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Does emergency general surgery model affect staff satisfaction, training and working hours?

Ned Kinnear1,2, Minh Tran2, Jennie Han2

  • 1Discipline of Surgery, Faculty of Medical and Health Sciences, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.

ANZ Journal of Surgery
|December 21, 2019
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Summary

Hybrid or acute surgical unit models enhance staff satisfaction in emergency general surgery without impacting operative experience. Traditional models lead to longer working hours and more frequent on-call duties for registrars, affecting safety.

Keywords:
acute care surgeryacute general surgeryacute surgical unitemergency general surgery

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Area of Science:

  • Surgery
  • Surgical Training
  • Healthcare Management

Background:

  • Limited research exists on emergency general surgery models and their impact on staff satisfaction, operative experience, and working hours.
  • The Royal Australasian College of Surgeons suggests a maximum on-call frequency of one-in-four for surgeons and registrars.

Purpose of the Study:

  • To assess the relationship between different emergency general surgery models and staff satisfaction, operative experience, and working hours.
  • To compare traditional emergency general surgery models with hybrid or acute surgical unit models.

Main Methods:

  • A cross-sectional study was conducted in Australian public hospitals offering elective general surgery.
  • On-call general surgery registrars and senior surgeons participated.
  • Primary outcomes included staff satisfaction and registrar-perceived operative exposure; secondary outcomes were working hours.

Main Results:

  • Hybrid or acute surgical unit models were linked to higher surgeon and registrar satisfaction compared to traditional models.
  • Registrar-perceived operative exposure remained consistent across models.
  • Traditional models were associated with longer on-duty hours and more frequent on-call duties for registrars, exceeding recommended limits.

Conclusions:

  • Hybrid or acute surgical unit models may improve staff satisfaction without compromising perceived operative exposure.
  • Unsafe working hours for registrars were more prevalent in traditional emergency general surgery structures.
  • Reviewing on-call rostering in general surgery departments is recommended to enhance staff and patient safety.