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Revising the surgical registrar on-call roster
A Peter Wysocki1, Brian McGowan
1Department of Surgery, Logan Hospital, Meadowbrook, Queensland, Australia. arek_p@ecn.net.au
ANZ Journal of Surgery
|August 28, 2010
Summary
Implementing a new on-call rota for surgical registrars significantly reduced working hours and eliminated fatigue. This change improved roster compliance without negatively impacting patient care, enhancing overall safety.
Area of Science:
- Medical Education
- Surgical Training
- Workforce Management
Background:
- Junior doctor work hours have been a significant concern since the 1980s.
- Rostering and unit structure aim to balance patient care quality with reasonable working hours for surgical staff.
Purpose of the Study:
- To compare actual hours worked under traditional and fatigue-friendly surgical registrar rosters.
- To assess roster compliance with fatigue recommendations.
- To evaluate the impact of a new roster on workload and satisfaction.
Main Methods:
- Two 12-week surgical registrar rosters were compared.
- Fatigue Audit InterDyne (FAID) software assessed roster compliance.
- Electronic prospective surgical audits determined workload.
- Consultant and registrar feedback was gathered.
Main Results:
- Total work hours decreased by 11%, with fatigue eliminated.
- Operative workload increased by 18% over 12 months.
- FAID compliance improved significantly, and satisfaction was high.
Conclusions:
- Restructuring surgical units and implementing a new on-call rota achieved safe working hours for surgical registrars.
- The changes did not negatively affect patient care.
- The new roster model is a successful approach to improving surgical trainee well-being.
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