Hartley C, Rothera M P
Department of Otolaryngology, Manchester Royal Infirmary.
Ann R Coll Surg Engl. 1994 Sep;76(5 Suppl):228-31.
To reduce junior doctors' hours by introducing an on-call system involving cross-cover at SHO level between two separate ENT units.
Prospective collection of data on the cross-cover system introduced in September 1992 with analysis after 12 months.
ENT departments within Salford and Central Manchester.
Five SHOs and four registrars within the two ENT units.
SHOs work a 1 in 5 rota providing first on-call cover for two adjacent ENT units. The system has proved to be an effective means of decreasing junior doctors' hours, though actual hours exceed the contracted hours by approximately 8 hours per week. Initial problems of contacting SHOs were overcome by the introduction of new bleep arrangements while the system produced a number of unforeseen benefits. The experience in Manchester suggests that major ENT units do not necessarily require resident first on-call staff, though formal arrangements are recommended to cope with acute emergencies requiring immediate attention.
An effective on-call system has been devised which decreases junior doctors' hours by combining the on-call rotas of two adjacent ENT units. Recommendations for the successful implementation of such a system are presented.
通过引入一种值班系统来减少初级医生的工作时长，该系统涉及两个独立耳鼻喉科单位之间的住院医师交叉值班。
前瞻性收集1992年9月引入的交叉值班系统的数据，并在12个月后进行分析。
索尔福德和曼彻斯特市中心的耳鼻喉科。
两个耳鼻喉科单位的五名住院医师和四名住院总医师。
住院医师按五分之一的轮值表工作，为两个相邻的耳鼻喉科单位提供首次值班服务。该系统已被证明是减少初级医生工作时长的有效手段，尽管实际工作时长比合同规定的时长每周大约超出8小时。通过引入新的传呼安排克服了最初联系住院医师的问题，同时该系统还带来了一些意想不到的好处。曼彻斯特的经验表明，大型耳鼻喉科单位不一定需要常驻的首次值班人员，不过建议制定正式安排以应对需要立即关注的紧急情况。
已设计出一种有效的值班系统，通过合并两个相邻耳鼻喉科单位的值班轮值表来减少初级医生的工作时长。并提出了成功实施该系统的建议。
