Department of Development and Delivery, Ko Awatea Health Systems Innovation and Improvement, Middlemore Hospital, 54/100 Hospital Rd, Auckland 2025, New Zealand.
Quality, Research and Standards, Royal College of Physicians of Edinburgh, 9 Queen Street, Edinburgh EH2 1JQ, UK.
QJM. 2018 May 1;111(5):295-301. doi: 10.1093/qjmed/hcy024.
Acute medical units (AMUs) are a central component of the admission pathway for the majority of medical patients presenting to hospital in the United Kingdom and other international settings. Detail on multidisciplinary staffing provision on weekdays and weekends is lacking. Equity of staffing across 7 days is a strategic priority for national health services in the United Kingdom.
To evaluate weekday compared with weekend multidisciplinary staffing in a national set of AMUs.
Cross-sectional survey.
Twenty-nine Scottish AMUs were identified and all were included in the study population. Data were collected by semi-structured interviews with nursing, pharmacy, therapy, non-consultant medical and consultant staff. Staffing was quantified in staff hours. A correction factor of 0.5 was applied to non-dedicated staff. The percentage of weekend/weekday staffing was calculated for each unit and the mean of these percentages was calculated to give a summary measure for each professional group.
As a percentage of weekday staffing levels, weekend staffing across the units was 93.8% for nursing staff; 2.2% for pharmacy staff; 13.1% for therapy staff; 69.6% for non-consultant staff and 65.0% for consultant staff.
There is a contrast between weekday and weekend staffing on the AMU, with reductions at weekends in total staff hours, the proportion of dedicated vs. undedicated staff and the seniority of nursing staff. The weekday/weekend difference was far more pronounced for allied healthcare professional staff than any other group. These findings have potential implications for patient outcomes, quality of care, hospital flow and workforce planning.
急性医疗单位（AMU）是英国和其他国际环境中大多数就诊于医院的内科患者入院途径的核心组成部分。关于平日和周末多学科人员配置的详细信息尚不清楚。7 天内人员配置的公平性是英国国民健康服务的战略重点。
评估英国一组 AMU 平日与周末的多学科人员配备情况。
横断面调查。
确定了 29 家苏格兰 AMU，并将所有 AMU 纳入研究人群。通过对护理、药剂、治疗、非顾问医生和顾问医生的半结构化访谈收集数据。以工作人员小时数来量化人员配备。对非专职人员应用了 0.5 的修正系数。为每个单位计算了周末/平日的人员配备百分比，并计算了这些百分比的平均值，以给出每个专业组的综合衡量标准。
按平日人员配备水平的百分比计算，各单位的周末护理人员配备比例为 93.8%；药剂人员配备比例为 2.2%；治疗人员配备比例为 13.1%；非顾问医生人员配备比例为 69.6%；顾问医生人员配备比例为 65.0%。
AMU 上的平日和周末人员配备存在差异，周末总工作人员小时数、专职与非专职人员比例以及护理人员的资历都有所减少。与其他任何群体相比，辅助医疗专业人员的工作日/周末差异更为明显。这些发现可能对患者结局、护理质量、医院流程和劳动力规划产生影响。
