Objective: In this paper, we aim to evaluate the use of electronic technologies in Out of Hours (OoH) task-management for assisting the design of effective support systems in health care; targeting local facilities, wards or specific working groups. In addition, we seek to draw and validate conclusions with relevance to a frequently revised service, subject to increasing pressures.Methods and Material : We have analysed 4 years of digitised demand-data extracted from a recently deployed electronic task-management system, within the Hospital at Night setting in two jointly coordinated hospitals in the United Kingdom. The methodology employed relies on Bayesian inference methods and parameter-driven state-space models for multivariate series of count data.Results: Main results support claims relating to (i) the importance of datadriven staffing alternatives and (ii) demand forecasts serving as a basis to intelligent scheduling within working groups. We have displayed a split in workload patterns across groups of medical and surgical specialities, and sustained assertions regarding staff behaviour and work-need changes according to shifts or days of the week. Also, we have provided evidence regarding the relevance of day-to-day planning and prioritisation.Conclusions: The work exhibits potential contributions of electronic tasking alternatives for the purpose of data-driven support systems design; for scheduling, prioritisation and management of care delivery.
Response to reviewersGeneral Comments: We are grateful to all reviewers for taking the time to review our paper and make a number of helpful comments that we believe have significantly improved the quality of the manuscript. All comments have been, according to their nature, merged, described and addressed here:
5Comment 1: The major concern shared by reviewers relates to a lack practical relevance of the results presented; for instance, managerial conclusions are not well exploited, the paper lacks a managerial perspective of the output from professionals involved in the study, or results do not extrapolate to different settings neither is it clear why they support the decision making.
10Response to Comment 1: The authors agree that the previous version of the manuscript offered a mostly descriptive study of the data and lacked relevant interpretations and conclusions drawn from results. In addition, we believe we were not successful in clearly conveying the aims and scope of our work; yet, we have made the efforts to undertake the alterations necessary in order to correct 15 these problems.Nationwide hospital settings are indeed subject to disparate workload pressures; these may drastically vary within distant geographical regions and in relation to specialities covered by each facility. The focus of our research team and this work relates to support systems for effective management that can 20 target local facilities and working groups. This is indeed a great problem, in that policy alterations and intelligent design of support systems (for instan...