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

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dc.contributor.authorKinnear, N.
dc.contributor.authorTran, M.
dc.contributor.authorHan, J.
dc.contributor.authorJolly, S.
dc.contributor.authorHerath, M.
dc.contributor.authorHennessey, D.
dc.contributor.authorDobbins, C.
dc.contributor.authorSammour, T.
dc.contributor.authorMoore, J.
dc.date.issued2020
dc.descriptionFirst published online 19 December 2019
dc.description.abstractBACKGROUND: Few studies have assessed the relationship between different emergency general surgery models and staff satisfaction, operative experience or working hours. The Royal Australasian College of Surgeons recommends maximum on-call frequency of one-in-four for surgeons and registrars. METHODS: A cross-sectional study was conducted of all medium- to major-sized Australian public hospitals offering elective general surgery. At each site, an on-call general surgery registrar and senior surgeon were invited to participate. Primary outcomes were staff satisfaction and registrar-perceived operative exposure. Secondary outcomes were working hours. RESULTS: Among eligible hospitals, 119/120 (99%) were enrolled. Compared with traditional emergency general surgery models, hybrid or acute surgical unit models were associated with greater surgeon and registrar satisfaction on quantitative (P = 0.012) and qualitative measures. Registrar-perceived operating exposure was unaffected by emergency general surgery model. Longest duration on-duty was higher among traditional structures for both registrars (mean 22 versus 15 h; P = 0.0003) and surgeons (mean 59 versus 41 h; P = 0.020). On-call frequency greater than one-in-four was more common in traditional structures for registrars (51% versus 28%; P = 0.012) but not surgeons (6% versus 0%; P = 0.089). Data on average hours per day off-duty were obtained for registrars only, and were lower in traditional structures (13 versus 15 h; P = 0.00002). CONCLUSION: Hybrid or acute surgical unit models may improve staff satisfaction without sacrificing perceived operative exposure. While average maximum duration on-duty exceeded hazardous thresholds for surgeons regardless of model, unsafe working hours for registrars were more common in traditional structures. General surgical departments should review on-call rostering to optimize staff and patient safety.
dc.description.statementofresponsibilityNed Kinnear, Minh Tran, Jennie Han, Samantha Jolly, Matheesha Herath, Derek Hennessey, Christopher Dobbins, Tarik Sammour and James Moore
dc.identifier.citationANZ Journal of Surgery, 2020; 90(3):262-267
dc.identifier.doi10.1111/ans.15628
dc.identifier.issn1445-2197
dc.identifier.issn1445-2197
dc.identifier.orcidKinnear, N. [0000-0002-7833-2537]
dc.identifier.orcidJolly, S. [0000-0002-7674-508X]
dc.identifier.orcidHerath, M. [0000-0003-2756-5864]
dc.identifier.orcidSammour, T. [0000-0002-4918-8871]
dc.identifier.urihttp://hdl.handle.net/2440/123099
dc.language.isoen
dc.publisherWiley
dc.relation.grantNHMRC
dc.rights© 2019 Royal Australasian College of Surgeons
dc.source.urihttps://doi.org/10.1111/ans.15628
dc.subjectCross-Sectional Studies *Emergency Service, Hospital *Emergency Treatment General Surgery/*education Humans *Job Satisfaction *Models, Theoretical Time Factors Workload/*statistics & numerical data *acute care surgery *acute general surgery *acute surgical unit *emergency general surgery
dc.titleDoes emergency general surgery model affect staff satisfaction, training and working hours?
dc.typeJournal article
pubs.publication-statusPublished

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