Self-Rostering for Emergency Career Medical Officers (CMOs) and Registrars Within a Small Metropolitan Emergency...

To review a newly implemented medical staff self-rostering process in a small metropolitan emergency department to ensure sustainability without compromising emergency department safe staffing guidelines.

We performed a multi-methods study on the implementation and user experience of a novel rostering process for registrars and CMOs in a small emergency department. Quantitative analysis was performed using a Likert scale to assess operational and implementation success as well as data on hours spent on roster generation, number of sick calls and number of shift swaps. Qualitative structured interviews were also analysed using an inductive process resulting in a thematic analysis.

Our implementation outcome scoring showed a median score of 5 for all three domains of the implementation questionnaire including acceptability (IQR 4-5), appropriateness (IQR 4-5) and feasibility (IQR 4-5). Our thematic analysis demonstrated strong themes around flexibility and choice, usability and interface, responsibility for a complete roster, as well as wellbeing and balance. Our analysis of roster metrics showed a large reduction in required shift swaps (29 vs. 163) and time spent on roster development and publication (4 h vs. 20 h) over a 13-week rostering period. While consultant time spent on roster development and publication was reduced, this was accompanied by a redistribution of workload to participating staff, who spent a median of 1.4 h per rostering cycle.

We conclude that in a small metropolitan hospital, self-rostering is a feasible and implementable operational intervention with improvements in employee wellbeing.