center in the United States. Residents were asked questions regarding awareness of the time-off policy, use of the policy, health care status, reasons for policy use, and barriers to use.
A total of 490 (90%) residents responded. Eighty-nine percent of those surveyed were aware of the policy. Of those who were aware, 49.7% used the policy to access health care. Top reasons for policy use were for personal routine or preventive health care, dental care, and urgent health care needs. The most commonly reported barrier to policy use was concern about the impact the resident's absence would have on colleagues.
Implementation of policies to prospectively schedule residents' time off during business hours to address health care needs is an important means to promote resident wellness. Such policies remove one commonly cited barrier to residents' access to health care. However, residents still reported concerns about impact on peers and patients as the main reason they were reluctant to take the time off to address their health care needs. More work is needed on both wellness policy implementation practices and on refining the systems that will allow seamless and guiltless transitions of care.
评估一项新的机构政策的知晓度和利用率，该政策允许住院医师请假以获得个人和家庭医疗保健服务。
2012年，即政策实施两年后，向美国一家三级医疗学术医学中心的所有546名住院医师和研究员发送了电子调查问卷。询问住院医师关于请假政策的知晓情况、政策的使用情况、医疗保健状况、使用政策的原因以及使用的障碍。
共有490名（90%）住院医师回复。89%的受访者知晓该政策。在知晓该政策的人中，49.7%使用该政策来获得医疗保健服务。使用政策的首要原因是个人常规或预防性医疗保健、牙科护理以及紧急医疗保健需求。报告的使用政策最常见的障碍是担心住院医师的缺勤会对同事产生影响。
实施政策以便在工作时间前瞻性地安排住院医师的休假时间以满足医疗保健需求，是促进住院医师健康的重要手段。此类政策消除了一个常被提及的住院医师获得医疗保健服务的障碍。然而，住院医师仍报告称，担心对同事和患者的影响是他们不愿请假去满足自身医疗保健需求的主要原因。在健康政策实施实践以及完善能够实现无缝且无负罪感的护理交接的系统方面，仍需要开展更多工作。
