Mitarbeiterzufriedenheit im Arbeitszeitmodell: Längsschnittstudie zu Praxistauglichkeit und Gesetzeskonformität in einer chirurgischen Klinik der Maximalversorgung

Abstract

Between the conflicting requirements of clinic organisation, the European Working Time Directive, patient safety, an increasing lack of junior staff, and competitiveness, the development of ideal duty hour models is vital to ensure maximum quality of care within the legal requirements. To achieve this, it is useful to evaluate the actual effects of duty hour models on staff satisfaction. After the traditional 24-hour duty shift was given up in a surgical maximum care centre in 2007, an 18-hour duty shift was implemented, followed by a 12-hour shift in 2008, to improve handovers and reduce loss of information. The effects on work organisation, quality of life and salary were analysed in an anonymous survey in 2008. The staff survey was repeated in 2014. With a response rate of 95% of questionnaires in 2008 and a 93% response rate in 2014, the 12-hour duty model received negative ratings due to its high duty frequency and subsequent social strain. Also the physical strain and chronic tiredness were rated as most severe in the 12-hour rota. The 18-hour duty shift was the model of choice amongst staff. The 24-hour duty model was rated as the best compromise between the requirements of work organisation and staff satisfaction, and therefore this duty model was adapted accordingly in 2015. The essential basis of a surgical department is a duty hour model suited to the requirements of work organisation, the Working Time Directive and the needs of the surgical staff. A 12-hour duty model can be ideal for work organisation, but only if augmented with an adequate number of staff members, the implementation of this model is possible without the frequency of 12-hour shifts being too high associated with strain on surgical staff and a perceived deterioration of quality of life. A staff survey should be performed on a regular basis to assess the actual effects of duty hour models and enable further optimisation. The much criticised 24-hour duty model seems to be much better than its reputation, if augmented by additional staff members in the evening hours.

Überlegungen und Berechnungen zur Effizienz des Einsatzes von Ärzten für delegierbare, nichtärztliche Tätigkeiten – ein Denkanstoß in Zeiten des Nachwuchsmangels

“…Die Berechnung des Einsparpotenzials verdeutlicht, dass eine sinnvolle Delegation für den Krankenhausträger nicht nur wirtschaftlich unmittelbar von Vorteil ist, sondern auch, dass mit einer Steigerung der Mitarbeiterzufriedenheit eine gesteigerte Attraktivität der Klinikinstitution im Wettbewerb um neue Mitarbeiter verbunden sein kann. Zwar gehören neben vielen individuellen Ansprüchen auch Aspekte zur Vereinbarkeit mit einem aktiven Familienleben, Arbeitszeitbedingungen, bis hin zu wissenschaftlichen Rahmenbedingungen zu den bei chirurgischen Assistenzärztinnen und -ärzten am häufigsten genannten Zufriedenheitsfaktoren 13 , 14 , 15 , aber auch die Möglichkeit zur Delegation sog. nichtärztlicher Tätigkeiten ist gemäß aktuellen Umfragen ein wesentlicher Aspekt 5 .…”