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Nov 24, 2007 · Between those trusts that have implemented the Hospital at Night (H@N) concept and are now introducing it around the clock, and those that are struggling to break away from the traditional model for providing nocturnal care.
- John Bonner
- 2007
Night Doctors (also known as Night Riders, Night Witches, Ku Klux Doctors and Student Doctors) are bogeymen of African American folklore, resulting from some factual basis.
Nov 1, 2006 · Working through an entire night is now a standard part of most junior doctors' rosters. The competing needs of service provision and limited hours has resulted in the widespread introduction of night shift systems; a junior doctor will cover several hospital wards, as well as manage acute admissions, between the hours of 10 pm and 8 am. 1.
- Geoffrey Robinson, Sharmila Bernau, Sarah Aldington, Richard Beasley
- 2006
H@N is a multiprofessional, multispecialty approach to delivering care at night and out of hours, with the aim of improving patient safety. It involves members of medical and nursing staff coming together to form a team that manages patients across many disciplines in a hospital.
- Aaisha Saqib, Kevin Cairney, Karen Mcintyre, Emma Coutts, Tamara Stephens, Lesley Roberts, Sandip Ba...
- 2021
- Context
- Outline of Problem
- Key Measures of Improvement
- Process of Gathering Information
- Strategy For Change
- Effects of Change on Patients
- Effects of Change on Education
- Effects of Change on Finances
- Lessons Learned
- Message For Others
Guy’s and St Thomas’ NHS Foundation Trust is a large secondary and tertiary teaching hospital with an annual budget of £1 billion. It serves a deprived local population of 1.3 million, providing regional and national referral services in most major specialties and subspecialties. For example, this hospital is the specialist cancer centre for South ...
In 2003 there were a total of 144 on-call rotas. These medical teams – consisting of two levels of doctors on-call at any one time, with a consultant on-call from home – were on-call only for their own patients. The work intensity experienced by these teams varied according to specialty. Emergency and admitting, General Internal Medicine, Obstetric...
The vision was to reorganize care so that all patients had access to the right person with the right skills for their needs at the right time. Patient care and patient safety were the prime goals, along with the achievement of the EWTR. Identified outcome measures included a reduction in serious adverse incidents, a reduction in the number of cases...
Colleagues in Human Resources collected information about all medical rotas. A financial costing was done of maintaining on-call rotas. In addition, an analysis of on-call work from 5 p.m. to 8 a.m. was undertaken. Meetings to understand patients requirements out of hours were held with all staff, including porters, transport, medical records, and ...
A review of all data showed that better care could be provided on-call by fewer people with the introduction of three multi-professional teams across the hospital sites, with a fourth for the Evelina Children’s Hospital. In addition, only minimal changes were made to the emergency admission teams. The strategy was operationalized as follows: 1. Eac...
The analysis of benefits of the night teams – which had been first introduced in 2004 – took place in 2009. Overall, analysis showed that patients are seen in a timely fashion and that more than 95% of the time routine tasks are completed before the night shift starts. More importantly, we found only one serious adverse incident in 2007; this was m...
On the night team, most junior doctors work alongside, and are supported and supervised by, SNPs who are trained to do procedural assessments. Under this system, the junior doctors’ education continues overnight. More senior medical staff are always available for complex cases, and junior staff are never asked to perform beyond their competence. Re...
The estimated cost to maintain the original 144 on-call rotas in 2003 was £7 million. As described, it cost £2.4 million to introduce the changes. The number of rotas was reduced to 102, of which only 25 are physically present on-site. The remainder go home at 9 p.m. Only 15 remain on-duty from home, responding by phone more than 80% of the time; h...
This major cultural change took time both to start and to embed. The main hurdle was for specialists to fully trust that the overnight urgent care needs of their patients were mostly generic and that they very rarely required specialist intervention. The impact on the hospital has been more far-reaching than we had imagined. What began as H@N has e...
It is key to have a senior clinical champion who believes that this change will improve patient care. It is also important to do the following: collect initial data; engage in detailed discussions and ensure that there is sufficient time to engage with all groups of staff; train those individuals whose roles are changing; and focus on the quality a...
Jul 7, 2016 · Traditionally, residents and nurses manage patients overnight while more experienced physicians remain on-call from home. If the night staff need guidance, attending physicians—who had already worked a full day's shift—are called at home. The changing physician workforce.
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Sep 18, 2024 · Surviving a night shift. Location: UK. Audience: Resident doctors Medical students. Updated: Wednesday 18 September 2024. Topics: Your wellbeing. By Lydia Akinola. I feel like a bit of a fraud writing this as I still have trouble with night shifts as a resident doctor.
