Maximizing time from the constraining European Working Time Directive (EWTD): The Heidelberg New Working Time Model

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• 作者：Simon Schimmack ; Ulf Hinz ; Andreas Wagner ; Thomas Schmidt…
• 关键词：Working time model ; European working time directive ; EWTD ; Workload analysis ; Surgical training ; Heidelberg
• 刊名：Health Economics Review
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：4
• 期：1
• 全文大小：1,461 KB
• 参考文献：1. New York Times: September 6th, 2010.
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• 刊物主题：Public Health; Economic Policy; Public Finance & Economics; Health Informatics; Statistics for Life Sciences, Medicine, Health Sciences; Statistics for Business/Economics/Mathematical Finance/Insurance;
• 出版者：Springer Berlin Heidelberg
• ISSN：2191-1991

文摘

Background The introduction of the European Working Time Directive (EWTD) has greatly reduced training hours of surgical residents, which translates into 30% less surgical and clinical experience. Such a dramatic drop in attendance has serious implications such compromised quality of medical care. As the surgical department of the University of Heidelberg, our goal was to establish a model that was compliant with the EWTD while avoiding reduction in quality of patient care and surgical training. Methods We first performed workload analyses and performance statistics for all working areas of our department (operation theater, emergency room, specialized consultations, surgical wards and on-call duties) using personal interviews, time cards, medical documentation software as well as data of the financial- and personnel-controlling sector of our administration. Using that information, we specifically designed an EWTD-compatible work model and implemented it. Results Surgical wards and operating rooms (ORs) were not compliant with the EWTD. Between 5?pm and 8?pm, three ORs were still operating two-thirds of the time. By creating an extended work shift (7:30?am-7:30?pm), we effectively reduced the workload to less than 49% from 4?pm and 8?am, allowing the combination of an eight-hour working day with a 16-hour on call duty; thus, maximizing surgical resident training and ensuring patient continuity of care while maintaining EDTW guidelines. Conclusion A precise workload analysis is the key to success. The Heidelberg New Working Time Model provides a legal model, which, by avoiding rotating work shifts, assures quality of patient care and surgical training.