The provision of seven day multidisciplinary staffing in Scottish acute medical units: a cross-sectional study

• Published in: QJM : An International Journal of Medicine Vol. 111; no. 5; pp. 295 - 301
• Main Authors: Reid, L E M, Lone, N I, Morrison, Z J, Weir, C J, Jones, M C
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.05.2018
• Subjects: Acute Disease; After-Hours Care - organization & administration; Cross-Sectional Studies; Health Services Research - methods; Hospital Units - organization & administration; Hospitalization; Humans; Nursing Staff, Hospital - organization & administration; Patient Care Team - organization & administration; Personnel Administration, Hospital; Personnel Staffing and Scheduling - organization & administration; Pharmacy Service, Hospital - organization & administration; Scotland; Workforce
• ISSN: 1460-2725; 1460-2393
• DOI: 10.1093/qjmed/hcy024

Abstract Background Acute medical units (AMUs) are a central component of the admission pathway for the majority of medical patients presenting to hospital in the United Kingdom and other international settings. Detail on multidisciplinary staffing provision on weekdays and weekends is lacking. Equity of staffing across 7 days is a strategic priority for national health services in the United Kingdom. Aim To evaluate weekday compared with weekend multidisciplinary staffing in a national set of AMUs. Design Cross-sectional survey. Methods Twenty-nine Scottish AMUs were identified and all were included in the study population. Data were collected by semi-structured interviews with nursing, pharmacy, therapy, non-consultant medical and consultant staff. Staffing was quantified in staff hours. A correction factor of 0.5 was applied to non-dedicated staff. The percentage of weekend/weekday staffing was calculated for each unit and the mean of these percentages was calculated to give a summary measure for each professional group. Results As a percentage of weekday staffing levels, weekend staffing across the units was 93.8% for nursing staff; 2.2% for pharmacy staff; 13.1% for therapy staff; 69.6% for non-consultant staff and 65.0% for consultant staff. Conclusions There is a contrast between weekday and weekend staffing on the AMU, with reductions at weekends in total staff hours, the proportion of dedicated vs. undedicated staff and the seniority of nursing staff. The weekday/weekend difference was far more pronounced for allied healthcare professional staff than any other group. These findings have potential implications for patient outcomes, quality of care, hospital flow and workforce planning.