More doctors need to work on weekends

It was a rough summer at NU Healthcare, which is part of the Västra Götaland district and consists of Norra Älvsborg County Hospital, NÄL, in Trollhättan and Uddevalla Hospital.

In May, NU Healthcare went into staff mode because healthcare was under so much pressure. The flow to the emergency department was described as high, causing problems with overcrowding and long waiting times. Hospital Director Björn Yarbor also stated that the number of care places available was less than required due to difficulties in recruiting staff for inpatient care.

On June 10, NU Healthcare switched to employee mode again and returned to normal on July 1.

The latter part of summer was also a problem. newly Johan Klar, Senior Medical Safety Representative at NU Healthcare, asked the Swedish Work Environment Agency to intervene Because of the difficult working environment of the doctors in the emergency department of NÄL in Trollhättan. In the report, he describes the unsustainable situation in which many critically ill patients remain in the emergency room for an extended period – sometimes several days – waiting for an available place of care.

According to Bjorn Yarbor, the primary problem is the shortage of nurses, which is a national problem in regions of the country. He told Läkartidningen he sees little chance of hiring more staff next summer.

Instead, new ways of working are needed so that next summer passes, he says — and fast. Already in the spring of this year, planning for the summer of 2023 should be nailed down.

We can’t believe we’ll have more employees in the future, but we have to get our wise heads together to see how we can work smarter. It’s the only way to meet the challenges that lie ahead, says Björn Yarbour.

On the other hand, NU Healthcare stands out compared to other hospitals in the Västra Götaland region, according to the hospital director: treatment times are longer. They differ mainly with respect to discharge-ready patients, with patients staying on NU significantly longer.

– We’ve been put on the right track in the form of our flows, and we’re not really satisfied with that, says the hospital director and continues:

We have very big differences in terms of the number of patients who are discharged from hospital on different days. Overcrowding is always the worst Sunday/Monday.

He called on all managers in clinical operations, including medical directors and medical staff, to find a solution. The main path is to increase the medical staff on the weekends at NÄL.

We are an emergency hospital and about 70 percent of our patients are emergency patients. But many doctors already go home at lunchtime on Friday because they work more Monday through Thursday. Then that leads to not many investigations and not many drainages in that time, says Björn Yarbor, who is basically a doctor.

During the staff case at the beginning of the summer, assistant physicians were brought on weekends to the surgical and medical departments of NÄL, among others. The effects have not been properly evaluated, but according to Björn Järbur it appears to have positive effects.

Want to break away from the day’s regime by being ready and being ready on demand?

– It’s too early to say. After all, we have an on-demand agreement and a set of regulations around that make it possible to work on a schedule if you prefer. There are some doctors in the emergency department doing this today, he says and continues:

– You can think of different types of groups. We must find a sustainable, long-term model for our patients and employees. It can’t be going to another summer the way we’re working now.

Johan Clare, chief protection representative for physicians at Northwestern University healthcare and president of the local medical association, has nothing against the issue under discussion. But it also indicates that it is complicated.

He said that many pieces are needed for it to work well. Municipalities need to be able to receive patients who are willing to go out even on weekends and that doctors need to have access to things like radiology, lab tests and clinical physiology, eg heart ultrasound, so they can do an effective working round check on Saturday or Sunday.

He wants to see an assessment of how it’s doing over the summer, and calls for a proper examination of the issue and broad grounding work.

– What is the total cost and what is the benefit of it? How much other resources do we need to make sense? And how much doctor time do we waste on, say, weekday receptions and surgery when doctors who worked on weekends need full time?

Lakartidningen.se 2022-08-29