The provision of seven day multidisciplinary staffing in Scottish acute medical units

A cross-sectional study

L. E.M. Reid*, N. I. Lone, Z. J. Morrison, C. J. Weir, M. C. Jones

*Corresponding author for this work

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)295-301
Number of pages7
JournalQJM
Volume111
Issue number5
Early online date2 Feb 2018
DOIs
Publication statusPublished - 31 May 2018

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Nursing Staff
Consultants
Cross-Sectional Studies
Quality of Health Care
Medical Staff
National Health Programs
Nursing
Interviews
Delivery of Health Care
Therapeutics
Population
United Kingdom

Keywords

  • consultants
  • personnel staffing and scheduling
  • weekend

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Reid, L. E. M., Lone, N. I., Morrison, Z. J., Weir, C. J., & Jones, M. C. (2018). The provision of seven day multidisciplinary staffing in Scottish acute medical units: A cross-sectional study. QJM, 111(5), 295-301. https://doi.org/10.1093/qjmed/hcy024

The provision of seven day multidisciplinary staffing in Scottish acute medical units : A cross-sectional study. / Reid, L. E.M.; Lone, N. I.; Morrison, Z. J.; Weir, C. J.; Jones, M. C.

In: QJM, Vol. 111, No. 5, 31.05.2018, p. 295-301.

Research output: Contribution to journalArticle

Reid, L. E.M. ; Lone, N. I. ; Morrison, Z. J. ; Weir, C. J. ; Jones, M. C. / The provision of seven day multidisciplinary staffing in Scottish acute medical units : A cross-sectional study. In: QJM. 2018 ; Vol. 111, No. 5. pp. 295-301.
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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.",
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note = "This study is an output from a programme of research commissioned by a jointly funded collaboration between the Royal College of Physicians of Edinburgh and the Scottish Government to review acute medical care in Scotland. The Royal College of Physicians of Edinburgh and the Scottish Government contributed to the study design and data collection. The Royal College of Physicians of Edinburgh contributed to the data analysis, interpretation and contextualization. C.J.W. was supported in this work by NHS Lothian via the Edinburgh Clinical Trials Unit.",
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