Tan Benjamin Yong-Qiang, Ngiam Nicholas Jinghao, Chang Zi Yun, Tan Sandra Ming Yien, Shen Xiayan, Mok Shao Feng, Subramanian Srinivas, Ooi Shirley Beng Suat, Kee Adrian Chin-Leong
Department of Medicine, National University Health System, Singapore.
Department of Emergency Medicine, National University Health System, Singapore.
Korean J Med Educ. 2019 Sep;31(3):271-276. doi: 10.3946/kjme.2019.137. Epub 2019 Aug 26.
Long duty hours have been associated with significant medical errors, adverse events, and physician "burn-out". An innovative night float (NF) system has been implemented in our internal medicine program to reduce the negative effects of long duty hours associated with conventional full-call systems. However, concerns remain if this would result in inadequate training for interns. We developed a structured questionnaire to assess junior doctors' perceptions of the NF system compared to full calls, in areas of patient safety, medical training, and well-being. Ninety-seven (71%) of the 137 doctors polled responded. Ninety-one (94%) felt the NF system was superior to the full call system. A strong majority felt NF was beneficial for patient safety compared to full call (94% vs. 2%, p<0.001). The NF system was also perceived to reduce medical errors (94% vs. 2%, p<0.001) and reduce physician "burn-out" (95% vs. 5%, p<0.001). Beyond being a practical solution to duty-hour limitations, there was a significant perceived benefit of the NF system compared to the full call in terms of overall satisfaction, patient safety, reducing medical errors and physician "burn-out".
长时间的值班与严重的医疗差错、不良事件以及医生的“职业倦怠”相关。我们在内科项目中实施了一种创新的夜间轮值(NF)系统,以减少与传统全值班系统相关的长时间值班的负面影响。然而,人们仍然担心这是否会导致实习医生培训不足。我们设计了一份结构化问卷,以评估初级医生对NF系统与全值班相比在患者安全、医学培训和幸福感方面的看法。在接受调查的137名医生中,有97名(71%)做出了回应。其中91名(94%)认为NF系统优于全值班系统。绝大多数人认为,与全值班相比,NF对患者安全有益(94%对2%,p<0.001)。NF系统还被认为可以减少医疗差错(94%对2%,p<0.001)和减轻医生的“职业倦怠”(95%对5%,p<0.001)。除了是解决值班时间限制的一个切实可行的办法外,与全值班相比,NF系统在总体满意度、患者安全、减少医疗差错和减轻医生“职业倦怠”方面有明显的益处。