Evaluation of the administrative chief duty system in a tertiary reproductive hospital through personnel analysis

The administrative chief duty system is a cornerstone of hospital governance to ensure continuity, coordination, and responsiveness during off-hours. This study evaluated the implementation and performance of the system in a tertiary reproductive hospital in Guangxi Zhuang Autonomous Region, China, drawing on personnel data, duty records, and staff interviews. Fifty-two duty personnel were profiled, and 145 duty records (October 2021-December 2024) were categorized into medical (21.38%), administrative (22.76%), and logistical events (55.86%). Semi-structured interviews highlighted challenges-personnel imbalance, inefficient interdepartmental communication, and reliance on manual records. The system effectively supported logistical operations and administrative coordination, and its impact on patient safety was constrained by structural and communication gaps. Personnel were educated (99.08% with bachelor's or higher) but showed professional imbalance, with 19.23% from clinical or nursing backgrounds. Targeted reforms-including digital record integration, cross-disciplinary training, and AI-assisted triage-are recommended to improve responsiveness, strengthen crisis management, and enhance patient safety. These findings provide a framework for optimizing hospital duty systems and offer transferable lessons for broader healthcare management.