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Safe Hours in Hospitals
11 October 2010.
Safe working hours for doctors depend on safe rostering. Having an adequate number of doctors rostered on to a shift will ensure that the work is evenly distributed. Safe rostering reduces the need for doctors to work large amounts of overtime and allows for adequate rest time.
AMA Victoria recommends the Government to commit to reforming practices around:
- unsafe hours,
- unrostered overtime not being recognised and paid, and
- legal documents such as time sheets being altered without authorisation.
The hours and patterns of work for 62 per cent of public hospital doctors fall into the category of ‘significant risk’ and ‘high risk’1. Safe working hours gives the community comfort in knowing that doctors can provide high quality healthcare, effective patient throughput and a productive environment for ongoing medical training.
Unsafe working hours lead to doctor fatigue and exhaustion, which can have negative consequences on doctors’ health, social life and family responsibilities, affect doctors’ capacity to consistently deliver high quality patient care and lessen doctors’ ability to learn and retain.
Clinicians in Victoria’s public hospitals believe safety and quality of care is paramount. Unsafe working hours are one variable that affects the delivery of safe, quality care in our public hospitals. More than half (54%) of respondents to the 2007 AMA Junior Doctor Health and Wellbeing survey reported that their workload had been excessive and 53% believed that an adverse event could occur because of their high workload. Forty-one per cent believed that their workload compromised patient safety.
Junior doctors frequently report variations between what is counted as "rostered hours" compared with required working hours. It has been reported to AMA Victoria that hospital time sheets are frequently changed retrospectively with overtime crossed off by hospital administrators without notifying the doctor. This practice both disadvantages junior doctors and masks the true resourcing needs of hospitals.
The airline industry – a comparable industry in terms of complexity and the critical nature of performance – has a cross-system approach to rostering depending on technology and the input of applied mathematicians, computer scientists, human resource and occupational health and safety consultants. The health system does not even appear to aspire to the same standard.
Clinicians in Victorian public hospitals believe that safety and quality of care is paramount. Commitments should be made by the Government to ensure our doctors are not working at levels that compromise patient care.
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