Maximizing time from the constraining European Working Time Directive (EWTD): the Heidelberg New Working Time Model
Background: The introduction of the European Working Time Directive (EWTD) has greatly reduced training hours of surgical residents, which translates into 30% less surgical and clinical experience. Such a dramatic drop in attendance has serious implications such compromised quality of medical care....
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| Other Authors: | , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2014
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| In: |
Health economics review
Year: 2014, Volume: 4, Pages: 1-10 |
| ISSN: | 2191-1991 |
| DOI: | 10.1186/s13561-014-0014-6 |
| Subjects: | |
| Online Access: | Resolving-System, Volltext: http://dx.doi.org/10.1186/s13561-014-0014-6 Verlag, Volltext: http://link.springer.com/content/pdf/10.1186/s13561-014-0014-6.pdf 
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| Author Notes: | Simon Schimmack, Ulf Hinz, Andreas Wagner, Thomas Schmidt, Hendrik Strothmann, Markus W. Büchler and Hubertus Schmitz-Winnenthal |
| Summary: | Background: The introduction of the European Working Time Directive (EWTD) has greatly reduced training hours of surgical residents, which translates into 30% less surgical and clinical experience. Such a dramatic drop in attendance has serious implications such compromised quality of medical care. As the surgical department of the University of Heidelberg, our goal was to establish a model that was compliant with the EWTD while avoiding reduction in quality of patient care and surgical training. Methods: We first performed workload analyses and performance statistics for all working areas of our department (operation theater, emergency room, specialized consultations, surgical wards and on-call duties) using personal interviews, time cards, medical documentation software as well as data of the financial- and personnel-controlling sector of our administration. Using that information, we specifically designed an EWTD-compatible work model and implemented it. Results: Surgical wards and operating rooms (ORs) were not compliant with the EWTD. Between 5 pm and 8 pm, three ORs were still operating two-thirds of the time. By creating an extended work shift (7:30 am-7:30 pm), we effectively reduced the workload to less than 49% from 4 pm and 8 am, allowing the combination of an eight-hour working day with a 16-hour on call duty; thus, maximizing surgical resident training and ensuring patient continuity of care while maintaining EDTW guidelines. Conclusion: A precise workload analysis is the key to success. The Heidelberg New Working Time Model provides a legal model, which, by avoiding rotating work shifts, assures quality of patient care and surgical training. |
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| Physical Description: | Online Resource |
| ISSN: | 2191-1991 |
| DOI: | 10.1186/s13561-014-0014-6 |