Consultant resident on-call system Salisbury顾问驻留在呼叫系统梳.pptVIP

Consultant resident on-call system: Salisbury Salisbury DH Rural Relatively isolated – nearest unit 25 miles Full obstetric and AE service Regional burns and plastics Child pop. C 40 000 2500 deliveries p.a. 18 bedded children’s ward Level 2b NICU Paediatric dept. 10 consultants (8 on 11 PAs, 2 on 8 PAs) 4 middle grades 5 junior grades 4 GP trainees, 1 FY2 Night on-call shared with 5 OG SHOs Resident consultant system All 10 do resident on call: part-timers pro rata Out-of-hours time divided between 4 MGs and 10 cons Cons also do on call from home covering either MG or cons colleague 13 hour shifts same as juniors Resident on call workload Resident shifts about 1 night per 2 weeks and 1 weekend (3 shifts, days or nights) every 10 weeks Always on with SHO Day off afterwards Contract: Daytime work: 6.5 PAs (including 2.5 SPAs) Resident shifts 3.5 Pas Other emergency work 1 PA Typical night shift 2100 – 2130: handover 2130- 2230: reviewing ward attenders and in-patients 2230- 0000: admin with interruptions 0000-0030: review patients 0030-0200: admin with interruptions 0200-0700: rest, with interruptions: Calls to ward, NICU, ED, Burns, labour ward 0700-0930: reviews and handover Accommodation Consultant flat, superior to juniors accommodation About 100m from labour ward Bedroom, bathroom, kitchen, lounge with TV and network computer Accommodation Bedroom Kitchen Lounge Back up consultant Resident cons always has back-up colleague on call from home for: 2 skilled people needed at once Transfers Advice Advantages for service Better out-of-hours care Fewer unnecessary admissions Better continuity Better supervision of juniors nurses Advantages for individual Financial More day time off during week More ‘hands-on’ work Disadvantages for service Fewer consultants around during the day Less time for supporting activities Cost Disadvantages for individual Tiredness Less continuity for own patients Less time for career development * * *