Borley N R, Steer S E, Collins R E
Kent & Canterbury NHS Trust.
Ann R Coll Surg Engl. 1995 Jul;77(4 Suppl):189-90.
Over a four-month period, we assessed the contribution made to the on-call workload of a general surgical team, by referrals and assessments of patients who had not been admitted under surgical care and were therefore not recorded in current audits of general surgical activity--the 'unseen workload'. Up to 5 1/2 hours per day on-call (mean 101 minutes) was spent assessing these referrals. There was a mean number of 3.6 referrals (range 1 to 7). Although 51 percent of these referrals were deemed to be non-surgical after assessment, the majority (77 percent) were believed to be appropriate. The Accident & Emergency Department referred 46 per cent of patients with only 7 percent requiring surgical management. This study shows that while hours of work are important in assessing the workload of a junior doctor on-call, the intensity of the workload is just as important in determining the impact on staff. There is a greater workload than revealed by audit of just surgical admissions and operations alone.
在四个月的时间里，我们评估了那些未接受外科护理入院治疗（因此未记录在当前普通外科活动审计中）的患者转诊和评估工作对普通外科团队值班工作量的贡献——即“隐性工作量”。每天值班期间用于评估这些转诊患者的时间长达5个半小时（平均101分钟）。转诊患者的平均数量为3.6例（范围为1至7例）。尽管经评估后，这些转诊患者中有51%被认为无需手术治疗，但大多数（77%）被认为是合理的。急诊科转诊了46%的患者，其中仅7%的患者需要手术治疗。这项研究表明，虽然工作时长对于评估值班初级医生的工作量很重要，但工作量的强度在确定对工作人员的影响方面同样重要。工作量比仅对外科入院和手术进行审计所显示的要大。
