Acute hospital medical staffing during the night shift

Abstract

There has been little or no attempt to define the need for 24-hour medical cover, norits appropriateness in acute hospitals, despite the great cost implications and thequestion of the quality of that care. This study examined the medical activity duringthe ?night shift? in an acute hospital. There were an average of 2.59 calls per night,most from the emergency department (247/475) and general wards (108/475). Manycalls were related to active resuscitation (88/475) and immediate treatment (83/475).Over 40% (81/286) of patients had to be transferred to a higher level of care, suchas an intensive care unit within the hospital. By collecting data on the demands ofhealth care during what amounts to over a third of the hospital?s time, it wasestablished that a high level of medical care was required. Appropriate levels ofstaffing, using junior doctors trained in acute medicine, was able to be provided tomatch need as determined by these data, and extra staff at higher costs were avoided.