Kinnear, N.Tran, M.Han, J.Jolly, S.Herath, M.Hennessey, D.Dobbins, C.Sammour, T.Moore, J.2020-02-022020-02-022020ANZ Journal of Surgery, 2020; 90(3):262-2671445-21971445-2197http://hdl.handle.net/2440/123099First published online 19 December 2019BACKGROUND: 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.en© 2019 Royal Australasian College of SurgeonsCross-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 surgeryJournal article100001154910.1111/ans.156280005037257000012-s2.0-85076794063513762Kinnear, N. [0000-0002-7833-2537]Jolly, S. [0000-0002-7674-508X]Herath, M. [0000-0003-2756-5864]Sammour, T. [0000-0002-4918-8871]